Autologous point-of-care stromal vascular fraction transplantation in dogs with advanced osteoarthritis of the knee and hip joints

OBJECTIVE

The aim of the study was to assess lameness in dogs with advanced osteoarthritis of the hip and knee joints after a single autologous point-of-care transplantation of the Stromal Vascular Fraction (SVF) into the affected joint.

MATERIALS AND METHODS

During a minilaparotomy, 10 g of falciform fat was removed from each patient for each joint to be treated. A modern and time-saving procedure (ARC TM System, InGeneron GmbH, Houston, USA) was used for the in-house preparation of the SVF, so that the isolated cells could be applied to the respective joint within 2 h after fat removal. In total, five knee joints of five patients and seven hip joints of four patients were treated.

RESULTS

Improvement in lameness according to owner questionnaires was seen in 3 of 5 patients with knee joint arthritis and 2 of 4 patients with hip joint arthritis. Based on gait analysis, only one dog with gonarthrosis and one dog with coxarthrosis showed improvement up to a maximum of 3 months after surgery.

CONCLUSION

This is the first case series on the treatment of osteoarthrosis of the knee or hip joint using point-of-care transplantation of the SVF. In individual cases, this method may represent a therapeutic approach for the treatment in dogs with advanced cox- or gonarthrosis, although only a short-term effect can be expected, which calls into question the effort and costs involved.

Growing Beagles and Foxhound-Boxer-Ingelheim Labrador Retriever mixed breeds show a forelimb-dominated gait and a cranial shift in weight support over time during a kinetic gait analysis

OBJECTIVE

To collect kinetic gait reference data of dogs of 2 breeds in their growth period during walking and trotting gait, to describe their development, and to investigate the weight support pattern over time.

ANIMALS

8 Foxhound-Boxer-Ingelheim Labrador Retriever mixed breeds and 4 Beagles.

PROCEDURES

Ground reaction force variables (GRFs), peak vertical force and vertical impulse, and temporal variables (TVs) derived therefrom; time of occurrence; and stance times were collected. Body weight distribution (BWD) was evaluated. Six measurements, each containing 1 trial in walking and 1 trial in trotting gait, were taken at age 10, 17, 26, 34, 52, and 78 weeks. The study period started July 17, 2013 and lasted until October 7, 2015. Area under the curve with respect to increase was applied. The difference of area under the curve with respect to increase values between breeds and gaits was analyzed using either the t test or the Mann-Whitney test. Generalized mixed linear models were applied.

RESULTS

Significant differences in gait and breed comparisons were found. Growing dogs showed a forelimb-dominated gait. The development of GRF and TV values over the study period were described.

CLINICAL RELEVANCE

Reference values for GRFs, TVs, and BWDs in growing dogs were given. A cranial shift in weight support over time was found during trotting gait. Smaller, younger dogs walked and trotted more inconsistently.

[Kinetic and kinematic gait analysis of the back movement in chondrodystrophic breeds following hemilaminectomy in comparison to a healthy control population]

OBJECTIVE

To collect kinetic and kinematic data on the back movement in healthy dogs in comparison to chondrodystrophic dogs following hemilaminectomy while walking and trotting.

MATERIAL AND METHODS

Gait analysis on the back movement was obtained from 19 healthy dogs and 21 chondrodystrophic dogs following hemilaminectomy procedure in consequence to disc herniation in the thoracic or lumbar region.

RESULTS

In transverse and sagittal planes the group of surgically treated dogs showed a higher range of motion (ROM) throughout the spine while walking and trotting. The difference in back movement depended on the region of the hemilaminectomy (thoracic, thoracolumbar, or lumbar). Operated dogs showed a significantly higher weight distribution towards their front limbs. When comparing the weight distribution among the hind limbs, there was a decreased Peak Vertical Force (PVF) and Vertical Impulse (VI) on the side corresponding to the hemilaminectomy.

CONCLUSIONS

Following hemilaminectomy, dogs displayed increased instability within their spine, which - depending on the region and side of the hemilaminectomy - affected the back movement in different ways. Weight bearing was generally shifted away from the hind limb of the affected side, and towards the front limbs.

CLINICAL RELEVANCE

Even though hemilaminectomy has an effect on the back movement of dogs, it seems not to have relevant influence of quality of life.

