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1.
Artículo en Inglés | MEDLINE | ID: mdl-39059441

RESUMEN

OBJECTIVES: The aims of this study are to describe a computed tomographic (CT) measurement method of feline femoral, tibial, and patellar conformation, and to compare these measurements between a cat population diagnosed with medial patellar luxation (MPL) and cats without MPL. MATERIALS AND METHODS: Eleven measurements were performed by two observers, including anatomical lateral distal femoral angle (aLDFA), femoral trochlear width (FTW) and femoral trochlear depth (FTD), anteversion angle of the femoral neck, patellar length, patellar width, patellar height, patellar volume, mechanical medial proximal tibial angle, tibial torsion angle, and tibial tuberosity displacement. Mean and standard deviation differences between the groups were statistically assessed. Intraobserver and interobserver interclass correlation coefficients (ICCs) were calculated. RESULTS: The aLDFA was significantly higher in the MPL II compared with the control and MPL III. The FTW was significantly larger in the MPL III than in the control or the MPL II group. The FTD in the control group was significantly larger than in the MPL II and III groups. The TTA of the control group was significantly smaller than the MPL II and III. The intraobserver ICC was high at 64%, and the interobserver ICC was high at 36% of the measurements. CLINICAL SIGNIFICANCE: This study identified shallower FTD and increased TTA in cats diagnosed with MPL. The TTA difference was less than 5 degrees and FTD was less than 1 mm. The findings provide information on feline pelvic limb morphology. However, the differences between the two populations are small.

2.
Vet Surg ; 52(6): 853-863, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36811178

RESUMEN

OBJECTIVE: To describe arthroscopic-assisted hip toggle stabilization (AA-HTS) in cats, evaluate its feasibility and associated rate of iatrogenic injury, and assess deviations from planned surgical technique. STUDY DESIGN: Ex vivo study. ANIMALS: Skeletally mature cat cadavers (n = 7). METHODS: Preoperative pelvic computed tomography (CT) was performed for surgical planning and to identify the ideal femoral bone tunnel projection. Ultrasound-guided transection of ligament of head of femur was performed. Following exploratory arthroscopy, AA-HTS was performed using a commercially available aiming device. Surgical time, intraoperative complications, and feasibility of technique were recorded. Iatrogenic injury and technique deviations were assessed by postoperative CT and gross dissection. RESULTS: Diagnostic arthroscopy and AA-HTS were successfully performed in all 14 joints. Median (range) surgical time was 46.5 (29-144) min, including 7 (3-12) min for diagnostic arthroscopy and 40 (26-134) min for AA-HTS. Intraoperative complications occurred in 5 hips, related to bone tunnel creation (4) and toggle dislodgment (1). Toggle passage through the femoral tunnel was the most challenging component of technique, recorded as mildly difficult in 6 joints. No damage to periarticular/intrapelvic structures was identified. Minor articular cartilage damage (<10% total cartilage area) was identified in 10 joints. Thirteen deviations (8 major, 5 minor) in surgical technique from preoperative planning were identified in 7 joints. CONCLUSION: In feline cadavers AA-HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations. CLINICAL SIGNIFICANCE: Hip toggle stabilization using an arthroscopic-assisted approach may be an effective technique for management of coxofemoral luxation in cats.


Asunto(s)
Enfermedades de los Gatos , Luxación de la Cadera , Gatos/cirugía , Animales , Artroscopía/veterinaria , Artroscopía/métodos , Estudios de Factibilidad , Luxación de la Cadera/cirugía , Luxación de la Cadera/veterinaria , Cadáver , Enfermedad Iatrogénica/veterinaria , Articulación de la Cadera/diagnóstico por imagen , Articulación de la Cadera/cirugía
3.
Vet Surg ; 52(2): 196-208, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36062338

