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von Pfeil DJF, Schulz K, Chou PY, Kapatkin AS, Kim SY, Ash K, Zheng J, Hayashi K. Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening. Vet Surg 2024; 53:535-545. [PMID: 38396343 DOI: 10.1111/vsu.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE To describe the short-term outcome of acute arthroscopically assisted ulnar shortening (AUS), to treat short radius syndrome in dogs. STUDY DESIGN Case series. ANIMALS Eleven client owned dogs. METHODS Records of dogs that had undergone AUS for treatment of short radius syndrome were reviewed for inclusion. Reporting data included among others pre- and postoperative radioulnar, humeroradial and humeroulnar distances, lameness scores, surgical times, complications and clinical outcome. RESULTS Following AUS, radiohumeral articulation was improved in all dogs. Median presurgery radioulnar, humeroradial and humeroulnar values were 4.5, 3.2, and 2.2 mm and were improved with surgery by a median of 3.2, 1.8, and 1.2 mm, respectively. Median surgery time was 140 min. Median time to bone healing was 8 weeks (range: 4-14). Median time to last follow-up was 9 weeks (4-468). Median lameness score (scale 0-4) improved from 2 to 1. No major complications were reported. Short-term clinical outcome was graded by the surgeons as full function in four cases and acceptable function in seven. CONCLUSION AND CLINICAL RELEVANCE Radiographic and arthroscopic radiohumeral articulation were improved and short-term clinical improvement was documented following AUS in all 11 dogs.
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Affiliation(s)
- Dirsko J F von Pfeil
- Small Animal Surgery Locum PLLC, Dallas, Texas, USA
- Bessy's Kleintierklinik, Regensdorf, Switzerland
| | - Kurt Schulz
- Ethos Veterinary Health, Williston, Vermont, USA
| | - Po-Yen Chou
- Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California, USA
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, University of California-Davis, Davis, California, USA
| | - Sun Young Kim
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Kristian Ash
- Ethos Veterinary Health, Williston, Vermont, USA
| | - Junxian Zheng
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Kei Hayashi
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA
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Matos Cruz AM, Mason DR. Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process. Front Vet Sci 2022; 9:938706. [PMID: 35982922 PMCID: PMC9378868 DOI: 10.3389/fvets.2022.938706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Document the outcomes of bilateral arthroscopic subtotal coronoidectomy for the fragmented medial coronoid process, quantify persistent lameness that required additional treatment (PRP), and document the outcomes of dogs that followed up with PRP injections. Study design Retrospective study. Sample population Overall, 115 dogs underwent arthroscopy alone and 31 received PRP at least 6 weeks after arthroscopy. The owner's response rate was ~50% (73 dogs). Methods Collected data included signalment, unilateral or bilateral clinical signs, intra-articular chondroprotective injection during the procedure, if PRP intra-articular injection was received postoperatively, and if it was received, the time from the initial surgery to administration was recorded. Outcomes were assessed via standardized owner questionnaires using the Liverpool Osteoarthritis in Dogs (LOAD) score, the Canine Brief Pain Inventory (CBPI) score, and the overall quality of life (QOL) assessment. Results Approximately 20% of the patients received PRP post-operatively due to persistent lameness following surgery. Similar pain scores were found between the two groups with an average of 11–13 LOAD score, 13–15 CBPI score, and good quality of life. Older animals at the time of surgery and those that received pain-relieving medications after the procedure were more painful and affected their functional outcome. PRP as an adjunctive therapy achieved a perceived good to excellent quality of life in ~90% of pets in this population. Conclusion Arthroscopy and subtotal coronoidectomy followed by PRP, if needed, seemed to decrease pain, and improve lameness in the long term. Clinical significance PRP should be considered as adjunctive therapy in dogs with the limited response to arthroscopy alone.
