Surgical Technique of the 3-Dimensional-printed Personalized Hip Implant for the Treatment of Canine Hip Dysplasia.

Hip dysplasia causes major disability in dogs. Treatment options are limited to palliative treatment (e.g., pain relief, physical exercise, lifestyle changes, and weight control) or invasive surgeries such as pelvic osteotomies and total hip arthroplasty. Hence, a strong unmet need exists for an effective and dog-friendly solution that enhances the quality of life of man's best friend. We fill this treatment gap by offering a minimally traumatic and extraarticular, dog-specific, 3-dimensional-printed, hip implant (3DHIP) that restores hip joint stability. The surgical treatment using a 3DHIP implant is less invasive than osteotomies and can be performed bilaterally in one surgical session. The 3DHIP implant extends the dorsal acetabular rim of the dysplastic hip joint thereby increasing coverage of the femoral head and inhibiting joint subluxation with fast recovery. Sufficient access to the dorsal acetabular rim and ventral border of the iliac body together with optimal fitting and fixation of the implant are key steps for a successful 3DHIP implantation and imply the need for a specific approach. The present article aims to showcase this innovative surgical technique with tips and tricks as a surgical manual for implantation of the 3DHIP implant in dogs affected by hip dysplasia.

Comparative analysis of post-operative rehabilitation approaches for medial patellar luxation in small-breed dogs.

Background and Aim: Electrical stimulation (ES) and light amplification by stimulated emission of radiation (LASER) therapy are frequently used in post-operative rehabilitation; however, there is currently insufficient research comparing their effectiveness. This study aimed to assess the effectiveness of post-operative rehabilitation following medial patellar luxation (MPL) surgical correction by comparing ES and LASER therapy when combined with exercise. This was compared with a control group that consisted solely of post-operative home exercise implemented by the owner. Materials and Methods: We conducted a prospective clinical trial on dogs that had undergone surgical treatment for MPL. The dogs were categorized into the following three groups: The control group, which did not participate in any post-operative rehabilitation program; the ES group, which received post-operative rehabilitation involving ES therapy; and the LASER group, which underwent post-operative rehabilitation featuring LASER therapy. Results: There were no significant differences among the groups regarding the evaluation parameters, including lameness score, pain score, thigh muscle circumference, and range of motion. Although there may have been a difference in pain score in some groups, it could be attributed to the pre-operative condition of patients. These results aligned with the owner questionnaires' canine brief pain inventory assessments, showing no significant differences between treatment groups. Conclusion: Post-operative rehabilitation for MPL correction may enhance limb usage, joint function, muscle mass, and pain relief. However, the duration and level of post-operative pain may influence the necessity for rehabilitation. In addition, ES and LASER therapy offer similar pain-relieving effects after MPL surgery; therefore, the choice between these methods depends on the availability of equipment and veterinarian preferences.

Short-term outcomes of cranial cruciate ligament rupture treated surgically with tibial plateau leveling osteotomy or non-surgically in small-breed dogs weighing less than10 kg.

Cranial cruciate ligament rupture (CCLR) is a common cause of stifle joint pain in dogs. This study assessed the short-term outcomes in the management of CCLR, with or without concurrent medial patellar luxation (MPL), in small-breed dogs, comparing surgical intervention using tibial plateau leveling osteotomy (TPLO) with non-surgical approaches. Dogs weighing less than 10 kg and suffering from CCLR were divided into two groups: surgical and non-surgical (nine stifles per group). Both groups followed the same rehabilitation protocol. Measurements were taken on days 0, 14, 28, 42, 56, 70, and 84. These measurements included the mean difference in orthopedic assessment score (diffOAS) and thigh muscle circumference (TMC) assessed by veterinarians, as well as the Canine Brief Pain Inventory score (CBPI) evaluated by the owners. Six stifles had concurrent MPL in the surgical group and five in the non-surgical group. No significant differences were observed in diffOAS (P=0.685), TMC (P=0.557), CBPI pain severity score (P=0.062), and CBPI pain interference score (P=0.29) between the two groups. However, both groups showed a significant decrease (P<0.05) in diffOAS and CBPI. The TMC remained relatively stable in the non-surgical group (P>0.05), but it significantly increased in the surgical group (P<0.05). Both groups demonstrated improved clinical outcomes in the short term, with no significant differences. However, cautious consideration should be given to a conservative treatment in small-breed dogs, particularly when considering the exclusive improvement observed in TMC within the TPLO group.