RESUMEN

OBJECTIVE: To report outcomes and complications associated with total hip replacements (THR) using a multiuser canine hip registry (CHR) and owner-administered questionnaire. STUDY DESIGN: Prospective longitudinal clinical study. ANIMALS: Dogs (n = 1852). METHODS: Total hip replacement cases submitted to a CHR were reviewed. An online questionnaire including an adapted "Liverpool Osteoarthritis in Dogs" (LOAD) score was e-mailed to owners. Data were analyzed to determine associations between clinical variables and the agreement by veterinary surgeons and owners for complications. RESULTS: A group of 1329 (72%) dogs had unilateral THRs and another group of 523 (28%) dogs had bilateral THRs, resulting in 2375 THRs. Indications included hip dysplasia and osteoarthritis (n = 2028/2375, 85%). Implants were manufactured by Kyon (n = 1087, 46%), BioMedtrix CFX (n = 514, 22%), BioMedtrix hybrid (n = 264, 11%), BioMedtrix BFX (n = 221, 9%), and Helica (n = 107, 4.5%). Median veterinary surgeon and owner follow up were 1328 and 900 days respectively. Postoperative LOAD scores (21 ± 9) reported by 461 owners improved compared to preoperative scores (11 ± 9) (P < .001). Veterinary surgeons reported complications in 201/2375 (8.5%) THRs and owners in 107/461 (23%) THRs, with moderate agreement (weighted kappa = 0.44). No associations were identified between complications and weight, age, sex, or breed. BioMedtrix BFX and Helica implants were associated with increased complications (P = .031) when used for revisions of femoral head and neck excisions. CONCLUSION: Excellent outcomes, including improved canine mobility, were reported after THRs. Complications were underreported by veterinary surgeons compared to owners in this first multiuser CHR. CLINICAL SIGNIFICANCE: Canine THRs are safe, effective procedures but THR implants should be carefully selected when revising femoral head and neck excisions.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Enfermedades de los Perros , Prótesis de Cadera , Osteoartritis , Perros , Animales , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/veterinaria , Artroplastia de Reemplazo de Cadera/métodos , Prótesis de Cadera/efectos adversos , Prótesis de Cadera/veterinaria , Estudios Prospectivos , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/etiología , Enfermedades de los Perros/cirugía , Resultado del Tratamiento , Osteoartritis/veterinaria , Sistema de Registros
4.
Vet Surg ; 50(5): 1042-1053, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33713478

RESUMEN

OBJECTIVE: To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. STUDY DESIGN: Multi-institutional retrospective cohort study. SAMPLE POPULATION: Forty-eight client-owned cats. METHODS: Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. RESULTS: Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. CONCLUSION: Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. CLINICAL SIGNIFICANCE: Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.


Asunto(s)
Enfermedades de los Gatos/cirugía , Luxación de la Cadera/veterinaria , Nylons , Procedimientos Ortopédicos/veterinaria , Polietilenos , Complicaciones Posoperatorias/veterinaria , Animales , Gatos , Femenino , Luxación de la Cadera/cirugía , Masculino , Procedimientos Ortopédicos/instrumentación , Procedimientos Ortopédicos/métodos , Complicaciones Posoperatorias/epidemiología , Recurrencia , Estudios Retrospectivos , Resultado del Tratamiento
5.
Vet Surg ; 49(8): 1527-1535, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33015879

RESUMEN

OBJECTIVE: To determine the effect of stifle flexion on the proximity of the cranial tibial artery to the proximal tibia in canine stifles with an intact or transected cranial cruciate ligament (CCL). STUDY DESIGN: Ex vivo randomized blinded computed tomographic angiographic study. SAMPLE POPULATION: Fifteen pelvic limbs from eight greyhound cadavers. METHODS: The femoral artery and vein were cannulated and injected with 10 mL of iohexol. Each limb was placed in lateral recumbency on an acrylic sheet with predrawn femoral and tibial lines representing angles of stifle extension. Computed tomography was performed before (limbs 1-15) and after (limbs 10-15) CCL transection. The shortest distance between the cranial tibial artery and proximal tibia (dCrTA-PT) was measured at a distance of one patellar length from medial intercondylar tubercle. RESULTS: Median dCrTA-PT in intact specimens at 70°, 90°, 110°, and 135° was 2.04, 2.05, 2.28, and 2.51 mm, respectively (P = .008). Pairwise comparisons identified a difference between 70° and 135° (P = .007). Mean dCrTA-PT in transected specimens at 70°, 90°, 110°, and 135° was 2.60, 2.57, 2.90, and 2.79 mm, respectively (P = .208). Median overall dCrTA-PT was 2.24 mm in intact specimens (limbs 1-15, all four angles of extension combined) and 2.76 mm in transected specimens (limbs 10-15, all angles combined; P = .01). CONCLUSION: Flexion of the stifle resulted in a negligible decrease in dCrTA-PT in intact specimens but had no effect in CCL transected stifles. CLINICAL SIGNIFICANCE: The angle of stifle extension does not appear to have any clinically significant effect on the proximity of cranial tibial artery to the proximal tibia.