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Affiliation(s)
- Alyssa M. Matos Cruz
- MedVet Columbus, Worthington, OH, United States
- *Correspondence: Alyssa M. Matos Cruz
| | - David R. Mason
- Las Vegas Veterinary Specialty Center, Las Vegas, NV, United States
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Alves-Pimenta S, Soares S, Colaço B, Ginja M. Effect Of Elbow Angle And Weight-Bearing On The Evaluation Of Joint Congruence In Dogs. Anat Rec (Hoboken) 2022; 305:3398-3409. [PMID: 35438239 DOI: 10.1002/ar.24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/20/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Joint congruence is relevant for the assessment of elbow dysplasia, a development disorder in dogs. However, quantification of its variation with joint angle and weight bearing, important factors in quadrupedal locomotion, is lacking. Our objective was to estimate those effects on the alignment of humeroradioulnar joint surfaces. The usual protocol for screening elbow dysplasia, including mediolateral extended and flexed elbow views, was preceded by a weight-bearing lateromedial standing radiographic view, without sedation. Minimum distances were measured at established points of the humeroradioulnar joints classified with a grade zero of dysplasia. Sixty elbows (30 Portuguese Pointer dogs) were studied. The joint space between the anconeal process and the ulnar trochlear notch increased with flexion, decreasing with weight bearing (P<0.001). The distance between the humeral trochlea and the trochlear notch at the widest point, increased with weight bearing, while it decreased with flexion. Step and distance between the radial head and the base of the medial coronoid process increased with flexion and decreased with weight bearing. At this point, physiological changes occurred at the humeroulnar joint space. The methodology allowed to quantify the variations on joint spaces with the elbow angle and weight bearing, important for the interpretation of congruence in diagnosis and treatment of dysplasia. Reference absolute and indexed values obtained allow future comparisons with other breeds and dysplastic dogs. Physiological variations denoted that radioulnar joint became more incongruent under flexion, and more congruent under weight bearing, while humeroulnar joint became more congruent under flexion, and more incongruent under weight bearing.
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Affiliation(s)
- Sofia Alves-Pimenta
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Sofia Soares
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Colaço
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Mário Ginja
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Rohwedder T. Biomechanics of the Canine Elbow Joint. Vet Med Sci 2021. [DOI: 10.5772/intechopen.99569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The canine elbow joint is a complex joint, whose musculoskeletal anatomy is well investigated. During the last 30 years kinematic analysis has gained importance in veterinary research and kinematics of the healthy and medial coronoid disease affected canine elbow joint are progressively investigated. Video-kinematographic analysis represents the most commonly used technique and multiple studies have investigated the range of motion, angular velocity, duration of swing and stance phase, stride length and other kinematic parameters, mostly in the sagittal plane only. However, this technique is more error-prone and data gained by video-kinematography represent the kinematics of the whole limb including the soft tissue envelope. A more precise evaluation of the in vivo bone and joint movement can only been achieved using fluoroscopic kinematography. Based on recent studies significant differences in the motion pattern between healthy joints and elbows with medial coronoid disease could be detected. Thereby not only adaptive changes, caused by pain and lameness, could be described, but primary changes in the micromotion of the joint forming bones could be found, which potentially represent new factors in the pathogenesis of medial coronoid disease. This chapter gives a review of current literature on elbow joint kinematics, with particular focus onto pathologic biomechanics in dysplastic canine elbows.
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Rohwedder T, Böttcher P. Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease. Vet Comp Orthop Traumatol 2021; 34:386-393. [PMID: 34344054 DOI: 10.1055/s-0041-1731811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking. STUDY DESIGN This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs). MATERIALS AND METHODS Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk. RESULTS Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772-1.8824). Mean dRUI in controls (-0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918-2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. -0.4 mm; p = 0.0138; CI: 0.1820-1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963). CONCLUSION In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to -0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.
