Evaluation of Thoracic Limb Loads, Elbow Movement, and Morphology in Dogs Before and After Arthroscopic Management of Unilateral Medial Coronoid Process Disease

Evaluation of forelimb gait variation overground at a walk in sound and lame dogs using a combination of diagnostic techniques

BACKGROUND

Kinetic and kinematic gait analysis is increasingly practised as a part of lameness evaluation in dogs. The aim of this study was to examine the normal short- and long-term variation in forelimb gait in sound control dogs (CD) at a walk using seven selected variables of objective kinetic and kinematic gait analyses. Also, to compare the findings in CD to a group of forelimb lame dogs with elbow osteoarthritis (OAD). An additional aim was to test a kinetic based graphic method for lameness detection; symmetry squares (SS). A prospective longitudinal study was carried out on client owned CD and OAD. Clinical and orthopaedic evaluations were performed to ensure soundness and detect and grade lameness. Seven kinetic and kinematic variables and SS were tested for lameness evaluation. The CD were divided into two subgroups, CD1 and CD2, and examined twice: CD1 with two months interval and CD2 with 3-4 h interval. The OAD group was evaluated once and compared to the CD groups' first examination.

RESULTS

Thirteen CD and 19 OAD were included. For CD1 and CD2, there were no significant differences in any examined variable between examination occasions. Total peak force/impulse symmetry and fore-hind peak force/impulse symmetry differed significantly between OAD and CD. Symmetry squares had a 74% agreement to subjective orthopaedic evaluations.

CONCLUSIONS

In CD, no difference in the examined variables was seen between examination occasions. Four out of seven objective variables differed significantly between CD and OAD. The graphic SS method might have diagnostic potential for lameness detection, making it possible to detect a shift from lame to non-lame limbs. Potentially, this might be especially helpful in bilaterally lame dogs, which often represent a clinical challenge in lameness evaluation.

Dogs with Bilateral Medial Coronoid Disease Can Be Clinically Sound after Unilateral Arthroscopic Fragment Removal-Preliminary Study

The purpose of this study was to assess the outcome of dogs with bilateral medial coronoid disease (MCD) treated with arthroscopic intervention for the clinically more severely affected side and conservative management for the contralateral side. The medical records of dogs with bilateral medial coronoid disease diagnosed using computed tomography (CT) and treated using arthroscopic intervention on one elbow and conservative management on the other elbow were retrospectively reviewed. The outcome evaluation included clinical re-examination; follow-up radiographic-visible osteophytic lesions; as well as sclerotic changes and Liverpool osteoarthritis in a dogs questionnaire. Data from 48 clinically affected elbow joints (24 dogs) with bilateral MCD diagnosed using CT were included. Every dog underwent arthroscopic intervention on the elbow joint, which was clinically more severely affected, and the other side was treated with conservative management. A fragment of the medial coronoid was diagnosed using CT in all elbows, whereas 19 elbows (39.4%) showed a dislocation of the fragment and the other 29 elbows (60.4%) did not. There are no findings regarding the radioulnar Incongruence. Initially, 86% of all radiographs had the same degree of osteophytes. At the time of follow-up, the arthroscopic-treated limbs had more severe radiological changes in comparison to the conservatively treated limbs. Lameness improved after arthroscopic therapy in walking. The conservative group showed a largely unchanged gait pattern. Radiological changes do not necessarily reflect the severity of clinical signs. Arthroscopic intervention showed an improvement of the clinical gait pattern, even though the radiographic changes worsened.

Therapeutic success in fragmented coronoid process disease and other canine medial elbow compartment pathology: a systematic review with meta-analyses

Introduction

The correct treatment of elbow dysplasia is controversial in modern small animal orthopedics. The aim of this study was to compile all relevant literature of the therapy of fragmented coronoid process and other hereditary disorders of the medial elbow compartment and to statistically evaluate the therapeutic results in three meta-analyses.