Asunto(s)
Ligamento Cruzado Anterior/fisiología , Rango del Movimiento Articular , Rodilla de Cuadrúpedos/fisiología , Tibia/fisiología , Arterias Tibiales/fisiología , Animales , Cadáver , Perros , Femenino , Masculino
6.
Vet Comp Orthop Traumatol ; 33(2): 102-109, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31978936

RESUMEN

OBJECTIVE: The aim of this study was to assess computed tomography (CT) images of cadaveric feline stifles and record the relationship between the patella and femoral trochlea in normal stifles; then to investigate the effect of block recession trochleoplasty (BRT) with and without partial parasagittal patellectomy (PPP) on patellofemoral contact, depth of patellar recession and size of trochlea and patella. MATERIALS AND METHODS: The sample population included six cat cadavers (12 stifles). Preoperative CT scans with stifles in three positions: extended (155-165°), neutral (85-95°) and flexed (35-45°). Lateral stifle arthrotomy was followed by BRT. CT scans were taken as above. PPP was performed so the width of the patella was 1 mm narrower than the BRT. CT scans were repeated and CT measurements were taken. RESULTS: The area of contact between the patella and femoral trochlea was significantly reduced after BRT and then significantly increased after PPP. The depth of patellar recession was unchanged after BRT, but then was significantly higher after PPP. The patella was wider than the trochlea preoperatively and post-BRT and narrower post-PPP. Reduction in bone volume following PPP (mean: 20%) was 50% the reduction in patella width (mean: 40%). CONCLUSION: Block recession trochleoplasty did not improve patellar recession and decreased patellofemoral contact area. Following BRT, the patella rides the trochlear ridges and loses contact with the trochlear sulcus. Block recession trochleoplasty alone should not be performed in cats. Instead, BRT should be combined with PPP.


Asunto(s)
Fémur/diagnóstico por imagen , Rótula/diagnóstico por imagen , Rodilla de Cuadrúpedos/diagnóstico por imagen , Tomografía Computarizada por Rayos X/veterinaria , Animales , Fenómenos Biomecánicos , Cadáver , Gatos , Fémur/patología , Fémur/cirugía , Rótula/patología , Rótula/cirugía , Luxación de la Rótula/diagnóstico por imagen , Luxación de la Rótula/patología , Luxación de la Rótula/veterinaria
7.
Res Vet Sci ; 128: 183-196, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31816501

RESUMEN

In this study, we propose a novel bioresorbable bioactive implant for tibial tuberosity advancement (TTA). The implant consists of a gradually resorbing load-bearing shell which encompasses rapidly resorbing small casings loaded with silica-based bioactive glass (BG) particulates which promote bone formation and reduce the risk of infection. The shell and the casings are manufactured by 3D printing from two medical grade bioresorbable polymers (a polyglycolide/lactide based and a polydioxanone based) that have different degradation rates. The casings are expected to resorb within days after surgery to expose the BG particulates while the shell would retain the load-bearing properties of the implant for the time required by bone healing. Unlike the currently used metallic devices, the novel implant is resorbed and excreted from the body once its purpose is fulfilled. This study presents a logical progression from the in vitro characterisation of the materials and implants to the in vivo investigation of the experimental implants. This included mechanical testing of the materials, finite element analysis of a preliminary design of the novel TTA implant, assessment of the degradation behaviour of the polymers and the ion exchange of BG in simulated body fluid, and investigation of the biological response to the novel implants after implantation in rabbits. The osteointegration of the novel implants was comparable to the osteointegration of Ti6Al4V implants in the control group; the biological efficacy and safety were confirmed. The biological response was in line with the expectations. The proof of concept for the novel TTA implants was demonstrated.


