The Prevalence and Risk Factors of Contralateral Cranial Cruciate Ligament Rupture in Medium-to-Large (≥15kg) Breed Dogs 8 Years of Age or Older.

OBJECTIVE: The aim of this study was to determine the prevalence of contralateral cranial cruciate ligament rupture (CCLR) in dogs 8 years of age or older, weighing more than or equal to 15 kg at the time of first-side CCLR and to assess associated risks. STUDY DESIGN: It is a cross-sectional retrospective study of 831 client-owned dogs METHODS: Medical records of dogs weighing more than or equal to 15 kgs that were more than or equal to 8 years of age at the time of first CCLR diagnosis were reviewed. Data collected included weight, sex, pre-operative tibial plateau angle, co-morbidities, time between diagnosis of first CCLR and diagnosis of contralateral CCLR. Multivariate logistic regression analysis was used to estimate odds ratio. A median follow-up period of over 112.7 months (25th/75th quartiles 75.4/157.7 months) from first CCLR diagnosis was allotted. RESULTS: Eight-hundred thirty-one dogs were identified and included. About 19.1% (159/831 dogs, 95% confidence interval: 16.6-22.0%) of dogs that experience a first-side CCLR at 8 years of age or older will rupture the contralateral side, a median of 12.9 months (25th/75th quartiles 6.5/24.3 months) later. Age (p = 0.003) and breed, Golden Retrievers (p = 0.028) and Labrador Retrievers (p = 0.007), were factors significantly associated with contralateral CCLR. CLINICAL RELEVANCE: The prevalence of contralateral CCLR in medium-to-large breed dogs more than or equal to 8 years of age old is less than previously reported and the risk decreases as they age. This important information will help guide owners when deciding to pursue surgical stifle stabilization following CCLR in older dogs.

Influence of fixation systems on complications after tibial plateau leveling osteotomy in dogs greater than 45.4 kilograms (100 lb).

OBJECTIVE: To determine the influence of 3 fixation systems on complications rate after tibial plateau leveling osteotomy (TPLO) in dogs >45.4 kg. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Dogs (N = 287, 342 stifles) >45.4 kg with cranial cruciate ligament tear treated with TPLO. METHODS: The medical records of dogs treated with TPLO were reviewed for fixation and postoperative complications, with a follow-up of at least 6 weeks. A random effects logistic regression model was used to evaluate the association between the type of TPLO fixation system and complications. RESULTS: The fixation systems included a 3.5-mm broad TPLO plate alone (8P; 78.4%), a 3.5-mm broad TPLO plate with SOP (String of Pearls) plate (8AP; 14.9%), and a 3.5-mm standard TPLO plate (6P; 6.7%). Among the included stifles, 214 (62.6%) fixation systems were classified as locking, and 128 (37.4%) were classified as nonlocking. The fixation system was predictive of complications. The 8P had the lowest odds ratio for complication among the 3 fixation systems. Odds of developing complications were higher with the 8AP fixation system than with the 8P fixation system. Locking fixation eliminated the association between weight and complication rate. CONCLUSION: Fixation of a TPLO with the 8AP increased the risk of complications compared with the 8P in this population of large dogs. CLINICAL SIGNIFICANCE: Locking fixation of TPLO with a 3.5-mm broad TPLO plate alone should be considered in large dogs because it may reduce complications.

Post-operative complications associated with the Arthrex Canine Cranial Cruciate Ligament Repair Anchor System in small- to medium-sized dogs: A retrospective analysis (2009-2012).

This study classified and determined the post-operative complication rate associated with stabilization of cranial (CCL) ligament deficient stifles in small- to medium-sized dogs with the Arthrex Canine Cranial Cruciate Ligament Repair Anchor System (CCLRAS). Eighty-five medical records from 2009 to 2012 from 1 institution were evaluated. Complications were classified according to previously proposed definitions for orthopedic studies in veterinary medicine. Fifty-two owners were contacted by telephone at least 6 months after surgery and given a questionnaire to classify complications related to the implant. A visual analog scale was used to assess functionality and degree of pain. The overall complication rate was 30.3% with an inflammation-infection rate of 5.4% and a documented infection rate requiring implant removal of 1.8%. Owners reported full or acceptable function in 96% of cases with an average functional score of 86.5. Stabilization of CCL-deficient stifles in small- to medium-sized dogs with the Arthrex Canine CCLRAS is reliable with acceptable complication rates.