Methods

The basis for the systematic literature review was a comprehensive database search of Web of Science, PubMed and Medline. Studies on living patients with above mentioned degenerative joint disease were included in the initial literature search. The data from the final studies, selected according to the PRISMA guidelines, was subsequently extracted. Finally, the success of the different therapies was compared and analyzed by three meta-analyses: success rate, mean difference and standardized mean difference.

Results

Fourteen of 494 publications covered by the systematic literature search remained. Their overall truth was: In studies where surgery outcomes was determined by clinical examination and owner questionnaires, it was found that surgical intervention had a significant positive outcome in the presence of fragmented coronoid process and medial compartment disease. Surgical outcomes were also good in three cross-over studies that investigated treatment success using computerized gait analysis. In contrast, comparative studies between surgical and conservative management yielded controversial results. The meta-analysis found no significant difference between medical and surgical therapy.

Discussion

The positive results of studies investigating owner satisfaction and veterinary clinical examination of surgical therapy for medial compartment disease were confirmed by two meta-analyses. However, their study designs were susceptible to observer biases. A third meta-analysis of standardized mean difference differentiating computerized gait analysis results of surgical and conservative management found no evidence of significant superiority of each treatment modality. It however had a limited number of subjects. More comparative studies of high evidence are needed to better understand medial compartment disease and provide the clinician with more accurate diagnostics to separate pathology that should be treated surgically from pathology that can benefit from conservative therapy similarly. Given the invasiveness a more cautious approach might be warranted regarding generally recommending surgery for pathology of the medial elbow compartment.

Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease

OBJECTIVE

To summarize the current peer-reviewed publications on minimally invasive surgery (MIS) for medial coronoid process disease (MCPD) in dogs.

STUDY DESIGN

Invited review.

METHODS

Pubmed, CAB Abstracts and Scopus databases were utilized for literature review (1990-2023).

RESULTS

More than 60 papers have been published that involve MIS evaluation or treatment of MCPD. Six prospective trials incorporated quantitative gait analysis evaluating outcome following MCPD debridement, of which three included a control group. Whilst case numbers were limited, all studies employing a control group failed to demonstrate superiority of surgery over nonsurgical management. Of three studies employing gait analysis and no control group, all documented some improvement in function compared to pretreatment lameness. Multiple studies document progression of osteoarthritis in dogs following MCPD debridement although this may not be synonymous with worsened function. Subtotal coronoid osteotomy (SCO) is described as an alternative to MCP fragment removal, although the long-term biomechanical consequences are currently unclear and quantitative data on the efficacy of this treatment in isolation for MCPD is awaited.

CONCLUSION

Arthroscopy of the canine elbow joint is a safe means by which to evaluate MCP pathology. Quantitative longitudinal analysis of outcome following minimally invasive surgery for MCPD is required. Correlation with clearly defined subclassification inclusion criteria such as age, incongruity and the precise arthroscopic findings in each case are required to more accurately differentiate any superiority of surgery over nonsurgical management for this disease.

Evaluation of a small-bore needle arthroscope for diagnosis and treatment of medial coronoid disease in dogs: a pilot study with short-term assessment

CASE HISTORY

Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months.

CLINICAL FINDINGS

Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs.

ARTHROSCOPIC FINDINGS

Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001).

CLINICAL RELEVANCE

Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid disease.

Comparison of Canine Forelimb Kinematic Joint Angles Collected with 2D and 3D Models

OBJECTIVE

 The aim of this study was to compare a Joint Coordinate System (JCS) three-dimensional (3D) kinematic model of the canine forelimb with more widely used linear (LIN) and segmental (SEG) 2D models.

STUDY DESIGN

 It was an in vivo biomechanical study.

ANIMALS

 Normal adult mixed breed dogs were used in this study (n = 6).

METHODS

 Nineteen retroreflective markers were applied to the skin of dogs' right forelimbs. Dogs were trotted and walked through the calibrated testing space. The first five good trials were used to generate sagittal plane (flexion and extension angle) waveforms from 3 different models (JCS, LIN and SEG) for the shoulder, elbow and carpal joints. The JCS model also generated transverse and frontal plane joint angular data (internal/external and abduction/adduction angles) for all three joints. Minimum, maximum and total angular displacement was calculated for each joint. Comparison of sagittal plane waveforms was performed before and after waveform alignment using statistical parametric mapping.