Reliability of range-of-motion measurements of healthy dogs examined while walking on a treadmill

OBJECTIVE

To determine the reliability of range-of-motion (ROM) measurements and describe physiologic differences in ROM or habituation effects during gait analysis of healthy dogs walking on a treadmill.

ANIMALS

11 orthopedically normal dogs.

PROCEDURES

ROM of appendicular joints was determined for each dog while walking on a treadmill on 3 consecutive examination days and once again 6 weeks later. Significant differences in ROM between examination days were determined and quantified. As a measure of reproducibility, the coefficient of variation for repeated measurements was calculated, as were the minimum differences necessary to distinguish between physiologic variation and true change in ROM.

RESULTS

Mean ROM of the shoulder, elbow, and carpal joints varied among examination days between 29.9° and 33.1°, 49.4° and 52.8°, and 7.7° and 88.1°, respectively. Mean associated minimum differences were 12.0°, 14.1°, and 35.6°. Mean ROM of the hip, knee, and tarsal joints varied between 32.9° and 35.8°, 33.7° and 36.8°, and 31.7° and 33.5°, respectively. Mean associated minimum differences were 16.2°, 14.0°, and 9.2°. Only ROM of the elbow joint was reproducible to a small degree. Few systematic effects were detected.

CONCLUSIONS AND CLINICAL RELEVANCE

Measurement of ROM in healthy dogs walking on a treadmill was shown to be diagnostically unreliable owing to high variation among examination days. However, random physiologic fluctuations could be distinguished from systematic effects, demonstrating the importance of reliably applicable threshold values for follow-up treadmill examinations. The applicability of the minimum differences determined here to orthopedically diseased dogs remains to be determined.

Compensatory Changes in Ground Reaction Forces in Small and Large Breed Dogs with Unilateral Hindlimb Lameness in Comparison to Healthy Dogs

OBJECTIVE

 The aim of this study was to investigate whether small- to medium-sized dogs with a naturally occurring unilateral hindlimb lameness show the same compensatory changes in ground reaction forces as large-breed dogs and how the changes are displayed compared with healthy small- to medium-sized dogs.

STUDY DESIGN

 Small- to medium-sized dogs (n = 15) and large-breed dogs (n = 16) with unilateral rupture of the cranial cruciate ligament were examined. The kinetic parameters peak vertical force and vertical impulse of the two groups were compared with each other and compared with healthy Beagles (n = 15) and with healthy Labrador Retrievers (n = 17), respectively.

RESULTS

 The healthy Beagle group showed a significantly higher weight loading on the forelimbs compared with the healthy Labrador group. The affected groups in comparison with the corresponding healthy groups showed a higher load on the non-affected body half and a significant lower weight bearing on the affected limb. Comparing the two affected groups, no significant difference could be found.

CONCLUSION

 Despite a substantially different initial situation regarding weight distribution of the examined small- to medium-sized dogs and large dogs, a unilateral hindlimb lameness leads to the same compensatory changes (cranial and lateral shift of the body mass centre).

Reliability of kinetic measurements of healthy dogs examined while walking on a treadmill

OBJECTIVE

To investigate whether an actual improvement in gait could be differentiated from physiologic differences or habituation effects during gait analysis of dogs.

ANIMALS

11 healthy dogs.

PROCEDURES

On 4 examination days, kinetic parameters were measured while dogs were walking on a treadmill. Differences in mean parameter values and habituation effects (ie, effect sizes) were quantified and compared among examination days. Coefficients of variation for repeated measurements were calculated to determine measurement reproducibility, and minimum differences were calculated to distinguish between physiologic fluctuation and an actual change in gait pattern.

RESULTS

Among the 4 examination days, mean absolute differences in peak vertical force and vertical impulse (VI) varied from 1.5% to 5.3% of body weight (BW) and 0.9% to 1.8% of BW·s, respectively. Mean absolute differences in the percentage of stance-phase duration (%SPD) and relative stride length (RSL) varied from 0.9% to 3.2% and 1.7% to 3.0%, respectively. Reproducibility of parameter measurements was good. Values for %SPD had the lowest amount of dispersion and largest effect size, suggesting a habituation effect for this parameter. Calculated minimum differences among the days for peak vertical force, VI, %SPD, and RSL did not exceed 9.9% of BW, 3.3% of BW·s, 5.8 percentage points, and 5.2 percentage points, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

The %SPD of healthy dogs walking on a treadmill was the most sensitive and diagnostically reliable of the measured kinetic parameters, in contrast to VI and RSL. Findings suggested that actual changes can be distinguished from random physiologic fluctuations during gait analysis of dogs.

