Effect of Tibial Plateau Leveling Osteotomy on Femorotibial Contact Mechanics and Stifle Kinematics     

STANLEY E. KIM  BVSc    ANTONIO POZZI  DMV  MS  Diplomate ACVS    SCOTT A. BANKS  PhD    BRYAN P. CONRAD  MEng    DANIEL D. LEWIS  DVM  Diplomate ACVS 《Veterinary surgery : VS》2009,38(1):23-32

Objective— To evaluate the effects of tibial plateau leveling osteotomy (TPLO) on femorotibial contact mechanics and 3-dimensional (3D) kinematics in cranial cruciate ligament (CrCL)-deficient stifles of dogs.
Study Design— In vitro biomechanical study.
Animals— Unpaired pelvic limbs from 8 dogs, weighing 28–35 kg.
Methods— Digital pressure sensors placed subjacent to the menisci were used to measure femorotibial contact force, contact area, peak and mean contact pressure, and peak pressure location with the limb under an axial load of 30% body weight and a stifle angle of 135°. Three-dimensional static poses of the stifle were obtained using a Microscribe digitizing arm. Each specimen was tested under normal, CrCL-deficient, and TPLO-treated conditions. Repeated measures analysis of variance with a Tukey post hoc test ( P <.05) was used for statistical comparison.
Results— Significant disturbances to all measured contact mechanical variables were evident after CrCL transection, which corresponded to marked cranial tibial subluxation and increased internal tibial rotation in the CrCL-deficient stifle. No significant differences in 3D femorotibial alignment were observed between normal and TPLO-treated stifles; however, femorotibial contact area remained significantly smaller and peak contact pressures in both medial and lateral stifle compartments were positioned more caudally on the tibial plateau, when compared with normal.
Conclusion— Whereas TPLO eliminates craniocaudal stifle instability during simulated weight bearing, the procedure fails to concurrently restore femorotibial contact mechanics to normal.
Clinical Relevance— Progression of stifle osteoarthritis in dogs treated with TPLO may be partly the result of abnormal stifle contact mechanics induced by altering the orientation of the proximal tibial articulating surface.  相似文献   

Video-Assisted Left Partial Arytenoidectomy by Diode Laser Photoablation for Treatment of Canine Laryngeal Paralysis     

MASSIMO OLIVIERI  DVM  PhD    SIMONA G. VOGHERA  DVM    THERESA. W. FOSSUM  DVM  PhD  Diplomate ACVS 《Veterinary surgery : VS》2009,38(4):439-444

Objectives— To evaluate the clinical outcome of left partial arytenoidectomy by video-assisted laser diode photoablation as a surgical treatment for canine laryngeal paralysis (LP).
Study Design— Case series.
Animals— Dogs with bilateral LP (n=20).
Methods— After endoscopic diagnosis of bilateral LP, left partial arytenoidectomy was performed by photoablation of arytenoid cartilage tissue using a diode laser (600 μm diameter, 15 W power, 980 nm wave length) to increase the width of the rima glottidis. Outcome was evaluated endoscopically (1 and 6 months) and clinically (1, 6, and 12 months).
Results— No substantial complications occurred during photoablation or in the immediate postoperative period. Postoperative width of the rima glottidis ranged from 6 to 10 mm at its widest aspect. At 1 month, respiratory function after walking and short running appeared good. Clinical and endoscopic examination revealed good outcome at 1 and 6 months. At 6 months, there was no evidence of hypertrophic scar, hypertrophic granulation tissue, or stricture of the laryngeal glottis in any dog. Two dogs developed aspiration pneumonia after 12 months.
Conclusions— Partial arytenoidectomy using video-assisted diode laser photoablation appears to be an effective technique for treating LP.
Clinical Relevance— Partial arytenoidectomy by diode laser photoablation should be considered as an alternative technique for treatment of canine LP.  相似文献   

