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Costa Junior JS, Curuci EHP, Carneiro RK, Nobile M, Giufrida R, Dias LGGG, Carrera ALC, Minto BW. Combination of closing-wedge distal femoral osteotomy and modified tibial plateau levelling osteotomy for the treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in dogs. Res Vet Sci 2024; 180:105437. [PMID: 39427476 DOI: 10.1016/j.rvsc.2024.105437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 09/20/2024] [Accepted: 10/13/2024] [Indexed: 10/22/2024]
Abstract
Considering the prevalence of cranial cruciate ligament disease (CCLD) and concurrent medial patellar luxation (MPL) among dogs, and the concomitant bone deviations routinely identified, the aim of this study is to evaluate the efficacy of the combination between distal femoral osteotomy (DFO) and modified tibial plateau levelling osteotomy (mTPLO) for the treatment of MPL with distal femoral varus, tibial torsion, and CCLD. Dogs with concurrent MPL and CCLD that underwent DFO and mTPLO procedures were included. Subjective clinical evaluations of gait and pre-operative and immediate post-operative radiographic examinations were performed. Surgical data were documented. The anatomical lateral distal femoral angle (aLDFA), femoral varus angle, mechanical medial proximal tibial angle, and tibial plateau angle (TPA) were compared between the pre- and post-operative periods. A total of 12 dogs were included in this study. Closing-wedge DFO and mTPLO procedures were performed on 14 limbs. The mean pre-operative and post-operative aLDFA values were 104.8 ± 3.9° and 95.4 ± 2.4°, respectively. TPA values were 26.2 ± 3.7° pre-operatively and 6.3 ± 3.2° post-operatively. Bone healing was observed in 7.1 %, 71.3 %, and 85.5 % of patients at the first, second, and third follow-up, respectively. Lameness was resolved in 28.5 %, 78.5 %, and 100 % at 30, 60, and 90 days, respectively. No major peri- or post-operative complications were reported. The combination of mTPLO and DFO aligns the stifle extensor mechanism, promoting dynamic stabilization. It can be considered for the treatment of concurrent MPL and CCLD in dogs, performed as a single procedure, and is associated with favorable short-term outcomes.
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Affiliation(s)
- Jose Sergio Costa Junior
- Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP, Jaboticabal, State of São Paulo, Brazil
| | | | - Rafael Kretzer Carneiro
- Department of Veterinary Medicine, Center for Agroveterinary Sciences, Santa Catarina State University - UDESC, Lages, State of Santa Catarina, Brazil
| | - Matheus Nobile
- Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP, Jaboticabal, State of São Paulo, Brazil
| | - Rogério Giufrida
- Department of Graduate Studies in Animal Science, Western São Paulo State University - UNOESTE, Presidente Prudente, State of São Paulo, Brazil
| | - Luís Gustavo Gosuen Gonçalves Dias
- Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP, Jaboticabal, State of São Paulo, Brazil
| | - Alefe Luiz Caliani Carrera
- Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP, Jaboticabal, State of São Paulo, Brazil.
| | - Bruno Watanabe Minto
- Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP, Jaboticabal, State of São Paulo, Brazil
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Alrehily FA. Assessing the inter-observer and intra-observer reliability of radiographic measurements for size-specific dose estimates. BMC Med Imaging 2024; 24:209. [PMID: 39134971 PMCID: PMC11318122 DOI: 10.1186/s12880-024-01397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/08/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Calculating size-specific dose estimates (SSDEs) requires measurement of the patient's anteroposterior (AP) and lateral thickness based on computed tomography (CT) images. However, these measurements can be subject to variation due to inter-observer and intra-observer differences. This study aimed to investigate the impact of these variations on the accuracy of the calculated SSDE. METHODS Four radiographers with 1-10 years of experience were invited to measure the AP and lateral thickness on 30 chest, abdomen, and pelvic CT images. The images were sourced from an internet-based database and anonymized for analysis. The observers were trained to perform the measurements using MicroDicom software and asked to repeat the measurements 1 week later. The study was approved by the institutional review board at Taibah University, and written informed consent was obtained from the observers. Statistical analyses were performed using Python libraries Pingouin (version 0.5.3), Seaborn (version 0.12.2), and Matplotlib (version 3.7.1). RESULTS The study revealed excellent inter-observer agreement for the calculated effective diameter and AP thickness measurements, with Intraclass correlation coefficients (ICC) values of 0.95 and 0.96, respectively. The agreement for lateral thickness measurements was lower, with an ICC value of 0.89. The second round of measurements yielded nearly the same levels of inter-observer agreement, with ICC values of 0.97 for the effective diameter, 1.0 for AP thickness, and 0.88 for lateral thickness. When the consistency of the observer was examined, excellent consistency was found for the calculated effective diameter, with ICC values ranging from 0.91 to 1.0 for all observers. This was observed despite the lower consistency in the lateral thickness measurements, which had ICC values ranging from 0.78 to 1.0. CONCLUSIONS The study's findings suggest that the measurements required for calculating SSDEs are robust to inter-observer and intra-observer differences. This is important for the clinical use of SSDEs to set diagnostic reference levels for CT scans.