RESULTS

 Each model produced similar sagittal plane waveforms, though the LIN model had a greater vertical shift along the y-axis for the shoulder and elbow. Before waveform alignment, differences were revealed between the LIN model when compared to JCS or SEG model at a trot. No differences were revealed at a walk. After waveform alignment, no differences were revealed between models at a walk or trot. There were no differences in angular displacement measurements between models before or after waveform alignment at a walk or trot.

CONCLUSIONS

 The 3D JCS model reported in this study produced sagittal plane waveforms comparable to conventional 2D models while also providing joint specific information from other planes of motion.

Comparative evaluation of radiographic and computed tomographic findings in dogs with bilateral medial coronoid disease (MCD) presenting with unilateral forelimb lameness

OBJECTIVES

The purpose of this study was to compare the radiographic and computed tomographic (CT) findings of dogs with diagnosed bilateral medial coronoid disease, which showed clinically only unilateral lameness of the forelimbs.

MATERIALS AND METHODS

Medical records, including radiographs and CT images of dogs with diagnosed bilateral MCD showing only a unilateral forelimb lameness clinically were reviewed retrospectively. Depending on the gait of each dog we established two groups to investigate their radiographs and CT data comparatively. Group I: affected non-lame limb. Group II: affected lame limb. Several evaluation systems were used to assess which factors are important for clinical decision making and a patient tailored therapeutic plan.

RESULTS

Data from 84 affected elbow joints (42 dogs) diagnosed with MCD by computed tomography were included. Both the radiological and the CT analysis showed that there are significant differences between Groups I and II. Group I had a lower modified International Elbow Working Group Score (IEWG), the values of the Trochlear notch sclerosis were only slightly deviated, and this group showed less often a dislocation of the fragment compared to group II. Furthermore, the size of the fragment (both the median and the mean value) of the forelimbs from group II was almost twice as big as the one from group I. The following sizes of the fragments were calculated (group I versus (vs.) group II)-median: 0.09 cm2 vs. 0.16 cm2, mean value: 0.112 cm2 vs. 0.202 cm2. It could be shown that a larger fragment is more likely to dislocate than a smaller one.

CLINICAL SIGNIFICANCE

This study provides some evidence towards a better understanding of which diagnostic parameters and findings might be important in clinical decision making. Nevertheless, a "decision tree" for the correct therapy of MCD could not be determined in this study.

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process

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.

Biomechanics of the Canine Elbow Joint

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.

Mid- to Long-Term Outcome after Arthroscopy and Proximal Abducting Ulnar Osteotomy Versus Arthroscopy Alone in Dogs with Medial Compartment Disease: Thirty Cases

OBJECTIVE

 The aim of this study was to determine owner-assessed mid- to long-term outcome for dogs with medial compartment disease treated arthroscopically with fragment removal with or without proximal abducting ulnar osteotomy (PAUL).

STUDY DESIGN

 This was a retrospective clinical study.

MATERIALS AND METHODS

 Records from 30 dogs with medial compartment disease treated with arthroscopy with or without PAUL were retrospectively reviewed over a 5-year period. Proximal abducting ulnar osteotomy cases were matched to arthroscopy-alone controls based on bodyweight and modified Outerbridge score. Outcome was assessed via owner questionnaire using the Canine Brief Pain Inventory (CBPI), frequency of non-steroidal anti-inflammatory drug (NSAID) administration and owner-assessed overall improvement.

RESULTS

 Canine Brief Pain Inventory score for dogs in the PAUL group was not significantly different from the control group (p = 0.54). Non-steroidal anti-inflammatory drug administration was similar between groups (p = 0.61) and there was no significant difference between modified Outerbridge score and outcome (p = 0.57) over a median of 43 months post-surgically (range: 7-66 months). Canine Brief Pain Inventory and NSAID use were affected by the age of the dog with dogs greater than 3 years of age at the time of surgery having a higher CBPI score and increased NSAID use regardless of the surgery that was performed. Overall, owner-assessed improvement was not different between groups (p = 0.72).