Synovial Hemangioma in a Dog     

J. IGNACIO ARIAS  DVM    CRISTIAN TORRES  DVM    DANIEL SAEZ  DVM 《Veterinary surgery : VS》2009,38(4):463-466

Objective— To report arthroscopic diagnosis and treatment of synovial hemangioma in a dog.
Study Design— Case report.
Animal— Standard Poodle (8-year-old neutered male).
Methods— A soft tissue density mass observed radiographically in the left stifle joint of a dog with a 2-month history of recurrent lameness, hemarthrosis, and a slight cranial drawer sign, was located by diagnostic arthroscopy and surgically excised via arthrotomy.
Results— Histologic evaluation revealed tissue composed of variably sized cavernous vascular spaces filled with erythrocytes that were considered compatible with synovial hemangioma.
Conclusions— In this dog, synovial hemangioma evident as a soft tissue mass on radiographs was associated with chronic lameness and hemarthrosis, and resolved with surgical excision.
Clinical Relevance— Synovial hemangioma, although seemingly rare in dogs, should be considered in the differential diagnosis for nontraumatic, recurrent lameness, and unresponsive to anti-inflammatory therapy when there is a circumscribed intracapsular soft tissue mass evident radiographically together with hemarthrosis.  相似文献   

External Fixator Clamp Reuse Degrades Clamp Mechanical Performance     

ROBERT S. GILLEY  DVM  MA  PhD  Diplomate ACVS    DAVID P. BEASON  MS    DAVID M. SNYDER  DVM  Diplomate ACVS    RAYMOND C. BOSTON  PhD    ALEX RADIN  PhD    AMY S. KAPATKIN  DVM  MS  Diplomate ACVS    GAIL K. SMITH  VMD  PhD    LOUIS J. SOSLOWSKY  PhD 《Veterinary surgery : VS》2009,38(4):530-536

Objective— To determine the effects of clamp reuse for the Kirschner–Ehmer (KE); Securos; and the IMEX–SK clamp.
Study Design— Experimental bench test of mechanical properties.
Methods— Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp–bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp–bolt tightening torque. Results were compared using repeated measures ANOVA.
Results— For the IMEX–SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp–bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only.
Conclusions— All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity.
Clinical Relevance— Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance.  相似文献   

Age, Tibial Plateau Angle, Sex, and Weight as Risk Factors for Contralateral Rupture of the Cranial Cruciate Ligament in Labradors     

NICOLE BUOTE  DVM    JASON FUSCO  DVM  Diplomate ACVS    ROBERT RADASCH  DVM  MS  Diplomate ACVS 《Veterinary surgery : VS》2009,38(4):481-489

Objective— To compare rates of contralateral cranial cruciate ligament rupture (CCLR) in Labradors based on age and weight at initial rupture, sex, and tibial plateau angle (TPA) and to determine whether Labradors that rupture their initial cranial cruciate ligament (CCL) at an earlier age (<4 years) are more likely to rupture their contralateral side within a certain period of time. Study Design— Case series. Animals— Labradors (n=94) that had tibial plateau leveling osteotomy (TPLO). Methods— Two groups: no contralateral rupture (NR) and contralateral rupture (CR) were compared for significant (P<.05) differences in percentage of subsequent cruciate tears using a Wilcoxon's rank‐sum tests for continuous variables and Fisher's exact test for sex. Adjusted odds ratios for likelihood of subsequent cruciate tears (yes/no) were estimated using logistic regression. Associations of these characteristics with time to subsequent rupture were assessed using Kaplan–Meier survival analysis estimation. Predictors of presentation with bilateral ruptures (BR) versus single rupture were also evaluated using Wilcoxon's rank‐sum tests and a generalized Fisher's exact test. Results— Subsequent CCLR occurred in 45 dogs (48%), and BR on admission were identified in 10 dogs (10.6%). Comparing NR and CR dogs, there were no significant differences between age or weight at initial rupture, sex or TPA; however there were associations toward longer time to CR for dogs older than the median age and female dogs (intact and spayed). There were no significant differences in age, sex, weight, or TPA of dogs with bilateral CCL ruptures compared with initial unilateral ruptures; however, there was a trend toward dogs presenting at an older age and with lower TPA's in the BR group. Among the 84 NR/CR dogs, the median time to rupture of the contralateral CCL was 5.5 months (95% CI 5.2–5.7). Conclusions— Age and weight at initial rupture, sex, and TPA does not affect likelihood or rate of contralateral CCL rupture or presentation with bilateral CCL ruptures. Clinical Relevance— Approximately 50% of Labradors will rupture the contralateral CCL within 5.5 months of the initial rupture but age, weight, sex, and TPA cannot be used as predictive features.  相似文献   