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Affiliation(s)
- Faisal A Alrehily
- Department of Diagnostic Radiology, College of Applied Medical Sciences (Building 115), Taibah University, Prince Naif Rd, Madinah, 42353, Saudi Arabia.
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Burg-Personnaz J, Zöllner M, Reese S, Meyer-Lindenberg A, Brühschwein A. 3D Slicer open-source software plug-in for vector-based angle calculation of canine hind limb alignment in computed tomographic images. PLoS One 2024; 19:e0283823. [PMID: 38551890 PMCID: PMC10980227 DOI: 10.1371/journal.pone.0283823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Severe and complex angular limb deformities in dogs require accurate morphological assessment using diagnostic imaging to achieve successful orthopedic surgery. Computed tomography (CT) is commonly used to overcome projection errors in two-dimensional angular measurements of dog hindlimb alignment. Three-dimensional volume rendering (VR) techniques permit virtual positioning and variable projection, but the final CT-image that defines the projection plane for angular measurements remains two-dimensional. OBJECTIVE We wanted to develop a true three-dimensional open-source technique to measure the alignments of the hind limbs of dogs in CT scanners. METHODS We developed an open-source 3D Slicer plug-in, to perform angular measurements using vector calculations in three-dimensional space. In 113 CT-scans of canine pelvic limbs, femoral torsion, femoral varus, femorotibial rotation, tibial torsion, tibial varus and tibiotalar rotation angles were calculated and compared to an already validated technique using VoXim®. RESULTS Reference points were identified and measurements were possible in the 113 acquisitions. The greatest difference between the two techniques was 1.4° at only one tibial torsion angle. Mean values for all Bland-Altman plots did not show significant differences and were less than 0.07° for all comparisons. DISCUSSION Based on these results we considered angular measurements of canine hind limb alignment in CT scans using the 3D Slicer extension program sufficiently accurate for clinical orthopedic and surgical purposes in veterinary medicine. CONCLUSION With our open-source 3D Slicer extension software, we provide a free accessible tool for veterinary orthopedic surgeons and thus we hope to improve angular measurements in CT-scans of canine hind limb deformities through true three-dimensionality.
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Affiliation(s)
- Juliette Burg-Personnaz
- Centre of Veterinary Clinical Medicine, Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, LMU, Munich, Germany
| | - Martin Zöllner
- Centre of Veterinary Clinical Medicine, Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, LMU, Munich, Germany
| | - Sven Reese
- Department of Veterinary Sciences, Veterinary Faculty, Institute of Veterinary Anatomy, Histology and Embryology, LMU, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Centre of Veterinary Clinical Medicine, Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, LMU, Munich, Germany
| | - Andreas Brühschwein
- Centre of Veterinary Clinical Medicine, Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, LMU, Munich, Germany
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Dursun S, Yilmaz O, Demircioğlu İ. Three-dimensional modelling and morphological investigation of the bones of the Articulatio genus using computed tomography images in Van cats. Anat Histol Embryol 2024; 53:e12994. [PMID: 37936559 DOI: 10.1111/ahe.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/26/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
In this study, it was aimed to make three-dimensional reconstruction of the stifle joint computed tomography (CT) images of the Van cats, to obtain their osteometric measurements, and to determine the statistical biometric differences of these measurement values in terms of both sexual dimorphism and homotypic variations. A total of 16 healthy adult Van cats of both sexes were used. The stifle joints of the cats were scanned with a CT device and images were obtained. Three-dimensional reconstructions of the bony structures of the stifle joint were performed using CT images using the MIMICS 20.1 modelling program. Then, osteometric measurements were calculated, and statistical analysis was performed. When the morphometric measurement values were examined in terms of gender, it was observed that almost all of the osteometric measurement values of the stifle joint in Van cats (except SPW measurement) were higher in male cats. According to homotypic variations, right side TPW (p = 0.009), TPCMA (p = 0.003) and TPMCA (p = 0.032) measurement values in female cats and right side TPLCA (p = 0.002) measurement values in male cats were found to be statistically significantly higher than the left side from the measurements of only the proximal tibia (p < 0.05). In general, although there were negative correlations between morphometric measurement values with age and body weight, mostly strong positive correlations were seen. As a result, statistical differences of the biometric values and anatomical features of the stifle joint between the sexes in Van cats between the sexes were examined using CT and a three-dimensional modelling program.