Asunto(s)
Implantes Absorbibles/veterinaria , Lesiones del Ligamento Cruzado Anterior/veterinaria , Ligamento Cruzado Anterior/cirugía , Implantes Experimentales/veterinaria , Animales , Ligamento Cruzado Anterior/patología , Lesiones del Ligamento Cruzado Anterior/cirugía , Perros , Impresión Tridimensional , Conejos , Rodilla de Cuadrúpedos/cirugía , Tibia/cirugía
8.
Vet Comp Orthop Traumatol ; 32(3): 250-256, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30921824

RESUMEN

OBJECTIVES: The aim of this study was to report the complication of lateral radial head subluxation following proximal ulnar osteotomy (PUOO) or proximal ulnar ostectomy (PUOE) in eight dogs. MATERIALS AND METHODS: Case records and diagnostic imaging of dogs developing lateral radial head subluxation following PUOO (n = 7) or PUOE (n = 2) were retrospectively reviewed. Information pertaining to clinical history, signalment, presenting condition, lameness grade, diagnostic imaging and initial surgery details, postoperative complications and their management were retrieved. Outcomes were established from subsequent clinical histories or telephone interviews with referring veterinarians. Comparison was made to a single-centre cohort without lateral radial head subluxation following PUOO or PUOE. RESULTS: Eight dogs (median age: 9.5 months [range: 6 months-6 years], median weight 7.7 kg [range: 5-28 kg]) were included. Six dogs had a PUOO performed; five dogs had unilateral surgery and one had bilateral surgery. Two dogs had unilateral PUOE surgery. Median time to diagnosis of lateral radial head subluxation following surgery was 6.5 weeks (range: 2-20 weeks). Five of the eight dogs had surgical revision of lateral radial head subluxation. Resolution of lateral radial head subluxation was achieved in four dogs, with three achieving acceptable to good mobility. One dog had poor postoperative mobility. A fifth dog remained lame after revision surgery failure. Three dogs did not have revision surgery; two underwent limb amputation and one dog remained lame as revision surgery was declined. CLINICAL SIGNIFICANCE: Lateral radial head subluxation is a potentially severe postoperative complication following PUOO or PUOE.


Asunto(s)
Perros/cirugía , Luxaciones Articulares/veterinaria , Osteotomía/veterinaria , Complicaciones Posoperatorias/veterinaria , Cúbito/cirugía , Animales , Miembro Anterior , Luxaciones Articulares/etiología , Osteotomía/efectos adversos , Cúbito/diagnóstico por imagen
9.
Vet Rec ; 181(1): 18, 2017 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-28386028

RESUMEN

The objective of this study was to assess the variables associated with complications of total hip replacement (THR) and report owner-assessed outcomes. Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between September 2011 and December 2012 were reviewed separately and in conjunction with previous data (January 2010-August 2011). An outcomes assessment questionnaire was used to collect data from owners. Incidences of surgeon-reported and owner-reported complications were 8.2 per cent and 4.3 per cent, respectively. THR using the BioMedtrix BFX cup/stem prosthesis had a greater incidence of complications compared with THR using the BioMedtrix CFX cup/stem prosthesis (P=0.002); complications were 4.48 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus the BioMedtrix CFX cup/stem prosthesis. THR using the BioMedtrix BFX cup/stem prosthesis had a higher incidence of complications compared with THR using a hybrid prosthesis (BioMedtrix BFX cup/CFX stem, BioMedtrix CFX cup/BFX stem) (P=0.046); complications were 2.85 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus a hybrid prosthesis. In 95 per cent of cases, owner satisfaction with the outcome of THR was 'very good' or 'good'. Complication rates from the BVOA-CHR are similar to previous studies. The data suggest that prosthesis type is associated with complication rate, with BioMedtrix BFX (circa 2012) having a high short-term complication rate.


Asunto(s)
Artroplastia de Reemplazo de Cadera/veterinaria , Enfermedades de los Perros/cirugía , Animales , Artroplastia de Reemplazo de Cadera/efectos adversos , Perros , Femenino , Prótesis de Cadera/efectos adversos , Prótesis de Cadera/veterinaria , Humanos , Masculino , Sistema de Registros , Resultado del Tratamiento , Reino Unido
10.
Vet Rec Open ; 3(1): e000172, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27547423

