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Wong N, Yu J, McCracken BD. Novel prosthetic ligament repair of a shoulder luxation in a cat using a bone anchor and ligament prosthesis. JFMS Open Rep 2023; 9:20551169231180724. [PMID: 37529231 PMCID: PMC10387692 DOI: 10.1177/20551169231180724] [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] [Indexed: 08/03/2023] Open
Abstract
Case summary A 7-year-old male castrated Ragdoll cat was presented for chronic shoulder instability after a previous medial luxation of the right shoulder. Upon examination, there was palpable instability of the glenohumeral joint and an increased abduction angle. Surgical stabilisation was elected due to lameness and instability after closed reduction, rest and medical management. A low-profile bone-anchor and a ligament prosthesis were used to stabilise the glenohumeral joint with minimal disruption to the cat's natural shoulder stabilisers. Clinical signs resolved after surgery and the cat remained non-symptomatic at the 12-month follow-up. Relevance and novel information Feline shoulder luxation is rarely described in the veterinary literature. To the authors' knowledge, this is the first report describing stabilisation of the glenohumeral joint in a cat using a bone anchor and a ligament prosthesis.
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Affiliation(s)
- Nadia Wong
- McIvor Road Veterinary Centre, Bendigo, VIC, Australia
| | - Jane Yu
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
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Piras LA, Olimpo M, Lafuente P, Tomba A, Del Magno S, Lardone E, Peirone B, Mancusi D. Surgical Treatment of Nonmineralized Supraspinatus Tendinopathy in Dogs: A Retrospective Long-Term Follow-Up. Animals (Basel) 2023; 13:ani13040592. [PMID: 36830379 PMCID: PMC9951642 DOI: 10.3390/ani13040592] [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: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023] Open
Abstract
(1) Background: two forms of supraspinatus tendinopathy (ST) have been reported in dogs: mineralized and non-mineralized. Surgical treatment consists of longitudinal incisions (splitting) in the tendon of insertion of the supraspinatus muscle. The purpose of this retrospective study is to describe the diagnostic workout, the surgical procedure and the short and long term follow up of dogs treated for non-mineralized ST. (2) Methods: medical records (2010-2017) of dogs diagnosed with non-mineralized ST that underwent surgical treatment were reviewed. Data retrieved were: signalment, history, clinical signs, orthopaedic examination findings, diagnostic imaging findings, surgical treatment, histopathologic diagnosis and clinical outcome. (3) Results: A total of 27 dogs met the inclusion criteria. The most consistent clinical findings were intermittent lameness accompanied by pain on palpation of the insertion of the supraspinatus. Magnetic resonance imaging (MRI) of 27 shoulders distended sheaths of the biceps tendon (10/27), compression of the biceps brachii tendon sheaths (5/27) and enlargement of the supraspinatus tendon (3/27) were observed. The most prominent histologic finding was severe myxomatous degeneration in all 27 samples. Resolution of lameness was achieved in 80% of the cases surgically treated without any further lameness episodes in the long-term follow-up. (4) Conclusions: the surgical splitting of the non-mineralized supraspinatus tendon is an effective procedure with no intra-operative complications and a low incidence of minor (18%) and major (4%) complications.