Acetabular rim extension using a personalized titanium implant for treatment of hip dysplasia in dogs: short-term results.

Hip dysplasia (HD) is a common orthopedic problem in young dogs. To decrease the laxity of the hip joint related to HD, the surgical treatments are recommended to increase femoral head coverage. ACEtabular rim eXtension (ACE-X) using a personalized 3-dimensional printed titanium shelf implant is a new surgical treatment to increase femoral head coverage and decrease laxity of the dysplastic hip joint, however, the efficacy is less know. Client-owned dogs older than 6 months with clinical signs of coxofemoral joint subluxation and radiographic evidence of HD with no or mild osteoarthritis (OA) were included. The Norberg angle (NA), linear percentage of femoral head overlap (LFO), and percentage of femoral head coverage (PC) were investigated radiographically and with computed tomography (CT) before and after surgery. OA was graded (scores 0-3) according to the maximum osteophyte size measured on CT. In addition, joint laxity (Ortolani) test results, gait analysis, and the Helsinki chronic pain index (HCPI) questionnaire were obtained at preoperative, immediately postoperative and at 1.5- and 3-month evaluations. Acetabular rim extension was performed in 61 hips of 34 dogs; NA, LFO, and PC were significantly higher immediately postoperatively and at the 1.5- and 3-month follow-up examinations compared with preoperative values (p < 0.05). Osteophyte size gradually increased over time (p < 0.05). The OA score significantly increased between preoperatively and directly postoperatively, and between preoperatively and at 3-month follow-up (p < 0.05). The laxity test normalized in 59 out of 61 hips after surgery, and the HCPI questionnaire showed that the pain score decreased significantly at 1.5 and 3 months, postoperatively. The force plate showed no significant improvement during the 3 months follow-up. Although pain reduction by the implant was unclear in short-term results, a personalized shelf implant significantly increased femoral head coverage and eliminated subluxation of the dysplastic hip joint. Further studies are required to study the long-term efficacy of gait, chronic pain, and progression of osteoarthritis.

The effectiveness of marine based fatty acid compound (PCSO-524) and firocoxib in the treatment of canine osteoarthritis.

BACKGROUND: NSAIDs are accepted as the most predictably efficacious medical treatment of the clinical signs of osteoarthritis (OA). The marine-based fatty-acid compound PCSO-524 has been proposed as an adjunctive treatment for canine OA, however benefits of this agent is still controversial. The purpose of this study was to evaluate and compare the effectiveness of PCSO-524 combined with the NSAID firocoxib using force plate gait analysis, orthopedic assessment score (OAS) and canine brief pain inventory score (CBPI) in dogs with OA. A prospective, randomized, double-blinded study was conducted. Seventy-nine dogs that had hip and/or stifle OA were assigned randomly into three treatment groups: firocoxib, PCSO-524 and combination of firocoxib and PCSO-524, orally for 4 weeks. Peak vertical force (PVF, expressed as a percentage of bodyweight), OAS, CBPI, serum prostaglandin E2 concentration, hematology and blood chemistry values were evaluated before treatment (Day0), as well as at the second (Day14) and fourth week (Day28) during treatment. RESULTS: Within group analysis revealed significant increases in PVF over the 4-week treatment period for firocoxib, PCSO-524 and the combination (p < 0.05). Mean increases in PVF were 3.25 ± 4.13, 2.01 ± 3.86, 4.11 ± 4.69%BW (mean ± SD) respectively. The OAS showed non-significant change in all treatment groups. There were significant decreases in CBPI pain severity score (PSS) and CBPI pain interference scores (PIS) within some groups over time, however no significant differences were found between the groups. Significantly decreased serum PGE2 concentration (p < 0.05) was found in the combination group. Significant increases in BUN and creatinine (p < 0.05) compared to pre-treatment values were found in the firocoxib and combination groups but not in the PCSO-524 group at day28, but all values in all dogs remained within the normal ranges. CONCLUSIONS: The results of this study suggested combination of both PCSO-524 and firocoxib is more effective in alleviation of inflammation and improvement of weight bearing ability when compared to the uses of either PCSO-524 or firocoxib alone. Further clinical studies are needed to confirm this, and to determine if there is any benefit of PCSO-524 over placebo.