CLINICAL SIGNIFICANCE

 Proximal abducting ulnar osteotomy showed no owner-assessed benefit over arthroscopic medial coronoid fragment removal for dogs with medial compartment disease and modified Outerbridge score of 3 or greater. A prospective, blinded, controlled clinical trial is warranted to determine the appropriate clinical application of the PAUL procedure.

Effect of antioxidants, mitochondrial cofactors and omega-3 fatty acids on telomere length and kinematic joint mobility in young and old shepherd dogs - A randomized, blinded and placebo-controlled study

In dogs, decreasing telomere length is a biomarker for cellular aging. On a systemic level, aging affects the locomotor system in particular, leading to restricted joint mobility. As aging is thought to be related to oxidative stress, it may be counteracted by a diet enriched with antioxidants, mitochondrial cofactors and omega-3 fatty acids. This randomized, blinded and placebo-controlled study examined the influence of an accordingly enriched diet compared to a control diet on 36 young and 38 old shepherd dogs. At the outset, after 3 and after 6 months, mean and minimum telomere lengths were measured. Furthermore, minimum and maximum joint angles and range of motion of the shoulder, elbow, carpal, hip, stifle and tarsal joints were measured by computer-assisted gait analysis. A positive influence of the enriched diet on old dogs could be verified for minimum telomere length and all three parameters of the shoulder joint on the side with the higher vertical ground reaction force after 6 months. In the other joints there were less significant differences; in some cases they indicated a contrary influence of the enriched diet on young dogs, probably due to its reduced protein content. The greater effect of the enriched diet on minimum than on mean telomere length may be due to the higher preference of telomerase for short telomeres. The greater effect on shoulder joint mobility is explained by the greater influence of musculature and connective tissue in this joint. For elderly dogs it is advisable to feed these nutritional supplements.

Center of pressure limb path differences for the detection of lameness in dogs: a preliminary study

Background

The limb center of pressure (COP) path measures and quantifies the load distribution within a limb in a still or moving subject. Under this premise, the aim of this study was to test whether data derived from this parameter could detect the differences between sound and lame limbs in unilaterally lame dogs with elbow dysplasia.

To accomplish this purpose, ten unilaterally lame dogs of similar conformation were walked over a pressure platform. Next, the COP path, in relation to the position of sound and lame limbs, was measured in a coordinate system over a standard paw template obtained by pedobarography during the whole support phase. To compare variables, force platform data (peak vertical force and vertical impulse) from the same animals were obtained. Sound and lame limb statokinesiograms were also obtained while the animals stood still.

Results

The statistical analysis clearly showed that COP in lame limbs start cranially and were shorter than sound limbs. In addition, the value of the COP excursion index was lower in lame limbs. Finally, the area of statokinesiograms was greater in lame limbs.

Conclusion

This methodology based in limb COP characteristics serves to discriminate between sound and lame limbs in dogs with elbow dysplasia.

Electronic supplementary material

The online version of this article (10.1186/s12917-019-1881-1) contains supplementary material, which is available to authorized users.

Comparative kinematic gait analysis in young and old Beagle dogs

Age-related involution in dogs involves loss of muscle mass and changes in connective tissue and articular cartilage. The aim of this study was to examine whether an age-related influence on joint mobility can be detected in the absence of disease. Five young (mean age 2.0 years) and five old (mean age 10.4 years) healthy and sound Beagle dogs underwent computer-assisted gait analysis during locomotion on a treadmill. Shoulder, elbow, carpal, hip, stifle, and tarsal joint angles including joint angle progression curves, minimum and maximum joint angles, and range of motion (ROM) in degrees were analyzed. The old group had a smaller maximum joint angle (p = 0.037) and ROM (p = 0.037) of the carpal joint; there were similar tendencies in the shoulder, elbow, and carpal joints. Descriptive analysis of the progression curves revealed less flexion and extension of the forelimb joints. The results indicate restricted joint mobility of the forelimb in old dogs, primarily of the carpal joint. Results in the joints of the hindlimb were inconsistent, and the contrasting alterations may be due to a compensatory mechanism. As most alterations were found in the distal joints, these should receive particular attention when examining elderly dogs.