Outcome after Tibial Plateau Levelling Osteotomy and Modified Maquet Procedure in Dogs with Cranial Cruciate Ligament Rupture

OBJECTIVE

 The aim of this study was to compare outcomes after tibial plateau levelling osteotomy (TPLO) and modified Maquet procedure (MMP) for the treatment of cranial cruciate ligament rupture (CCLR) in dogs using clinical and radiographic evaluation and treadmill-based force plate gait analysis.

STUDY DESIGN

 This study was a prospective, randomized, controlled study.

MATERIALS AND METHODS

 Sixty-one dogs (76 joints) with CCLR were treated with TPLO (n = 30 dogs, 41 joints) or MMP (n = 31 dogs, 35 joints) and compared with a control group of 16 healthy Labrador Retrievers. Outcomes after surgery were compared by clinical orthopaedic assessment, radiographic evaluation and force plate gait analysis performed preoperatively, and then at 6 weeks, 3 and 6 months postoperatively. For objective comparison of ground reaction forces, the data were compared with the control group. Major complications were reported.

RESULTS

 A significant improvement in ground reaction forces was reached in all surgically treated dogs. No significant difference was found between the surgical methods at any postoperative re-examination. With regard to peak vertical force (PVF), there were significantly more patients with TPLO within the reference range of healthy dogs at the 3 months re-examination than dogs with MMP. There was no significant difference in mean value comparisons between TPLO and control groups 6 months postoperatively. Compared with the control group, mean values of 93.9% (PVF) and 85.9% (vertical impulse [VI]) were reached by the TPLO group and 89.4% (PVF) and 79.9% (VI) by the MMP group, 6 months postoperatively.No significant differences were found regarding major complications or progression of osteoarthritis.

CONCLUSIONS

 Although no significant differences were found between the surgical methods, TPLO patients showed superiority with regard to clinical outcome.

Long-term outcome after surgical treatment of cranial cruciate ligament rupture in small breed dogs. Comparison of tibial plateau leveling osteotomy and extra-articular stifle stabilization

OBJECTIVE

Cranial cruciate ligament rupture is the most frequently occurring disease of the canine stifle. After introduction of corrective osteotomies of the proximal tibia as surgical treatment option in medium, large and giant breeds, the tibial plateau leveling osteotomy (TPLO) evolved into one of the favorite procedures. In the past small breed dogs have usually been treated by extra-articular stabilization techniques. TPLO has recently become an accepted treatment method in these breeds as well as, and is nowadays used with increasing frequency. The purpose of this study was to evaluate long-term outcomes of TPLO compared to an extra-articular stabilization technique in small breed dogs.

MATERIAL AND METHODS

A total of 40 stifles of 30 small breed dogs weighing ≤ 15 kg were treated for cranial cruciate ligament rupture with either TPLO (n = 23) or a lateral capsular-fascial imbrication technique (CFI; n = 17). Dogs were clinically examined before and at least 6 months after surgery by treadmill analysis and radiography. Moreover a questionnaire was provided to the owners to assess postoperative function and overall satisfaction.

RESULTS

Twenty-one of 23 operated limbs (91.3%) treated with TPLO and five of 17 (29.4%) treated with the CFI showed absolute values comparable to healthy dogs when evaluated by peak vertical force, vertical impulse and its symmetry index during objective gait analysis. Both groups showed mild, but continuous progression of osteoarthritis. TPLO led to a significantly faster recovery and a higher degree of owner satisfaction.

CONCLUSION

Based on clinical examination and objective gait analysis TPLO yielded excellent long-term results and a high degree of owner satisfaction in small breed dogs ≤ 15 kg treated for cranial cruciate ligament rupture.

CLINICAL RELEVANCE

TPLO seems to be superior to CFI treatment of small breed dogs in this study, although CFI should be considered as treatment option under certain circumstances.