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Affiliation(s)
- Süleyman Dursun
- Faculty of Veterinary Medicine, Department of Anatomy, Van Yuzuncu Yil University, Van, Turkey
| | - Osman Yilmaz
- Faculty of Veterinary Medicine, Department of Anatomy, Van Yuzuncu Yil University, Van, Turkey
| | - İsmail Demircioğlu
- Faculty of Veterinary Medicine, Department of Anatomy, Harran University, Sanliurfa, Turkey
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Brühschwein A, Burg-Personnaz J, Zöllner M, Reese S, Meyer-Lindenberg A. Comparison of CT-measured angles of pelvic limbs without patellar luxation of six canine breeds. Front Vet Sci 2023; 10:1194167. [PMID: 37519994 PMCID: PMC10373893 DOI: 10.3389/fvets.2023.1194167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Dogs with medial patellar luxation can be affected by pelvic limb deformities whose corrective osteotomies and associated biomechanical rebalancing might provide higher success rates than standard surgical procedures limited to the stifle joint. In bilaterally affected canine patients, comparison with the contralateral normal limb is impossible. Reference values are useful for orthopedic decision-making. Inconsistency of published reference values might depend on methodology or canine breed. We hypothesized that canine pelvic limb alignment is breed-specific. Methods CT scans of 42 pelvic limbs of dog breeds predisposed for medial patellar luxation, with an orthotopic patellar position and stability were studied. Several angleswere measured with an open-source 3D Slicer plugin using vector calculations. The breeds were compared with a general linear model with a Bonferonni adjustment using SPSS. Results Chihuahuas, Pomeranians, Jack Russel Terriers, Pugs, French Bulldogs, Maltese were examined. In the order of the listed breeds, the angles were as follows: 28.3°±10.7°, 20.1°±2.9°, 35.4°±6.9°, 32.8°±3.0°, 19.0°±7.1°, 26.6°±5.3° for the antetorsion, 5.3°±1.8°, 2.8°±2.8°, 8°±4.4°, 3.8 °±3.1°, 4.7°±3.3°, 2.3°±3.3° for the femoral varus, of -5.5°±6.2°, 1.1°±4.1°, -5.2°±9.5°, 6.1°±8.0°, -0.1°±5.9°, -9.2°±4.7° for the tibial torsion, 2.0°±2.9°, 2.1°±2.7°, 6.4°±6.8°, 0.0°±5.7°, 3.0°±5.8°, 8.8°±8.6° for the tibial valgus, 1.2°±10.4°, 1.8°±3.4°, -1.7°±4.9°, -1.7°±9.4°, 5.1°±8.8°, -0.2°±8.6° for the femorotibial rotation and -3.4°±2.2°, 1.1°±4.1°, -2.8°±3.4°, -5.2°±4.0°, -2.1°±4.4°, -5.4°±3.7° for the tibiotalar rotation. There were significant differences between breeds in femoral torsion, femoral varus, and tibial torsion angles, but no significant differences in tibial valgus, femorotibial, and tibiotalar rotation angles. Discussion Our hypothesis is therefore partially correct. Our results are limited to small dogs prone to medial patellar luxation and might not be generalized. To establish robust reference values larger case numbers and more breeds should be evaluated. In conclusion, canine pelvic limb alignment reference values for small dogs with a predisposition for medial patellar luxation should be considered breed-specific.
