Inter-rater reliability in performing stifle goniometry in normal and cranial cruciate ligament disease affected dogs: a prospective randomized controlled study

BACKGROUND

Goniometry can be performed clinically in dogs with cranial cruciate ligament disease (CCLD). The purpose of this study was (1) to compare reliability of stifle goniometry in dogs with CCLD and healthy dogs and (2) to investigate the effect of compliance on measurements. Dogs presented for surgical intervention for CCLD (CCL-Dogs; n = 15) and orthopedically healthy dogs (C-Dogs; n = 11) were enrolled in this prospective randomized controlled trial. In each dog, three observers randomly measured maximum stifle flexion (mSF) and maximum stifle extension (mSE) three times with a standard goniometer with the scale covered, while dog compliance was scored (Scores: C0: excellent - C4: poor). Intraclass correlation coefficient (ICC) was calculated for intra-/interobserver reliability. Effects on measurements were evaluated with mixed-effect models (MEM).

RESULTS

Maximum stifle extension and mSE-compliance were significantly decreased in CCL-Dogs compared to C-Dogs (p ≤ 0.004), but mSF and mSF-compliance did not differ between groups. Intraobserver reliability was excellent for all dogs during mSE (ICC:0.75-0.99) and mSF (ICC:0.89-0.99). Interobserver reliability was excellent for mSF in both groups (ICC: C-Dogs:0.84, CCL-Dogs:0.9) and for mSE in CCL-Dogs (ICC:0.94) but only fair for mSE in C-Dogs (ICC:0.58). Robust MEM showed that the combined average of all mSE measurements of all three observers was affected by compliance in both groups (p < 0.001). This effect was not observed for single mSE-measurements by themselves.

CONCLUSION

The results of this study indicate that compliance may affect goniometric stifle extension measurements in healthy and CCLD dogs. In a clinical setting, intra-/interobserver reliability was excellent for all measurements except for maximum stifle extension in healthy dogs.

Comparison of goniometric measurements of the stifle joint in seven breeds of normal dogs

Objective: To compare the goniometric measurements of the stifle joint in seven dog breeds, and to determine the relationship among goniometric measurements, age, body weight, tibial plateau angle, crus and thigh circumferences, and widths of quadriceps, hamstring, and gastrocnemius muscles in healthy dogs.

Methods: We used a total of 126 dogs from seven different breeds, and recorded the angle of the stifle joint at standing, extension, and flexion together with the range of motion (ROM). The circumferences of the thigh and crus were also measured. Medio -lateral radiographic projections of the tibia and the femur were obtained from the dogs, and the tibial plateau angles, as well as the widths of quadriceps, hamstring, and gas -trocnemius muscles, were measured from these images.

Results: Neither the sex of the dog nor the differences in the side measured affected the goniometric measurements of the stifle joint. The standing, extension, flexion, and ROM angles were different among the breeds. The standard deviations of the standing and extension angles were small relative to their means, but the standard deviations of the flexion angle were large relative to their means in all breeds. Body weight and muscular measurements were the most influential factors on the stifle flexion angle and ROM.

Clinical significance: Breed differences, body weights, and muscle mass should be taken into consideration during assessment of the stifle function using goniometric measurements.

Validity and repeatability of goniometry in normal horses

PURPOSE

To assess validity and inter- and intra-tester reliability of equine goniometry and to establish values for carpal, metacarpophalangeal, tarsal, and metatarsophalangeal flexion and extension in horses.

SUBJECTS

Seventeen healthy equine subjects of varied breeds were used.

METHODS

Three investigators blindly and independently measured in triplicate the extension and flexion of carpal, metacarpophalangeal, tarsal, and metatarsophalangeal joints of 17 horses after sedation. Radiographs of these joints in flexion and extension were acquired while under sedation. Goniometric and radiographic measurements were compared statistically and were correlated. A Bland-Altman plot was constructed. Inter- and intra-tester repeatability of goniometry were evaluated by calculating intraclass correlation coefficients (ICC). Mean flexion and extension of carpal, metacarpophalangeal, tarsal, and metatarsophalangeal joints were calculated.

RESULTS

Goniometric and radiographic measurements did not differ statistically and were significantly correlated (correlation coefficients ranged from 0.59 - 0.89). The mean difference between goniometric and radiographic measurements was 0.4°. Triplicate measurements collected by the three raters did not differ significantly within raters (ICC ranging from 0.950 - 0.995) and between raters (ICC ranging from 0.942 - 0.989).

CONCLUSION

Goniometry is a valid and repeatable tool for evaluation of the range of motion of carpal, metacarpophalangeal, tarsal, and metatarsophalangeal joints in standing, sedated healthy horses.

Diagnosis and Surgical Management of Congenital Laxity of the Fibularis Musculotendinous Unit Resulting in Hyperextension of the Tarsus in 14 Calves

OBJECTIVE

To describe the diagnosis and surgical management of congenital laxity of the fibularis tendon resulting in hyperextension of the tarsus in calves.

STUDY DESIGN

Case series.

ANIMALS

Fourteen calves (3 unilateral, 11 bilateral) diagnosed with congenital tarsal instability caused by laxity of the fibularis musculotendinous unit resulting in hyperextension of the tarsus.

METHODS

Diagnosis was made by clinical and radiologic assessments. The tarsus was surgically prepared and an incision made on the dorsal surface of the tarsus after intrathecal anesthesia with the calf sedated. A locking-loop suture (4 loops) was applied to the fibularis tendon using polyglactin 910. The free ends of the suture were then tied to the shank of a cortical bone screw inserted in the proximal metatarsus.

RESULTS

The calves were evaluated on postoperative days 15, 30, and 60 and were walking normally.

CONCLUSION

Congenital tarsal instability because of laxity of the fibularis musculotendoninous unit is described and surgical treatment directed at shortening the tendon shows promising results.

Prevalence and effect of oxytetracycline on congenital fetlock knuckling in neonatal dairy calves

Musculoskeletal system deformities were observed in 24 (34.3%) of 70 neonatal dairy calves that presented with different congenital abnormalities. Among them, 19 calves (27.1%), the majority of which were crossbred Jersey calves of either gender with mean (± s.e.) body weight 22.00 kg ± 1.17 kg and aged 7.11 ± 1.16 days, were presented for treatment of congenital knuckling. Five of the knuckling calves had additional concurrent congenital conditions and were excluded from the present study. All of the remaining 14 calves showing moderate, bilateral fetlock knuckling had a wooden or polyvinyl chloride (PVC) splint applied to the palmar or plantar aspect of the affected limbs. All of the animals received a dose of the analgesic tolfenamic acid intramuscularly, and were randomly allocated to two equal groups. Calves of Group I additionally received oxytetracycline (20 mg/kg intravenous daily for 3 days). The condition resolved satisfactorily in 83.3% and 80.0% calves from the two groups, respectively. The left and right fetlock angle (mean ± SE) reduced significantly (p ≤ 0.01) from 50.57° ± 4.20° to 4.00° ± 2.27° and 48.71° ± 2.37° to 5.33° ± 3.03°, respectively in animals of Group I. In Group II calves, the angles showed reduction from 50.86° ± 2.94° to 4.20° ± 2.75° and from 48.71° ± 3.14° to 6.80° ± 3.34°, respectively. From the present study, it was concluded that bilateral moderate fetlock knuckling in the neonatal dairy calves can be managed satisfactorily with early application of splints. Supplementary use of oxytetracycline at repeated doses of low toxicity had only a marginally beneficial effect.