Arytenoid Lateralization for Treatment of Laryngeal Paralysis in 10 Cats     

ROBERT J. HARDIE  DVM  Diplomate ACVS & ECVS    JESSICA GUNBY  DVM    DALE E. BJORLING  DVM  MS  Diplomate ACVS 《Veterinary surgery : VS》2009,38(4):445-451

Objective— To describe the signalment, history, clinical signs, surgical technique, and outcome for cats with laryngeal paralysis that had arytenoid lateralization.
Study Design— Case series.
Animals— Cats with laryngeal paralysis (n=10).
Methods— Medical records (1996–2002) for cats with laryngeal paralysis that had arytenoid lateralization were reviewed for signalment, history, clinical signs, degree of paralysis, cause, concurrent medical conditions, surgical technique, and outcome. Follow-up information was obtained from owners or referring veterinarians.
Results— Of 10 cats, 9 had bilateral and 1 had unilateral laryngeal paralysis. Arytenoid lateralization were unilateral (n=7), bilateral (1), and staged bilateral procedures (2), 10 days and 3 years apart, respectively. Postoperatively, 1 cat had persistent inspiratory noise because of minimal enlargement of the rima glottidis and 2 cats required a temporary tracheostomy for management of laryngeal swelling. Three cats developed aspiration pneumonia and died 4, 7, and 150 days after surgery; all 3 had bilateral (simultaneous or staged) procedures. Of the 7 remaining cats, 4 were alive at follow-up and 3 had died of causes unrelated to arytenoid lateralization. The calculated mean survival time for all 10 cats was 406 days (median, 150 days; range, 4–1825 days).
Conclusions— Arytenoid lateralization was effective at enlarging the rima glottidis and reducing signs of airway obstruction in most cats.
Clinical Relevance— Unilateral arytenoid lateralization is a feasible option for the surgical management of cats with marked clinical signs; however, bilateral procedures should be avoided or at least performed with considerable caution because of the apparent risk for aspiration pneumonia.  相似文献   

A Novel Pin Distraction Device for Arthroscopic Assessment of the Medial Meniscus in Dogs     

PETER BÖTTCHER  Dr. med. vet.  Diplomate ECVS    PHILIPP WINKELS  DVM    GERHARD OECHTERING  Prof. Dr. med. vet.  Diplomate ECVAA 《Veterinary surgery : VS》2009,38(5):595-600

Objective— To describe an extra-articular joint distractor for meniscal examination and treatment during canine stifle arthroscopy.
Study Design— Case series.
Animals— Dogs ≥20 kg with suspected cranial cruciate ligament (CrCL) deficiency.
Methods— A custom designed linear side bar was constructed to allow invasive pin distraction of the stifle joint. Its design efficacy for distraction of the medial joint compartment, observation and probing of the medial meniscus, and value during meniscal surgery was evaluated by clinical use.
Results— Application of the stifle distractor medial to the stifle joint using 2 negative threaded pins was easily performed percutaneously without the need of power equipment; however, unintended intra-articular placement of 1 threaded pin occurred in 2 stifles, without appreciable consequence to joint function. Observation as well as thorough probing of the caudal horn of the medial meniscus, even in the presence of a prominent remnant of the CrCL or severe periarticular fibrosis, was possible. Partial meniscectomy was effectively performed as needed without apparent damage to the associated articular surfaces.
Conclusions— Distraction and translation of the medial compartment of the stifle joint using invasive pin distraction allowed observation and palpation of the caudal horn of the medial meniscus so that assessment and treatment were readily accomplished without apparent morbidity.
Clinical Relevance— With careful attention to accurate pin placement, invasive pin distraction of the medial compartment of the canine stifle joint may improve arthroscopic evaluation and treatment of meniscal pathology.  相似文献   

Cementless Total Hip Replacement in an Alpaca     

KYLA F. ORTVED  DVM    URSULA KROTSCHECK  DVM  Diplomate ACVS    SAMANTHA A. COLLINS  Bsc    JEREMY J. RAWLINSON  PhD    JONATHAN DYCE  VetMB  DSAO  Diplomate ACVS 《Veterinary surgery : VS》2009,38(5):583-587