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Affiliation(s)
- Andreas Brühschwein
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Juliette Burg-Personnaz
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Martin Zöllner
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Sven Reese
- Institute of Veterinary Anatomy, Histology and Embryology, Department of Veterinary Sciences, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
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Clark EA, Condon AM, Ogden DM, Bright SR. Accuracy of Caudocranial Canine Femoral Radiographs Compared to Computed Tomography Multiplanar Reconstructions for Measurement of Anatomic Lateral Distal Femoral Angle. Vet Comp Orthop Traumatol 2023; 36:157-162. [PMID: 36796429 DOI: 10.1055/s-0043-1761242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This study aimed to compare the accuracy of sternal recumbency caudocranially obtained radiographs of canine femora to computed tomographic (CT) frontal plane reconstructions of the same femora for assessing anatomic distal lateral femoral angles (aLDFA). STUDY DESIGN Multicentre, retrospective study utilizing 81 matched radiographic and CT studies of clinical patients undergoing assessment for various issues were reviewed. Anatomic lateral distal femoral angles were measured, and accuracy assessed with descriptive statistics and Bland-Altman plot analysis, with CT considered the reference standard. Sensitivity and specificity of a cut-off for measured aLDFA (102 degrees) were determined to assess radiography as a screening tool for significant deformity. RESULTS Radiographs on average overestimated aLDFA by 1.8 degrees compared to CT. Bland-Altman analysis identified a 15.4 degrees 95% limit of agreement range and a tendency for greater overestimation at higher average measured value. Radiographic measurement of aLDFA of 102 degrees or less had a 90% sensitivity, 71.83% specificity, and 98.08% negative predictive value for the CT measurement being less than 102 degrees. CONCLUSION Accuracy of aLDFA measurement by caudocranial radiographs does not demonstrate sufficient accuracy when compared to CT frontal plane reconstructions with unpredictable differences. Radiographic assessment is a useful screening tool to exclude animals with a true aLDFA of greater than 102 degrees with a high degree of certainty.
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Affiliation(s)
| | - Anna Maria Condon
- Manchester Veterinary Specialists, Worsley, Greater Manchester, United Kingdom
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Aghapour M, Bockstahler B, Kneissl S, Vezzoni A, Gumpenberger M, Hechinger H, Tichy A, Vidoni B. Radiographic Diagnosis of Hip Laxity in Rottweilers: Interobserver Agreement at Eight- and Twelve-Months of Age. Animals (Basel) 2023; 13:ani13020231. [PMID: 36670771 PMCID: PMC9855059 DOI: 10.3390/ani13020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Hip laxity is one of the predisposing factors of canine hip dysplasia. The early diagnosis of hip laxity allows veterinarians to prevent the participation of dysplastic dogs in breeding programs, which could lower the disease's prevalence due to its genetic background. Furthermore, it allows them to plan preventive/therapeutic procedures for mild/near-normal hips to reduce the symptoms of the disease at older ages. A reliable screening program must be repeatable and reproducible, and intra- and inter-observer studies can help us to determine the best methods. In this study, we aimed to evaluate the radiographic parameters used for the early diagnosis of hip dysplasia in Rottweilers at 8 and 12 months of age with five observers to assess the interobserver agreements. According to our findings, there were high interobserver agreements at both ages for the quantitative values, such as the center edge angle (CEA), dorsal acetabular rim slope (DARS), distraction index (DI), and Norberg angle (NA), whereas we recorded from poor to moderate agreements for the qualitative values, such as the grading of the dorsal acetabular rim (GDAR), grading of the degenerative joint disease (GDJD), location of the center of the femoral head (LCFH), and sclerosis of the cranial acetabular rim (SCAR).
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Affiliation(s)
- Masoud Aghapour
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
- Correspondence:
| | - Barbara Bockstahler
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Sibylle Kneissl
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Aldo Vezzoni
- Clinica Veterinaria Vezzoni S.R.L., 26100 Cremona, Italy
| | - Michaela Gumpenberger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Harald Hechinger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Alexander Tichy
- Platform Bioinformatics and Biostatistics, Department for Biomedical Services, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Britta Vidoni
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria
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Brühschwein A, Schmitz B, Zöllner M, Reese S, Meyer-Lindenberg A. Computed tomographic angular measurements using a bone-centered three-dimensional coordinate system are accurate in a femoral torsional deformity model and precise in clinical canine patients. Front Vet Sci 2023; 10:1019216. [PMID: 37138905 PMCID: PMC10149667 DOI: 10.3389/fvets.2023.1019216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/13/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction In small animal orthopedics, angular measurements in the canine femur are often applied in clinical patients with bone deformities and especially in complex and severe cases. Computed tomography (CT) has been shown to be more precise and accurate than two-dimensional radiography, and several methods are described. Measurement techniques evaluated in normal bones must prove accuracy in deformed bones in clinical settings. Objectives The goals of our study were to evaluate the accuracy of canine femoral torsion angle measurements in a femoral torsional deformity model and to test repeatability and reproducibility of canine femoral neck inclination, torsion, and varus angle measurements in CT datasets of dogs applying a CT-based technique using a three-dimensional (3D) bone-centered coordinate system. Materials and methods For precision testing, femoral torsion, femoral neck inclination, and femoral varus angles were measured in CT data of 68 canine hind limbs by two operators, and their results were compared. For accuracy testing, a femoral torsional deformity model was preset from 0° to +/-90° with a goniometer and scanned. Torsion angles were measured in the CT data and compared to the preset value. Results In the femoral torsion model, the Bland-Altman plots demonstrated a mean difference of 2.11°, and the Passing-Bablok analysis demonstrated a correlation between goniometer and CT-based measurements. In the clinical CT scans, intra- and interobserver agreement resulted in coefficients of variation for repeated measurements (%) between 1.99 and 8.26 for the femoral torsion, between 0.59 and 4.47 for the femoral neck inclination, and between 1.06 and 5.15 for the femoral varus angles. Discussion Evaluation of femoral malformations with torsional deformities is the target area of this technique. Further studies are required to assess its value in different types, degrees, and combinations of osseous deformities and to establish normal reference values and guidelines for corrective osteotomies. Conclusion Based on the results of this study, the accuracy of the torsion angle measurements and the precision of inclination, torsion, and the varus angle measurements were considered acceptable for clinical application.