RESUMEN

OBJECTIVES: To investigate whether a surgeon can drill accurately a specified angle and whether surgeon experience, task repetition, drill bit size and perceived difficulty influence drilling angle accuracy. METHODS: The sample population consisted of final-year students (n=25), non-specialist veterinarians (n=22) and board-certified orthopaedic surgeons (n=8). Each participant drilled a hole twice in a horizontal oak plank at 30°, 45°, 60°, 80°, 85° and 90° angles with either a 2.5  or a 3.5 mm drill bit. Participants then rated the perceived difficulty to drill each angle. The true angle of each hole was measured using a digital goniometer. RESULTS: Greater drilling accuracy was achieved at angles closer to 90°. An error of ≤±4° was achieved by 84.5 per cent of participants drilling a 90° angle compared with approximately 20 per cent of participants drilling a 30-45° angle. There was no effect of surgeon experience, task repetition or drill bit size on the mean error for intended versus achieved angle. Increased perception of difficulty was associated with the more acute angles and decreased accuracy, but not experience level. CLINICAL SIGNIFICANCE: This study shows that surgeon ability to drill accurately (within ±4° error) is limited, particularly at angles ≤60°. In situations where drill angle is critical, use of computer-assisted navigation or custom-made drill guides may be preferable.

11.
Vet Surg ; 44(2): 246-55, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25243596

RESUMEN

OBJECTIVES: To assess the impact of stabilization method on the complication rate after lateral humeral condylar fracture (LHCF) repair. STUDY DESIGN: Retrospective multicenter clinical cohort study. ANIMALS: Dogs (n = 151) with LHCF. METHODS: Medical records (2004-2012) were reviewed for dogs that had surgical repair of LHCF. Data retrieved included signalment, cause of fracture, evidence of incomplete ossification of the humeral condyle, occurrence of postoperative complications, presence of supracondylar comminution preoperatively, and persistence of an intracondylar fissure postoperatively. Outcome was assessed based on the most recent data available and graded as excellent, good, fair, or poor. RESULTS: LHCF (n = 135) were evaluated in 132 dogs; 61 fractures were stabilized using a transcondylar screw and supracondylar K-wire, 13 using a transcondylar screw and supracondylar screw, and 61 using a transcondylar screw and lateral epicondylar plate. Major complications were significantly (P = .01) more common after stabilization using a transcondylar screw and supracondylar K-wire (28%) than in dogs where a supracondylar screw or lateral epicondylar plate were used (11%). Cases that had postoperative complications were significantly (P = .02) more likely to have a poor outcome. CONCLUSIONS: LHCF stabilized using a transcondylar screw and supracondylar K-wire are more likely to have major complications resulting in a poorer outcome than cases stabilized using a supracondylar screw or lateral epicondylar plate.


Asunto(s)
Perros/lesiones , Fijación Interna de Fracturas/veterinaria , Fracturas del Húmero/veterinaria , Complicaciones Posoperatorias/veterinaria , Animales , Placas Óseas/veterinaria , Tornillos Óseos/veterinaria , Hilos Ortopédicos/veterinaria , Estudios de Cohortes , Perros/cirugía , Inglaterra , Femenino , Fijación Interna de Fracturas/efectos adversos , Fijación Interna de Fracturas/métodos , Fracturas del Húmero/cirugía , Masculino , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento
12.
J Feline Med Surg ; 17(4): 312-7, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24990869

RESUMEN

The objective was to review surgical techniques and postoperative complications of surgical correction for patellar luxation (PL) in cats. A retrospective study evaluating 85 surgeries in 71 cats was performed. The records from four referral centres were searched for cats with surgical management of PL. Signalment, history, PL grade and direction, corrective surgical techniques and outcome were retrieved. Binary logistic regression analysis was used to interrogate relationships between case features, surgical correction methods and outcomes. The outcomes were classified as minor and major complications (requiring revision surgery), including continued PL (reluxation). Postoperative complications occurred in 26% of cases; 20% had major complications, including 5% patellar reluxation, and 6% had minor complications. Cats with previous ipsilateral femoral fracture were significantly more likely to suffer complications, including minor (P = 0.02, odds ratio = 12.67), major (P = 0.03, OR = 7.2) and patellar reluxation (P = 0.01, OR = 19.25). Minor complications were significantly more likely with grade 4 PL (P = 0.03, OR = 8.5). Major complications were significantly more likely with tibial tuberosity transposition (TTT; P = 0.03, OR = 5.57). Patellar reluxation was significantly more likely if stifle surgery had been performed previously (P = 0.05, OR = 8.00). The presence of bilateral PL, hip dysplasia, grade 1, 2 or 3 PL, corrective surgery using an anti-rotational suture or femoral sulcoplasty did not influence complications. Complications were more likely for grade 4 PL, previous ipsilateral femoral fracture, if TTT was performed and for cases with previous stifle surgery. This information allows consideration of risks and complicating factors.