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Affiliation(s)
- Lisa Adele Piras
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy
- Correspondence:
| | - Matteo Olimpo
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy
| | - Pilar Lafuente
- Facultad de Salud, Universidad International de La Rioja (UNIR), 26006 Logroño, Spain
| | - Anna Tomba
- Norad Diagnostica, 21017 Samarate, Italy
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Elena Lardone
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy
| | - Bruno Peirone
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy
| | - Davide Mancusi
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy
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Llido M, Livet V, Carozzo C, Viguier É, Cachon T. Treatment of Medial Shoulder Joint Instability by Stabilization with an Arthroscopically Guided Prosthetic Ligament: A Cadaveric Feasibility Study in Dogs. Vet Comp Orthop Traumatol 2023; 36:1-9. [PMID: 35253123 DOI: 10.1055/s-0042-1744174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of this study was to assess the feasibility and efficiency of an arthroscopically guided ligamentoplasty of the medial glenohumeral ligament to treat medial shoulder joint instability. STUDY DESIGN Six Beagle cadavers were used (12 limbs). Both arms of the medial glenohumeral ligament were severed using arthroscopic guidance. Arthroscopically guided reconstruction of the ligament was performed. Threaded sutures were fixed with a bone anchor on the medial aspect of the glenoidal cavity of the scapula, passed through a humeral tunnel and finally tensioned with a suture button on lateral aspect of the humerus. Shoulder abduction angles were measured before and after the section of the medial glenohumeral ligament, and following the surgery. Two orthogonal radiographic projections and dissections were performed after each procedure to grade the placement of the implants. RESULTS Surgical repairs were achieved in 10 out of 12 limbs. The abduction angles after repair with ligamentoplasty were not significantly different from the abduction angles measured before the section of the medial glenohumeral ligament. CONCLUSION Arthroscopically guided ligamentoplasty with a scapular bone anchor and a humeral drilling tunnel is feasible in cadavers, and efficient to restore acutely shoulder abduction angle in a minimally invasive manner. Further clinical studies are required to assess in vivo results.
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Affiliation(s)
- Marie Llido
- Small Animal Surgery Department, School of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Québec, Canada
| | | | - Claude Carozzo
- Small Animal Surgery Department, Lyon University, VetAgro Sup, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2016-A104, Lyon University, VetAgro Sup, Marcy l'Etoile, France
| | - Éric Viguier
- Small Animal Surgery Department, Lyon University, VetAgro Sup, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2016-A104, Lyon University, VetAgro Sup, Marcy l'Etoile, France
| | - Thibaut Cachon
- Small Animal Surgery Department, Lyon University, VetAgro Sup, Marcy l'Etoile, France.,Research Unit ICE, UPSP 2016-A104, Lyon University, VetAgro Sup, Marcy l'Etoile, France
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Griffin H, Guerin V. Novel technique using bone tunnels and ligament prostheses to treat a craniolateral shoulder luxation in a dog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Henry Griffin
- Davies Veterinary Specialist Higham Gobion UK
- Royal (Dick) School for Veterinary Studies Roslin UK
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Hammer M, Grand JG. Inverted V-shaped extracapsular stabilisation technique and arthroscopic findings in six dogs with medial shoulder instability. J Small Anim Pract 2021; 62:795-804. [PMID: 34041760 DOI: 10.1111/jsap.13347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/28/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this case series was to report arthroscopic findings and to evaluate clinical outcomes of dogs treated with an inverted V-shaped extracapsular stabilisation technique without additional external coaptation for medial shoulder instability. MATERIAL AND METHODS Medical records of dogs with medial shoulder instability that underwent arthroscopy and an inverted V-shaped extracapsular stabilisation technique were retrospectively reviewed. Extracapsular stabilisation was performed in all dogs using screws and spiked washers as anchor points for the coated polyester prosthetic ligament. No additional external coaptation was used in any dog. A minimum 18-month follow-up period was required for study inclusion. Complications and long-term outcomes were recorded. RESULTS The subscapularis tendon and medial glenohumeral ligament were the structures most commonly affected. All dogs had pathological cartilage fibrillations. Implants were successfully placed in all dogs. Implant loosening was recorded in two out of six dogs on recheck but no revision surgery was performed. Function at the time of last clinical follow-up (median, 28 months, range 18 to 33 months) was full in four out of six and acceptable in two out of six dogs. CLINICAL SIGNIFICANCE Surgical treatment of medial shoulder instability using the novel inverted V-shaped extracapsular stabilisation technique was successful. Potential complications such as implant loosening may occur. Despite the limited number of cases, the present study suggests that additional postoperative external coaptation may not be necessary for successful management of dogs with medial shoulder instability.