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Affiliation(s)
- Andreas Brühschwein
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
- *Correspondence: Andreas Brühschwein
| | - Bronson Schmitz
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Martin Zöllner
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
| | - Sven Reese
- Department of Veterinary Sciences, Veterinary Faculty, Institute of Veterinary Anatomy, Histology, and Embryology, LMU Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Centre of Veterinary Clinical Medicine, Veterinary Faculty, LMU Munich, Munich, Germany
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Brühschwein A, Schmitz B, Zöllner M, Reese S, Meyer-Lindenberg A. Introduction of a bone-centered three-dimensional coordinate system enables computed tomographic canine femoral angle measurements independent of positioning. Front Vet Sci 2022; 9:1019215. [PMID: 36504862 PMCID: PMC9730830 DOI: 10.3389/fvets.2022.1019215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/27/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Measurement of torsional deformities and varus alignment in the canine femur is clinically and surgically important but difficult. Computed tomography (CT) generates true three-dimensional (3D) information and is used to overcome the limitations of radiography. The 3D CT images can be rotated freely, but the final view for angle measurements remains a subjective variable decision, especially in severe and complex angular and torsional deformities. The aim of this study was the development of a technique to measure femoral angles in a truly three-dimensional way, independent of femoral positioning. Methods To be able to set reference points in any image and at arbitrary positions of the CT series, the 3D coordinates of the reference points were used for mathematical calculation of the angle measurements using the 3D medical imaging Software VoXim®. Anatomical reference points were described in multiplanar reconstructions and volume rendering CT. A 3D bone-centered coordinate system was introduced and aligned with the anatomical planes of the femur. For torsion angle measurements, the transverse projection plane was mathematically defined by orthogonality to the longitudinal diaphyseal axis. For varus angle measurements, the dorsal plane was defined by a femoral retrocondylar axis. Independence positioning was tested by comparison of angle measurement results in repeated scans of 13 femur bones in different parallel and two double oblique (15/45°) positions in the gantry. Femoralvarus (or valgus), neck version (torsion), and inclination angles were measured, each in two variations. Results Resulting mean differences ranged between -0.9° and 1.3° for all six determined types of angles and in a difference of <1° for 17 out of 18 comparisons by subtraction of the mean angles between different positions, with one outlier of 1.3°. Intra- and inter-observer agreements determined by repeated measurements resulted in coefficients of variation for repeated measurements between 0.2 and 13.5%. Discussion The introduction of a bone-centered 3D coordinate system and mathematical definition of projection planes enabled 3D CT measurements of canine femoral varus and neck version and inclination angles. Agreement between angular measurements results of bones scanned in different positions on the CT table demonstrated that the technique is independent of femoral positioning.