Asunto(s)
Enfermedades de los Gatos/cirugía , Fracturas del Fémur/veterinaria , Luxación de la Rótula/veterinaria , Complicaciones Posoperatorias/veterinaria , Animales , Gatos , Fracturas del Fémur/cirugía , Luxación de la Rótula/cirugía , Complicaciones Posoperatorias/prevención & control , Rango del Movimiento Articular , Estudios Retrospectivos , Rodilla de Cuadrúpedos/lesiones , Rodilla de Cuadrúpedos/cirugía , Resultado del Tratamiento
13.
Vet Surg ; 44(1): 70-7, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24708556

RESUMEN

OBJECTIVE: To describe and compare a large population of dogs that had pancarpal arthrodesis (PCA) using either a hybrid dynamic compression plate (HDCP) or a CastLess Plate (CLP). STUDY DESIGN: Multicenter, retrospective, cohort study. ANIMALS: Dogs (n = 240; 261 PCA). METHODS: Medical records (2000-2012) from 12 UK orthopedic centers were reviewed for dogs that had PCA to document signalment, diagnosis, arthrodesis method, and complication rates. Follow-up data were used to compare outcome (lameness evaluation and radiographic healing) after use of HDCP and CLP plates. RESULTS: PCA was performed with HDCP in 125 cases, CLP in 105, and by other techniques in 31. Carpal hyperextension injury was the most common diagnosis in HDCP and CLP groups. Surgical site infection (18.3%) was the most common postoperative complication. There was no difference in intra- (11% HDCP, 21% CLP) or postoperative (34% HDCP, 41% CLP) complication rates. Use of external coaptation did not affect postoperative complication rates or outcome. External coaptation related complications occurred in 32% HDCP and 18% CLP (P = .02). At median follow-up, most dogs were classified as having no or mild lameness (73% HDCP, 83% CLP) and there was radiographic healing in 40% HDCP and 46% CLP (P = .8) cases. CONCLUSIONS: CLP and HDCP may both be used successfully to achieve pancarpal arthrodesis. Adjunctive external coaptation does not appear to have a measurable clinical benefit but is associated with morbidity.


Asunto(s)
Artrodesis/veterinaria , Placas Óseas/veterinaria , Carpo Animal/cirugía , Animales , Estudios de Cohortes , Perros , Inglaterra , Femenino , Marcha , Masculino , Periodo Posoperatorio , Estudios Retrospectivos , Infección de la Herida Quirúrgica/veterinaria , Encuestas y Cuestionarios , Cicatrización de Heridas
14.
J Feline Med Surg ; 16(8): 689-94, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24217708

RESUMEN

We describe a novel surgical technique used to correct feline patellar luxation (PL) where abnormal patellar tracking persists despite conventional corrective surgery. An anatomical difference between feline and canine stifles is that the feline patella is wider relative to the trochlear sulcus. This results in less constrained patellar tracking. Therefore, patellar subluxation is common in normal cats. It was noticed that in some feline cases with clinically significant PL, PL persisted intraoperatively despite performing the standard corrective procedures. We report a novel surgical technique - partial parasagittal patellectomy - to address the wide shape of the feline patella relative to the sulcus. This technique has been successfully performed in four cats with good outcomes. However, the immediate risks and long-term effects of partial parasaggital patellectomy are not known. We reserve this technique for surgical cases where PL cannot be controlled by conventional means.