Investigating canine elbow joint stabilisation through mechanical constraints of the deep fascia and other soft tissues

The objective of this research was to investigate how the range of flexion and extension of the canine elbow joint is constrained by the mechanical connections and attachments of soft tissue structures. The skin, a section of deep fascia and several muscles from both forelimbs from six adult greyhounds and seven other breeds were sequentially transected or removed, over 13 steps. During each step, repeated measurements of elbow flexion and extension were recorded using a goniometer. Only marginally significant changes to the range of flexion occurred in any of the 13 steps or overall for the greyhounds. Clearly significant changes to extension occurred in several dissection steps. Removing the skin resulted in a significant increase in elbow extension of 1.7° ± 0.3 (P < 0.001) in the greyhounds and 1.6° ± 0.3 (P < 0.001) in the other breeds. Severing the deep fascia from the humerus and its connections across the elbow joint resulted in the largest significant change in elbow extension of 9.9° ± 0.3 (P < 0.001) in the greyhounds and 6.9° ± 0.7 (P < 0.001) in the other breeds. Transecting the biceps brachii m. close to the elbow resulted in an increase of 2.8° ± 0.3 (P < 0.001) in the greyhounds but a non-significant change in the other breeds. Transecting the extensor carpi radialis m. from its origin resulted in an increase of 5.5° ± 0.4 (P < 0.001) in the greyhounds and 3.9° ± 0.7 (P < 0.001) in the other breeds. These results suggest that the collagenous framework and attachments of the skin, deep fascia, and extensor carpi radialis m., play a significant role in the function of the canine elbow by restricting it from overextension and hence stabilising it during periods of loading, in a variety of different canine breeds, and that these structures are functionally integrated into the way the forelimb supports the bodyweight separately from any involvement of muscle tone or muscle movements. Observations on the anatomical connections of the deep fascia between the cranial distal humerus and the antebrachial fascia highlighted its probable importance in relating movements between the shoulder and the carpus.

Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada

RESUMO: Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.

Goniometrie evaluation of standing extension and maximum flexion joint angles of llamas and alpacas

OBJECTIVE To determine and compare mean standing extension and maximum flexion angles of various joints in healthy adult alpacas and llamas, and determine the reliability of goniometric data within and between 2 observers for each joint of interest. SAMPLE 6 healthy adult llamas and 6 healthy adult alpacas. PROCEDURES The shoulder joint, elbow joint, carpal, and metacarpophalangeal (MCP) joints of the forelimbs and the hip joint, stifle joint, tarsal, and metatarsophalangeal (MTP) joints of the hind limbs were investigated. Each articulation was measured with a universal goniometer by 2 observers, who each obtained 2 measurements when each joint was maintained in standing extension and in maximal passive flexion. Two sample (unpaired) t tests were performed for comparisons of mean standing extension and maximum passive flexion angles between alpacas and llamas. Intraclass correlation coefficients were calculated for each articulation to assess interobserver and intra-observer reliability of measurements. RESULTS Llamas had larger mean standing extension angles than alpacas for the tarsal and elbow joint, but there were no significant differences between species for all other joints. For all joints, flexion measurements did not differ significantly between the 2 species. For most joints, the reliability of goniometric data between observers was good to excellent (intraclass correlation coefficients, 0.6 to 0.95) CONCLUSIONS AND CLINICAL RELEVANCE Except for the elbow joint and tarsus in extension, the angle of limb articulations during flexion and extension can be considered similar for alpacas and llamas. These measurements have relevance for veterinary surgeons when assessing joint mobility and conformation and determining appropriate angles for arthrodesis.