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Affiliation(s)
- Andreas Brühschwein
- Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, Centre of Veterinary Clinical Medicine, Ludwig-Maximilians-Universität München Munich, Munich, Germany,*Correspondence: Andreas Brühschwein
| | - Bronson Schmitz
- Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, Centre of Veterinary Clinical Medicine, Ludwig-Maximilians-Universität München Munich, Munich, Germany
| | - Martin Zöllner
- Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, Centre of Veterinary Clinical Medicine, Ludwig-Maximilians-Universität München Munich, Munich, Germany
| | - Sven Reese
- Department of Veterinary Sciences, Veterinary Faculty, Institute of Veterinary Anatomy, Histology and Embryology, Ludwig-Maximilians-Universität München Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Veterinary Faculty, Centre of Veterinary Clinical Medicine, Ludwig-Maximilians-Universität München Munich, Munich, Germany
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Vidoni B, Aghapour M, Kneissl S, Vezzoni A, Gumpenberger M, Hechinger H, Tichy A, Bockstahler B. Inter-Observer Agreement in Radiographic Diagnosis of Coxofemoral Joint Disease in a Closed Cohort of Four-Month-Old Rottweilers. Animals (Basel) 2022; 12:1269. [PMID: 35625115 PMCID: PMC9137964 DOI: 10.3390/ani12101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Canine hip dysplasia is a complex and multifactorial disease. The early diagnosis of dysplastic dogs under one year of age helps veterinarians to plan proper preventive/therapeutic methods. Having an accurate screening method increases the chance of the early detection of dysplasia. The goal of our study was to assess the inter-observer reliability of eight radiographic parameters in four-month-old Rottweilers. Radiographs of the 28 Rottweilers were investigated by five experienced observers. The radiographs were taken in ventrodorsal view with extended legs, frog-leg ventrodorsal view, distraction view, and dorsal acetabular rim view. Four quantitative parameters such as Norberg angle (NA), distraction index (DI), dorsal acetabular rim slope (DARS), and center edge angle (CEA) and four qualitative parameters such as sclerosis of the cranial acetabular rim (SCAR), location of the center of the femoral head (LCFH), grading of the degenerative joint disease (GDJD), and grading of the dorsal acetabular rim (GDAR) were evaluated. High inter-observer agreements were recorded for quantitative values, whereas the inter-observer agreement of the qualitative parameters was low. It can be deduced that the evaluated quantitative parameters are reliable, and a combination of these methods with clinical examinations might increase the accuracy of the examinations.
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Affiliation(s)
- Britta Vidoni
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Masoud Aghapour
- Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Sibylle Kneissl
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Aldo Vezzoni
- Clinica Veterinaria Vezzoni S.R.L., 26100 Cremona, Italy;
| | - Michaela Gumpenberger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Harald Hechinger
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria; (S.K.); (M.G.); (H.H.)
| | - Alexander Tichy
- Platform Bioinformatics and Biostatistics, Department for Biomedical Services, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Barbara Bockstahler
- Section of Physical Therapy, Small Animal Surgery, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria;
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11
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Inter- and Intra-Observer Variations in Radiographic Evaluation of Pelvic Limbs in Yorkshire Terriers with Cranial Cruciate Ligament Rupture and Patellar Luxation. Vet Sci 2022; 9:vetsci9040179. [PMID: 35448677 PMCID: PMC9024879 DOI: 10.3390/vetsci9040179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
The main aims of the study were to describe bone alignment differences in Yorkshire Terriers (YT) with cranial cruciate ligament rupture (CCLR), patellar luxation (PL), or with a combination of both (CCLR + PL); to verify the theory of increased strain on cranial cruciate ligament (CrCL) due to PL as a predisposing factor; and to evaluate intra- and inter-observer variability of the protocols developed for measurement of femoral and tibial alignment in Yorkshire Terriers. Fifty-five hindlimbs of YT were divided into four groups: Control, CCLR, PL, and CCLR + PL. Thirty parameters were radiographically evaluated including hip joint, femoral, tibial, and intercondylar fossa (ICF) parameters. Three observers evaluated all parameters on two separate occasions with a twelve-week interval between measurements. Significant differences in conjunction with CCLR and PL theories between groups were noticed in: Norberg angle (NA), quadriceps angle (Qa), anatomic lateral distal femoral angle (aLDFA), femoral varus (FVA), mechanical cranial proximal tibial angle (mCrPTA), mechanical caudal proximal tibial angle (mCdPTA), tibial plateau angle (TPA), distal tibial axis/proximal tibial axis angle (DPA). Some interesting findings are the similarity of values between Control and CCLR vs. CCLR + PL and PL groups in Na, Qa, aLDFA; between CCLR + PL and PL in FVA and a significantly lower age of dogs in CCLR + PL compared to CCLR group. Based on our results, we can conclude that YT with different clinical findings have differing bone morphology. Moreover, these findings may support PL as a predisposing factor for CCLR in small breeds. Measurements in which excellent inter- observer agreement was achieved may be used for surgical planning or for further discussions.