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Affiliation(s)
- M Hammer
- Department for Small Animal Surgery, Clinique Vétérinaire Aquivetet, Eysines, 33320, France
| | - J G Grand
- Department for Small Animal Surgery, Clinique Vétérinaire Aquivetet, Eysines, 33320, France
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Abstract
The shoulder is a complex joint composed mostly of static and dynamic capsuloligamentous structures and plays an important role in forelimb lameness. Its complex anatomy and biomechanics necessitate thorough examination and diagnostic work-up for accurate diagnosis. This article provides an updated review of common canine shoulder pathologies, including osteochondrosis, bicipital and supraspinatus tendinopathies, infraspinatus contracture, medial shoulder syndrome, and luxation.
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Affiliation(s)
- Rebecca Stokes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Iowa State University, Vet Med, 1800 Christensen Drive, Ames, IA 50011, USA
| | - David Dycus
- Department of Orthopedic Surgery, Nexus Veterinary Bone & Joint Center, Baltimore, MD 21224, USA.
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Barber LN, Lewis DD, Porter EG, Elam LH. Long-term outcome following cranial biceps brachii tendon transposition in a dog with a traumatic cranial scapulohumeral luxation. Open Vet J 2020; 10:400-406. [PMID: 33614435 PMCID: PMC7830182 DOI: 10.4314/ovj.v10i4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Cranial luxation of the scapulohumeral has been rarely reported in dogs and there is limited information available regarding surgical management of this condition, particularly with respect to long-term functional outcomes. Case Description: This report describes the successful resolution of a chronic traumatic cranial scapulohumeral joint luxation in a dog that was stabilized by cranial transposition of the biceps brachii tendon of origin. At surgery, an osteotomy of the greater tubercle was performed and a trough was made in the exposed bed of the osteotomy. The transverse humeral ligament was incised, and the bicipital tendon was levered into the trough and secured in that location by reattachment of the greater tubercle using multiple Kirschner wires and a figure-of-eight tension band wire. Postoperatively, the dog was maintained in a Spica splint for 2 weeks. Although surgical reduction was performed 4 months after the original injury, the luxation did not recur and the dog did not have appreciable lameness 14 months following the surgery. Conclusion: Although cranial transposition of the bicipital tendon is an invasive procedure, this dog’s scapulohumeral luxation did not recur and the procedure yielded an excellent long-term functional outcome.
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Affiliation(s)
| | - Daniel D Lewis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Erin G Porter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Lindsay H Elam
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Pinna S, Lanzi F, Tassani C, Mian G. Intra-articular replacement of a ruptured cranial cruciate ligament using the Mini-TightRope in the dog: a preliminary study. J Vet Sci 2020; 21:e53. [PMID: 33016013 PMCID: PMC7533390 DOI: 10.4142/jvs.2020.21.e53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/12/2020] [Accepted: 04/09/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The TightRope System is a device developed to provide extracapsular stabilization of the cranial cruciate ligament (CCL) rupture in canine stifles. I was then also employed for the extra-articular treatment of shoulder instability and for the intra-articular treatment of hip luxation in dogs and cats. OBJECTIVES To evaluate the feasibility of the Mini-TightRope (mTR) System for the intra-articular treatment of CCL rupture in small breed dogs. METHODS A cadaveric canine model was used to record the steps of the surgical procedure. Five client owned dogs weighing from 8 to 10 kg and from 2 to 12 years of age were enrolled in the prospective study in which the mTR device was implanted in the stifle joint to replace the ruptured CCL. The dogs were graded using the Bologna Healing Stifle Injury Index (BHSII) and radiographic osteoarthritis (OA) scores. RESULTS The outcomes obtained at the time of the surgery (T0) and for the following 12 months (T12) showed an improvement in the functional parameters (BHSII from a median of 74.3 [range, 58.1-82.4] at T0 to 95.6 [range, 94.1-99.3] at T12]). The OA did not change in 3 dogs and increased by only 1 point in 2 dogs. CONCLUSIONS In this preliminary study, the mTR was a successful and repeatable intra-articular surgical procedure for all dogs. Additional studies related to the clinical application of the technique in medium-large dogs should be encouraged.
