Inverse dynamics analysis evaluation of tibial tuberosity advancement for cranial cruciate ligament failure in dogs

Compensatory Changes in Ground Reaction Forces in Small and Large Breed Dogs with Unilateral Hindlimb Lameness in Comparison to Healthy Dogs

OBJECTIVE

 The aim of this study was to investigate whether small- to medium-sized dogs with a naturally occurring unilateral hindlimb lameness show the same compensatory changes in ground reaction forces as large-breed dogs and how the changes are displayed compared with healthy small- to medium-sized dogs.

STUDY DESIGN

 Small- to medium-sized dogs (n = 15) and large-breed dogs (n = 16) with unilateral rupture of the cranial cruciate ligament were examined. The kinetic parameters peak vertical force and vertical impulse of the two groups were compared with each other and compared with healthy Beagles (n = 15) and with healthy Labrador Retrievers (n = 17), respectively.

RESULTS

 The healthy Beagle group showed a significantly higher weight loading on the forelimbs compared with the healthy Labrador group. The affected groups in comparison with the corresponding healthy groups showed a higher load on the non-affected body half and a significant lower weight bearing on the affected limb. Comparing the two affected groups, no significant difference could be found.

CONCLUSION

 Despite a substantially different initial situation regarding weight distribution of the examined small- to medium-sized dogs and large dogs, a unilateral hindlimb lameness leads to the same compensatory changes (cranial and lateral shift of the body mass centre).

Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs

Background

Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively.

Results

The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected.

Conclusions

Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.

Effect of Limb Position at the Time of Skin Marker Application on Sagittal Plane Kinematics of the Dog

Objectives To evaluate the effect of limb position during initial skin marker application on sagittal plane kinematics of the hindlimb.

Methods Six healthy dogs (20–30 kg) were evaluated. An established two-dimensional kinematic model of the pelvic limb was utilized to describe sagittal plane motion. Kinematic markers were applied separately for each dog while standing in three different positions: (1) the limb extended cranially, (2) a normal standing limb position and (3) the limb extended caudally. Following marker application at each of the three positions, dynamic gait was recorded at a walk (velocity, 0.9–1.2 m/s; acceleration, 0.5m/s ² ). Five valid trials were used for comparison. Complete waveform analysis was performed with generalized indicator function analysis (GIFA). Maximum and minimum joint angles and joint range of motion were compared with a one-way repeated measures ANOVA with significance at p < 0.05.

Results Significant differences were found between stifle waveforms. No differences were found between the hip or tarsus waveforms. Minimum and maximum joint angles were significantly different for the hip and stifle but not for the tarsus. No differences were found between ranges of motion for any joint evaluated.

Clinical Significance Limb position at the time of skin marker application affects gait data and is an important consideration for kinematic analysis of the hindlimb in dogs.

Systematic review of surgical treatments for cranial cruciate ligament disease in dogs

Surgery for cranial cruciate ligament disease is often recommended; however, it is unclear if one procedure is superior. The aim of this systematic review was to answer the a priori question, "Is there a surgical procedure that will allow a consistent return to normal clinical function in dogs with cranial cruciate ligament disease and is that procedure superior to others?" A systematic literature search was performed through September 2013. Peer reviewed publication in the English language and 6 mo of postoperative follow-up were required. In total, 444 manuscripts were identified and reviewed, and 34 met the inclusion criteria. Two studies provided level 1, 6 provided level 2, 6 provided level 3, and 20 provided level 4 evidence relative to the study question. The most common surgical procedures included tibial plateau leveling osteotomy (TPLO, n = 14), lateral extracapsular suture (n = 13), tibial tuberosity advancement (n = 6). The strength of the evaluated evidence most strongly supports the ability of the TPLO in the ability to return dogs to normal function. It also provided strong support that functional recovery in the intermediate postoperative time period was superior following TPLO compared with lateral extracapsular suture. There was insufficient data to adequately evaluate other surgical procedures.