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Garnoeva RS, Paskalev MD. Post-operative radiographic measures of pelvic limb alignment in dogs with medial patellar luxation after trochlear wedge recession versus trochlear block recession surgery. Vet World 2021; 14:1504-1510. [PMID: 34316198 PMCID: PMC8304435 DOI: 10.14202/vetworld.2021.1504-1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Aim: Anatomical and mechanical femoral angles are quite different among dog breeds. Most published data are about large dog breeds, however, medial luxation of patella is more common in small breeds. Measures of pelvic limb alignment are important for outcome of patellar luxation surgery. Therefore, the aim of the present study was to compare the values of anatomical and mechanical femoral and tibial angles in dogs before, immediately after, and 1 month after surgery for correction of medial patellar luxation (MPL). Materials and Methods: The study was conducted with 54 dogs (67 stifle joints) from four small breeds that underwent surgery by either trochlear block recession (36 stifle joints) or trochlear wedge recession (31 stifle joints) techniques. Results: In both trochleoplasty techniques, statistically significant differences in the values of the anatomical medial proximal femoral angle (aMPFA), anatomical lateral distal femoral angle (aLDFA), and femoral varus angle (in MPL Grade II) and of aMPFA and Q-angle (in MPL Grade III) were found out. Conclusion: After block recession surgery, more angles were positively influenced and this effect was more pronounced in patients with MPL Grade II.
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Affiliation(s)
- Radka Stayova Garnoeva
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, 6000 Stara Zagora, Bulgaria
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13
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Park KM, Marcellin-Little DJ, Garcia TC. Evaluation of computer-aided design software methods for assessment of the three-dimensional geometry of the canine radius. Am J Vet Res 2021; 82:435-448. [PMID: 34032484 DOI: 10.2460/ajvr.82.6.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe methods to measure the 3-D orientation of the proximal, diaphyseal, and distal segments of the canine radius by use of computer-aided design software (CADS) and to compare the repeatability and reliability of measurements derived by those methods. SAMPLE 31 canine radii with biapical deformities and 24 clinically normal (control) canine radii. PROCEDURES Select CT scans of radii were imported into a CADS program. Cartesian coordinate systems for the humerus and proximal, diaphyseal, and distal radial segments were developed. The orientation of each radial segment in the frontal, sagittal, and transverse planes was measured in triplicate by 3 methods. The repeatability and reliability of those measurements were calculated and compared among the 3 measurement methods. RESULTS The mean ± SD within-subject repeatability of radial angular measurements for all 3 methods was 1.40 ± 0.67° in the frontal plane, 3.17 ± 2.21° in the sagittal plane, and 3.01 ± 1.11° in the transverse plane for control radii and 2.56 ± 1.95° in the frontal plane, 3.59 ± 2.39° in the sagittal plane, and 3.47 ± 1.19° in the transverse plane for abnormal radii. Mean ± SD bias between radial measurement methods was 1.88 ± 2.07° in the frontal plane, 6.44 ± 6.80° in the sagittal plane, and 2.27 ± 2.81° in the transverse plane. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that use of CADS to assess the 3-D orientation of the proximal, diaphyseal, and distal segments of normal and abnormal canine radii yielded highly repeatable and reliable measurements.
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14
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Lehmann SV, Andrada E, Taszus R, Koch D, Fischer MS. Three-dimensional motion of the patella in French bulldogs with and without medial patellar luxation. BMC Vet Res 2021; 17:76. [PMID: 33579272 PMCID: PMC7881552 DOI: 10.1186/s12917-021-02787-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background French bulldogs exhibit significantly larger femoral external rotation and abduction than other breeds. We were curious as to whether this peculiar leg kinematic affects patellar motion and/or might induce medial patellar subluxation (MPSL) or medial patellar permanent luxation (MPPL). We hypothesized that the more abducted leg posture during stance causes an unusual medial pull direction of the rectus femoris muscle during stance, and that this may facilitate the occurrence of MPSL or even MPPL during locomotion. To test our hypothesis, we analyzed existing stifle-joint X-ray-sequences collected during the treadmill walk and trot of seven adult female French bulldogs. We estimated 3D-patellar kinematics using Scientific Rotoscoping. Results The three-dimensional motion of the patella comprises rotations and translations. From the seven dogs analyzed, three exhibited MPSL and one MPPL during the gait cycle. Medial patellar luxation (MPL) occurred mostly around toe-off in both gaits studied. Patellar position was generally not gait-related at the analyzed timepoints. In dogs with MPL, the patella was placed significantly more distally (p = 0.037) at touch-down (TD) and at midswing (p = 0.024), and significantly more medial at midswing (p = 0.045) compared to dogs without MPL. Conclusions Medial patellar luxation seems to be the consequence of the far from parasagittal position of the stifle joint during stance due to a broad trunk, and a wide pelvis. This peculiar leg orientation leads to a medial sideway pull caused by the rectus femoris muscle and the quadriceps femoris and may initiate plastic deformation of the growing femur and tibia. Thus, a way to avoid MPL could be to control breeding by selecting dogs with lean bodies and narrow pelvis. Actual breeding control programs based on the orthopedic examination are susceptible to errors. Systematic errors arise from the fact that the grading system is highly dependent on the dog’s condition and the veterinarians’ ability to perform the palpation on the stifle. Based on our results, the position of the patella at TD, or even perhaps during stand might offer a possibility of an objective radioscopic diagnostic of the MPL. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-02787-z.