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Affiliation(s)
- Stefania Pinna
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064, Ozzano E., Bologna, Italy.
| | - Francesco Lanzi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064, Ozzano E., Bologna, Italy
| | - Chiara Tassani
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064, Ozzano E., Bologna, Italy
| | - Giacomo Mian
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064, Ozzano E., Bologna, Italy
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Abstract
Physical therapy and rehabilitation following orthopaedic surgery in companion animals have become more common and new advancements in this field have been made in recent years. Surgery alone may not return the animal to its previous physical activity or work-related tasks, whether due to concurrent soft tissue trauma, arthrogenic muscle inhibition or osteoarthritis. Rehabilitation therapies following surgery can restore function as well as strength, coordination and balance. Many simple techniques such as cryotherapy and passive range of motion exercises have been shown to improve outcomes following musculoskeletal procedures and may help restore function as well as reduce pain and facilitate healing. Some techniques are more useful during different stages in order to achieve optimum tissue healing and recovery of function. During the first 72 hours, rehabilitation should focus on reduction of inflammation and pain, maintaining joint nutrition and range of motion, and stimulating vascularisation and healing; and may include cryotherapy, passive range of motion exercises, massage and therapeutic exercises. Following the initial recovery period, the goals of rehabilitation also include restoring strength, balance and normal gait patterns, as well as recovery of function. During this period the focus of therapy may shift toward therapeutic exercises, aquatic therapy and increasing activity in the animal. Therapeutic modalities such as neuromuscular electrical stimulation, photobiomodulation (laser therapy), therapeutic ultrasound and extracorporeal shock wave therapy have been reported to reduce pain and inflammation, enhance healing and reduce recovery time in the early and late stages following orthopaedic surgery.
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Affiliation(s)
- W I Baltzer
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Penelas A, Gutbrod A, Kühn K, Pozzi A. Feasibility and safety of arthroscopic medial glenohumeral ligament and subscapularis tendon repair with knotless anchors: A cadaveric study in dogs. Vet Surg 2018; 47:817-826. [PMID: 30091179 DOI: 10.1111/vsu.12929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/17/2018] [Accepted: 05/29/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To test the feasibility and safety of an arthroscopic imbrication of the medial glenohumeral ligament (MGHL) and the subscapularis tendon with knotless anchors in dogs. STUDY DESIGN Cadaveric study. SAMPLE POPULATION Ten limbs. METHODS Cranial and caudal arms of the MGHL were imbricated with a 2.9- or a 2.4-mm knotless anchor. A horizontal mattress suture secured with a 3.5-mm knotless anchor was used to imbricate the subscapularis tendon. Computed tomography measurements included (1) the bone stock around the anchors, (2) the angle between the anchor and the joint surface (insertion angle), and (3) the angle formed by lines tangent to the cortices of the bones (safety angle). Limbs were dissected to assess the position of anchors. Safety and insertion angles and bone stock were compared among anchors with a Kruskal-Wallis test (P < .05). RESULTS Surgical repairs were achieved in all limbs, with only 2 of 30 anchors incorrectly placed, both in the glenoid. The safety angle of the humeral anchor (HA; median, 89°) was greater than that of the cranial glenoid anchor (CrGA; P = .0017) and the caudal glenoid anchor (CdGA; P < .001). The insertion angle of the HA (median, 68°) was also greater than that of the other anchors (P < .001 and P = .001). The insertion angle of the CrGA (median, 26°) was greater (P = .0191) than that of the CdGA (median, 7°). All anchors were inserted at the MGHL and subscapularis footprint. CONCLUSION Arthroscopic imbrication of MGHL and subscapularis tendon was feasible. HA were safer to place than glenoid anchors. CLINICAL SIGNIFICANCE The results of this feasibility study justify further evaluation of the indications and outcomes of this technique in dogs with shoulder instability.
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Affiliation(s)
- Alexandra Penelas
- Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Andreas Gutbrod
- Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Karolin Kühn
- Clinic for Diagnostic Imaging, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Antonio Pozzi
- Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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