Asunto(s)
Enfermedades de los Gatos/cirugía , Procedimientos Ortopédicos/veterinaria , Rótula/cirugía , Luxación de la Rótula/veterinaria , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Gatos , Perros , Procedimientos Ortopédicos/métodos , Luxación de la Rótula/cirugía , Radiografía , Rodilla de Cuadrúpedos/cirugía
15.
J Feline Med Surg ; 16(2): 149-56, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24027051

RESUMEN

The timing of physeal closure is dependent upon many factors, including gonadal steroids, and previous studies have shown that early neutering delays physeal closure. Pelvic and femoral radiographs of 808 cats were analysed and physes at the greater trochanter, proximal femur, distal femur and proximal tibia were recorded as being open or closed. Date of birth, gender, neuter status and breed of cases were recorded. Each physis was analysed individually at a specific age. The number of male entire (ME), male neutered (MN), female entire (FE), female neutered (FN), pedigree and non-pedigree cases at each of these ages was recorded. The number of cases that were open or closed at each stated age were compared between the neutered and entire, the female and male, and the pedigree and non-pedigree groups using a Fischer's exact test, with P <0.05 being considered significant. Seven hundred and eighty-three radiographs were included: 359 MN, 95 ME, 237 FN and 92 FE. Ninety-six cats were pedigree and 687 were non-pedigree. A statistically significant effect was shown with physes closing later in MN than in ME cats for the greater trochanter (P = 0.0037), distal femur (P = 0.0205) and tibial tuberosity (P = 0.0003). No effect was shown for the proximal tibial or proximal femoral physes, nor for any physis when comparing FE with FN cats. No statistically significant effect of breed or sex was noted. Physeal closure will occur later in MN cats than in ME cats for the greater trochanteric, distal femoral and tibial tuberosity physes, and the potential clinical consequences of this should be evaluated further.


Asunto(s)
Gatos/crecimiento & desarrollo , Gatos/genética , Fémur/crecimiento & desarrollo , Histerectomía/veterinaria , Orquiectomía/veterinaria , Ovariectomía/veterinaria , Animales , Epífisis/crecimiento & desarrollo , Femenino , Masculino , Tibia/crecimiento & desarrollo
16.
J Feline Med Surg ; 14(12): 946-51, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22968200

RESUMEN

An 11-year-old cat was referred following vehicular trauma for evaluation and treatment of right thoracic limb lameness which was non-responsive to conservative management. Gait assessment revealed a severe weight-bearing right thoracic limb lameness, soft tissue swelling over the dorsal border of the scapula, crepitus upon direct palpation over the scapula and lateralisation of the scapula upon adduction of the distal limb allowing a diagnosis of scapular avulsion to be made. Computed tomography (CT) demonstrated a comminuted fracture of the right scapula and a tear of the serratus ventralis muscle. The scapular fractures involved the caudal scapular angle and therefore a circumcostal suture was not placed. Stabilisation was achieved through reattachment of the scapula to the serratus ventralis muscle with sutures placed through small holes in the dorsal and cranial borders of the scapula. Follow-up revealed resolution of lameness at 14 weeks postoperatively but non-union of the scapular fractures as evidenced by repeat CT. This case report details the medium-term outcome following this very unusual injury and contributes to the sparse literature regarding the progression of conservatively managed scapular fractures. It demonstrates that full return to function can occur following this injury even when radiographic union of the fracture is not achieved. To our knowledge this is the first report of this specific combination of injuries detailed with medium-term and advanced imaging follow-up.


Asunto(s)
Enfermedades de los Gatos/patología , Enfermedades de los Gatos/cirugía , Fracturas Óseas/veterinaria , Cojera Animal/etiología , Escápula/lesiones , Escápula/cirugía , Animales , Gatos , Estudios de Seguimiento , Fijación Interna de Fracturas , Fracturas Óseas/complicaciones , Fracturas Óseas/patología , Fracturas Óseas/cirugía , Cojera Animal/cirugía , Masculino , Resultado del Tratamiento
17.
Vet Surg ; 41(5): 545-50, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22731937