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Affiliation(s)
- Silvia V Lehmann
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany.
| | - Emanuel Andrada
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Roxana Taszus
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Daniel Koch
- Daniel Koch Kleintierchirurgie AG, Diessenhofen, Switzerland
| | - Martin S Fischer
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
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15
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Palumbo Piccionello A, Salvaggio A, Volta A, Emiliozzi F, Botto R, Dini F, Petazzoni M. Good Inter- and Intra-Observer Reliability for Assessment of Radiographic Femoral and Tibial Frontal and Sagittal Planes Joints Angles in Normal Cats. Vet Comp Orthop Traumatol 2020; 33:308-315. [PMID: 32408358 DOI: 10.1055/s-0040-1709694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the inter- and intra-observer reliability of plain digital radiographs for assessing normal feline femoral and tibial joint reference angles in the sagittal and frontal planes. STUDY DESIGN This was a cadaveric radiographic anatomical study. that involved 20 short-haired domestic adult cats. MATERIALS AND METHODS Sagittal and frontal plane tibial and femoral joint angles of 40 limbs were measured twice by three observers with different levels of experience. Inter- and intraobserver reliability was determined by the intra-class correlation coefficient (ICC). An ICC > 0.75 was considered high correlation, 0.74 > ICC > 0.60 good correlation, 0.59 > ICC > 0.4 fair correlation and an ICC < 0.40 poor correlation. RESULTS Mean ± standard deviation angles were anatomic lateral proximal femoral angle (aLPFA) 110.6 ± 3.6; anatomic lateral distal femoral angle (aLDFA) 91.9 ± 2.1; mechanical lateral proximal femoral angle; mLPFA (mLPFA) 107.3 ± 3.6; mechanical lateral distal femoral angle (mLDFA) 95.5 ± 1.7; femoral neck anteversion (FNA) 121.9 ± 4.1; anatomical caudal proximal femoral angle (aCPFA) 156.1 ± 3.9; anatomical caudal distal femoral angle (aCDFA) 101.4 ± 1.4; mechanical medial proximal tibial angle (mMPTA) 93.5 ± 1.2; mechanical medial distal tibial angle (mMDTA) 100.5 ± 2.3; mechanical cranial proximal tibial angle (mCrPTA) 113.1 ± 3.2; tibial plateau angle (TPA) 23.1 ± 3.2; mechanical cranial proximal tibial angle (mCrDTA) 86.7 ± 3.1.The intra-observer ICC indicated high correlation for 70% or more of the measurements. The inter-observer agreement among observers was high. These results show that the radiographic method for measuring femoral and tibial joint angles was good or high, except for FNA and mCrDTA. CONCLUSIONS This study provides some radiographic anatomical and mechanical joint angles of the femurs and tibias of normal domestic short-haired cats. We found good reliability for both intra- and interobserver measurements.
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Affiliation(s)
| | - Alberto Salvaggio
- Clinica Veterinaria San Silvestro, VetSanSilvestro s.r.l, Castiglion Fiorentino (AR), Italy
| | - Antonella Volta
- Dipartimento di Scienze Medico-Veterinarie, Università di Parma, Parma (PR), Italy
| | - Fabiola Emiliozzi
- Scuola di Bioscienze e Medicina Veterinaria, Università degli Studi di Camerino, Matelica, Italy
| | - Riccardo Botto
- Scuola di Bioscienze e Medicina Veterinaria, Università degli Studi di Camerino, Matelica, Italy
| | - Fabrizio Dini
- Scuola di Bioscienze e Medicina Veterinaria, Università degli Studi di Camerino, Matelica, Italy
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