Inter- and intra-operator variability associated with extracapsular suture tensioning: an ex vivo study.

OBJECTIVES: To determine inter- and intra- operator variability associated with extracapsular suture tensioning as performed during lateral fabello-tibial suture placement. STUDY DESIGN: Ex vivo study. METHODS: Fifteen Greyhound cadaveric pelvic limbs were prepared by cutting the cranial cruciate ligament and placing an extracapsular fabello-tibial suture. On two occasions, three surgeons tensioned the extracapsular suture of each stifle. Stifles were returned to 135 degrees of flexion and the suture tension was measured using a commercially available suture tensioner with inbuilt tensiometer. STATISTICAL ANALYSIS: Intra-operator and inter-operator agreement were assessed using the limits of agreement method. A linear mixed effects model was specified to assess the effect of operator, repeated estimates and stifle order on tension applied. RESULTS: The mean difference within the three operators ranged from 0 to 14.7N. With 95% limits of agreement, on most occasions for all three operators, the difference was between -31.7 and 41.0 N. The mean difference between the three operators ranged from 6.0 to 30.7 N. With 95% limits of agreement, on most occasions the difference between operators was between -25.6 and 62.5 N. CLINICAL SIGNIFICANCE: Marked variation exists in the tension applied during fabello-tibial suture application, both within and between surgeons. This variation may lead to inconsistent clinical outcomes. Further studies are required to determine the clinical consequences of this marked variation in extracapsular suture tensioning.

Osteosarcoma at the site of titanium orthopaedic implants in a dog.

An Alaskan Malamute underwent unilateral tibial tuberosity advancement (TTA) surgery to stabilise a stifle joint with a deficient cranial cruciate ligament. The dog made an excellent recovery with no postoperative complications, until 20 months post-surgery when he presented with acute onset ipsilateral pelvic limb lameness. Osteosarcoma (OSA) was diagnosed adjacent to the titanium implants. Currently, there is a paucity of information on the epidemiology of OSA adjacent to orthopaedic implants in canine patients. The clinical, radiological and pathological findings of this case of periprosthetic OSA, and a potential causal relationship between titanium implants and bone neoplasia, are discussed.

The effects of wound lavage solutions on canine fibroblasts: an in vitro study.

OBJECTIVE: The purpose of this study was to determine the effects of phosphate-buffered saline (PBS), sterile tap water, normal saline, and Ringer's lactate on wound healing in an in vitro model. STUDY DESIGN: The effects of PBS, sterile tap water, normal saline, and Ringer's lactate on a primary line of canine embryonic fibroblasts were determined. ANIMALS OR SAMPLE POPULATION: A primary line of canine embryonic fibroblasts. METHODS: The effects of the various lavage solutions were determined by (1) vital staining of the treated cells with a 0.5% trypan blue solution, (2) evaluation of the amount of lactate dehydrogenase released by the treated cells, and (3) cytopathologic evaluation of hematoxylin and eosin-stained monolayers of treated canine fibroblasts. The cells were exposed to the lavage treatments for the following time intervals: 0.5 minute, 1 minute, 2.5 minutes, 5 minutes, and 10 minutes. PBS was used as the control. RESULTS: Sterile tap water significantly damaged canine fibroblasts at all time intervals (P = .05). This was attributed to the alkaline pH, hypotonicity, and presence of numerous cytotoxic trace elements in the tap water used. Cytotoxic effects were noted in fibroblasts after 10 minutes' exposure to normal saline; this may be because of the acidic pH of normal saline and lack of a buffering system. Ringer's lactate did not induce any significant fibroblast injury. CONCLUSIONS: PBS and Ringer's lactate do not induce any significant fibroblast injury, whereas normal saline and sterile tap water cause mild and severe cytotoxic effects in vitro. CLINICAL RELEVANCE: Further clinical investigation is indicated to establish whether Ringer's lactate is the wound lavage solution of choice compared with normal saline. Sterile tap water may cause considerable fibroblast injury.

Effect of dietary biotin supplement on equine hoof horn growth rate and hardness.

Over a 10-month period, 24 randomly selected riding horses were fed various amounts of biotin. Statistically significant improvements in growth rates and hardness of hooves were produced by biotin supplementation. Greater growth rates and hardness were achieved at a daily dose of 15 mg than at 7.5 mg. Increased hoof hardness was greatest in the hoof quarters and toe. No ring formation occurred in hooves of horses fed biotin intermittently.