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Leach ES, Krotscheck U, Goode KJ, Hayes GM, Böttcher P. Long-term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs. Vet Surg 2018; 47:566-571. [PMID: 29607519 DOI: 10.1111/vsu.12790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 10/14/2017] [Accepted: 01/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate long-term loading patterns using subchondral bone density (SBD) distribution of the tibial plateau after tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA). STUDY DESIGN Cross-sectional study. ANIMALS Adult (> 2 years), medium to large breed dogs (>20 kg) that had been treated with TPLO or TTA at least 1 year prior to the study were recruited. A normal cohort of similar age and weight dogs with normal physical and orthopedic examinations served as control. METHODS Dogs were sedated for computed tomography (CT) of the stifle, and DICOM (digital imaging and communications in medicine) files were processed for CT osteoabsorptiometry (CTOAM). Tibial plateaus were sampled at 6 zones, and CTOAM was used to determine regional and maximal areas of SBD as a marker of joint loading. RESULTS Data were collected on 48 stifles in 31 dogs (15 TPLO, 11 TTA, 22 control). Lower Hounsfield unit (HU) values were measured in the caudal and mid-region of the lateral tibial plateau after TPLO and compared to normal. HU values did not differ between joints treated with TTA and those in the control group. CONCLUSION TPLO may alter stifle load distribution relative to the normal control group. There were no differences between TTA and the control group. CLINICAL SIGNIFICANCE/IMPACT Despite ongoing osteoarthritis (OA) in dogs after surgical intervention for cranial cruciate disease, changes in tibial SBD are minor and may not correlate with clinical function.
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Affiliation(s)
- Elizabeth S Leach
- Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Ursula Krotscheck
- Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Kelsey J Goode
- Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Galina M Hayes
- Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Peter Böttcher
- Klinik für Kleine Haustiere, Freie Universität Berlin, Berlin, Germany
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Rohwedder T, Fischer M, Böttcher P. In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Vet J 2017; 7:221-228. [PMID: 28795018 PMCID: PMC5538087 DOI: 10.4314/ovj.v7i3.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022] Open
Abstract
Aim of the study was to investigate dynamic radio-ulnar incongruence (dRUI) in the
canine elbow joint comparing orthopedic healthy and dysplastic dogs in a prospective
in vivo study design. In 6 orthopedic sound elbow joints (5 dogs, median age 17
months & mean body weight 27.9 kg) and 7 elbow joints with medial coronoid
disease (6 dogs, median age 17.5 months & mean body weight 27.6 kg) 0.8 mm
Ø tantalum beads were surgically implanted into radius, ulna and humerus for
dynamic radiosteriometric analysis (RSA) using high-speed biplanar fluoroscopy with
the dogs walking on a treadmill. dRUI, in the form of proximo-distal translation of
the radius relative to the ulna, was measured for the first third of stance phase and
compared between groups using unpaired t-testing. Healthy elbow joints exhibited a
relative radio-ulnar translation of 0.7 mm (SD 0.31 mm), while dysplastic joints
showed a translation of 0.5 mm (SD 0.30 mm). No significant difference between groups
was detected (p = 0.2092, confidence interval -0.6 – 0.2). Based on these
findings dRUI is present in every canine elbow joint, as part of the physiological
kinematic pattern. However, dysplastic elbow joints do not show an increased
radio-ulnar translation, and therfore dRUI cannot be considered causative for medial
coronoid disease.
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Affiliation(s)
- Thomas Rohwedder
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
| | - Martin Fischer
- Institute of Systematic Zoology and Evolutionary Biology with Phyletic Museum, Friedrich-Schiller-University, Jena, Germany
| | - Peter Böttcher
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
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Ballegeer EA. Computed Tomography of the Musculoskeletal System. Vet Clin North Am Small Anim Pract 2016; 46:373-420, v. [DOI: 10.1016/j.cvsm.2015.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Eljack H, Böttcher P. Relationship Between Axial Radioulnar Incongruence With Cartilage Damage in Dogs With Medial Coronoid Disease. Vet Surg 2014; 44:174-9. [DOI: 10.1111/j.1532-950x.2014.12234.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Hamdi Eljack
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
| | - Peter Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
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