RESUMEN

OBJECTIVE: To assess the variables associated with the complications of total hip replacement (THR) and report owner-assessed outcomes, through surgeon-based registration of cases via an online database, informed owner consent, and prospective outcomes assessment using a client-administered clinical metrology instrument. STUDY DESIGN: Prospective case series ANIMALS: Dogs (n = 170) METHODS: Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between January 2010 and August 2011 were reviewed. Variables evaluated included dog age, body weight, breed, and indication for THR and prosthesis. Associations between each variable and the incidence of complications were assessed using logistic regression. Additionally, an on-line, owner-administered outcomes assessment questionnaire (modified from the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire) was used to collect data from owners. RESULTS: One hundred and seventy cases met the inclusion criteria. Surgical indications included hip dysplasia and coxofemoral osteoarthritis (n = 150), Legg-Calves-Perthes disease (7), coxofemoral luxation (6), fracture (4), slipped capital physis (2), and femoral head and neck ostectomy revision (1). Surgical implants were from 4 systems. The incidence of surgeon-reported complication was 9.4%. No significant association was identified between weight, age, sex, breed, indication for THR, surgical technique and prosthesis, and the incidence of complications. In 82% of the cases, owners described their satisfaction with the outcome of THR as "very good" and a total of 20% complication rate was reported. There was a statistically significant improvement in owner-assessed questionnaire score before and after THR (P < .001). CONCLUSIONS: The BVOA-CHR offers a novel framework for the prospective studies on THR and on a national/international scale. Initial complication rates from the BVOA-CHR are similar to previous studies.


Asunto(s)
Artroplastia de Reemplazo de Cadera/veterinaria , Enfermedades de los Perros/cirugía , Internet , Animales , Artroplastia de Reemplazo de Cadera/efectos adversos , Perros , Femenino , Displasia Pélvica Canina/cirugía , Prótesis de Cadera/efectos adversos , Prótesis de Cadera/veterinaria , Humanos , Masculino , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Cadera/veterinaria , Resultado del Tratamiento
18.
Vet Surg ; 41(6): 738-44, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22642497

RESUMEN

OBJECTIVE: To determine mechanical differences between two plates with different requirements for supplementary casting after pancarpal arthrodesis (PCA): the Veterinary Instrumentation Hybrid Dynamic Compression Plate (HDCP), and the OrthoMed CastLess Arthrodesis Plate (CLP). STUDY DESIGN: In vitro mechanical analysis. SAMPLE POPULATION: HDCP(n = 10), CLP(10). METHODS: Single-cycle load to failure using a materials-testing machine and cyclic loading between 38 and 380 N ± 5% to simulate estimated in vivo loads until failure or 10(6) cycles. RESULTS: Single-cycle to failure: bending stiffness was significantly higher for the HDCP(2269 ± 175 N/mm) than CLP(1754 ± 88 N/mm; P < .001). Bending structural stiffness was higher for the HDCP(3.8 ± 0.3 Nm(2) ) versus CLP(2.9 ± 0.2 Nm(2) ; P= .0022). A difference between the 2 plates for bending strength was not demonstrated; HDCP= 13.9 ± 1.4 Nm, CLP13.2 ± 0.5 Nm (P= .24). Cyclic Loading: no failures occurred with either plate type when plates were cycled to 10(6) cycles. CONCLUSION: There is no mechanical advantage in bending resistance afforded by the CLPover the HDCP. Fatigue failure of either plate during the convalescent period of an estimated 150,000-250,000 cycles is unlikely. Based on the bending performance, there is no evidence to support the use of the CLPover the HDCPfor castless PCA.


Asunto(s)
Artrodesis/veterinaria , Placas Óseas/veterinaria , Perros , Inestabilidad de la Articulación/veterinaria , Ensayo de Materiales/veterinaria , Animales , Artrodesis/instrumentación , Artrodesis/métodos , Fenómenos Biomecánicos , Miembro Anterior , Ensayo de Materiales/métodos
19.
J Am Anim Hosp Assoc ; 48(3): 188-93, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22474051

RESUMEN

A 7 yr old spayed female mastiff presented for examination of a left pelvic limb lameness of 3 mo duration. Six years previously, the dog had undergone tibial plateau leveling osteotomy (TPLO) surgery of the left pelvic limb for the treatment of cranial cruciate disease. On presentation, the dog had a painful and swollen proximal tibia. Following investigation, a diagnosis of osteosarcoma of the proximal left tibia at the site of the previous TPLO surgery was made. This is the first reported case of osteosarcoma following TPLO using an implant other than the Slocum plate.


Asunto(s)
Neoplasias Óseas/veterinaria , Enfermedades de los Perros/diagnóstico , Osteosarcoma/veterinaria , Osteotomía/veterinaria , Tibia , Animales , Ligamento Cruzado Anterior/cirugía , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/etiología , Perros , Resultado Fatal , Femenino , Cojera Animal , Osteosarcoma/diagnóstico , Osteosarcoma/etiología , Osteotomía/efectos adversos
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