Objective— To report management of a chronic slipped capital femoral epiphysis (SCFE) in an alpaca using cementless total hip replacement (THR).
Study Design— Case report.
Animal— An 18-month-old, 47 kg alpaca male.
Methods— Cementless THR was performed in an alpaca with a chronic, right SCFE, and secondary osteoarthritis. Force plate gait analysis was performed before and 8 weeks after surgery. Outcome was determined through clinical evaluation, radiography, and force plate gait analysis.
Results— Cementless THR resulted in marked improvement in the alpaca's comfort level, degree of lameness, and range of motion. On preoperative force plate gait analysis there was decreased contact time ( P =.01) and vertical impulse ( P <.01) of the affected limb, whereas at 8 weeks postoperatively significant differences in gait analysis between pelvic limbs were not apparent.
Conclusion— THR using a BioMedtrix^® canine cementless modular prosthesis restored hip function in an alpaca with coxofemoral osteoarthritis from chronic SCFE.
Clinical Relevance— THR may be an appropriate treatment for selected traumatic and degenerative conditions of the coxofemoral joint in alpacas.  相似文献   

Mapping of Split-Line Pattern and Cartilage Thickness of Selected Donor and Recipient Sites for Autologous Osteochondral Transplantation in the Canine Stifle Joint     

PETER BÖTTCHER  Dr med vet  Diplomate ECVS    MARKUS ZEISSLER  DVM    JOHANN MAIERL  PhD  Dr med vet    VERA GREVEL  Prof. Dr med vet  Diplomate ECVS    GERHARD OECHTERING  Prof. Dr med vet  Diplomate ECVAA 《Veterinary surgery : VS》2009,38(6):696-704

Objective— To characterize donor and recipient sites for autologous osteochondral transplantation in the canine stifle joint with respect to split-line pattern and cartilage thickness.
Study Design— In vitro study.
Sample Population— Stifle joints (n=30) of dogs >20 kg.
Methods— Collagen network orientation of the hyaline cartilage coverage of the distal femur was assessed using split-line technique (n=10). Cartilage thickness was measured radiographically on osteochondral plugs harvested at the abaxial and axial surfaces of the femoropatellar joint (n=15), the most proximal abaxial aspect of the medial condyle (CO; n=5) and at both femoral condyles (n=15).
Results— Cartilage within the femoropatellar joint and both femoral condyles had mostly transversely orientated pattern of split-lines. Abaxial to the femoropatellar joint split-lines were absent. All donor sites had significantly thinner cartilage than the medial condyle (CM). Only the distal trochlea had cartilage thickness comparable to the lateral condyle (CL). The thinnest cartilage was found abaxial to the femoropatellar joint followed by CO, which was ∼2–3 times thinner than the cartilage at both condyles.
Conclusions— None of the investigated donor sites provided transplants of comparable cartilage thickness to CM. Transplants from within the femoropatellar joint should be harvested in priority as they reach cartilage morphology comparable to CL.
Clinical Relevance— Adjusting for cartilage thickness and split-line pattern may improve long-term outcome after autologous osteochondral transplantation. But surface curvature and donor-site morbidity have to be considered as well when choosing the most suitable donor site.  相似文献   

Multiple Rib Fracture Repair in a Neonatal Holstein Calf     

BENJAMIN J. AHERN  BVSc    DAVID G. LEVINE  DVM 《Veterinary surgery : VS》2009,38(6):787-790

Objectives— To report rib fracture repair in a neonatal calf using the Securos^® Cranial Cruciate Ligament Repair System (SCCLRS).
Study Design— Case report.
Animals— A 2-day-old female Holstein calf with fracture of right ribs 4–10.
Methods— On the day of admission the calf was anesthetized and rib fractures were repaired using open reduction and the SCCLRS.
Results— Rib fractures were successfully stabilized and the calf discharged from the hospital 8 days postoperatively.
Conclusions— Modification of previously reported use of the SCCLRS to repair rib fractures in foals was required because of the different anatomy in the calf. This new technique was rapidly and easily performed for a large number of fractured ribs in this case.
Clinical Relevance— Effective rib fracture repair in calves can be readily performed using the SCCLRS with modification of the technique reported in foals.  相似文献