Complications postopératoires associées au système d'ancrage canin Arthrex pour la réparation du ligament croisé antérieur chez des chiens de petite à moyenne taille : une analyse rétrospective (2009­2012). Cette étude a classé et déterminé le taux de complications postopératoires associé à la stabilisation des grassets ayant un ligament croisé antérieur (LCA) déficient chez des chiens de petite à moyenne taille à l'aide du Système d'ancrage de réparation du ligament croisé antérieur Arthrex canin (SARLCA). Quatre-vingt-cinq dossiers médicaux datant de 2009 à 2012 qui provenaient de 1 institution ont été évalués. Les complications étaient classées selon des définitions proposées antérieurement pour des études orthopédiques en médecine vétérinaire. Cinquante-deux propriétaires ont été contactés par téléphone au moins 6 mois après la chirurgie et on les a interrogés afin de classer les complications relatives à l'implant. Une échelle analogue visuelle a été utilisée pour évaluer la fonctionnalité et le degré de douleur. Le taux global de complication a été de 30,3 % avec un taux d'inflammation-infection de 5,4 % et un taux d'infection documenté exigeant l'enlèvement de l'implant de 1,8 %. Les propriétaires ont signalé une fonction complète ou acceptable dans 96 % des cas avec une note fonctionnelle moyenne de 86,5. La stabilisation des grassets dont le LCA est déficient chez les chiens de petite à moyenne taille est fiable à l'aide du SARLCA Arthrex canin et comporte des taux de complications acceptables.(Traduit par Isabelle Vallières).

Distal femoral osteotomy using a novel deformity reduction device.

Distal femoral osteotomy is a surgical procedure used to correct patellar luxation, secondary to a femoral deformity. A distal femoral osteotomy using the tibial plateau levelling osteotomy-jig to temporarily provide stability of the distal femoral osteotomy, maintaining limb alignment in the frontal and axial planes prior to internal plate fixation of the osteotomy, has been described. This report describes a novel jig named Deformity Reduction Device (DRD). This device was developed with the specific aim of increasing precision and predictability during corrective osteotomy execution in order to be consistent with the preoperative planning. The distal femoral osteotomy DRD-assisted procedure is described in detail, discussing the theoretical and practical principles of the application.

Descriptive report of antebrachial growth deformity correction in 17 dogs from 1999 to 2007, using hybrid linear-circular external fixator constructs.

The radiographic and clinical results from 17 dogs (18 limbs) in which hybrid linear-circular external fixators (HLCEF) were used for the correction of antebrachial growth deformities (AGD) are described, retrospectively. Wedge ostectomy and the application of a type IA or IB HLCEF were performed in all cases. Pre- and postoperative AGD measurements, complications, time to staged destabilization and/or fixator removal, cosmesis, and limb function were evaluated. Complications included wire and/or pin tract inflammation (11 limbs) and radial fracture (2 limbs). All dogs had improved function and appearance after surgery. Limb function was assessed as excellent in 13 cases and good in 4 cases. Limb appearance was assessed as excellent in 12 cases and good in 5 cases. This case series substantiates the utility of HLCEF for the correction of AGD in dogs.

Pancarpal and partial carpal arthrodesis.

Arthrodesis can be an effective procedure to restore acceptable function and alleviate pain when other medical or surgical treatments are not possible. A thorough knowledge of carpal anatomy and strict adherence to the principles of arthrodesis are essential to success. The most important factor in determining whether a partial carpal arthrodesis can be performed is the stability of the antebrachiocarpal joint. Multiple techniques, including plating, pinning, and external skeletal fixation, have proven successful, and this article discusses these techniques and the complications of each.

Age, tibial plateau angle, sex, and weight as risk factors for contralateral rupture of the cranial cruciate ligament in Labradors.

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.

Management of humeral and femoral fractures in dogs and cats with linear- circular hybrid external skeletal fixators.

Linear-circular hybrid fixators were used to stabilize humeral and femoral fractures in 21 dogs and five cats. Twenty-two of 24 fractures with sufficient follow-up radiographic evaluation obtained union. Time to radiographic union ranged from 25 to 280 days (mean +/- standard deviation [SD] 110+/-69 days; median 98 days). Eleven animals developed minor and two dogs developed major pin and/or wire tract inflammation. Functional outcome was rated as excellent (n=16), good (n=5), and fair (n=3) at the time of final long-term assessment (range 4.5 to 60.0 months; mean +/- SD 28.4+/-15.4 months; median 28.5 months). Follow-up information was unavailable for two animals. Hybrid fixators were useful constructs for stabilization of humeral and femoral fractures, particularly fractures with short, juxta-articular fracture segments.

Pes varus correction in Dachshunds using a hybrid external fixator.

OBJECTIVE: To describe surgical correction of pes varus deformity in Dachshunds by acute medial opening wedge osteotomy of the distal aspect of the tibia stabilized with a hybrid external skeletal fixator (HESF), and report clinical and radiographic outcomes. STUDY DESIGN: Multicenter, retrospective clinical study. ANIMALS: Immature Dachshunds (n=13) with pes varus deformity. METHODS: Limb function and lameness scores were assigned before and after surgery, and correction was determined visually at surgery. Tibiotarsal joint orientation (TTJO) and medial and lateral tibial cortex lengths, measured on radiographs of deformed and normal (when available) limbs, were compared before correction and after fixator removal. RESULTS: Pes varus deformities (n=14) were corrected; 93% had good to excellent clinical outcome. None of the dogs had a normal preoperative gait. Mean TTJO of abnormal and normal tibiae before surgery were 29 degrees varus (median, 28 degrees), and 12 degrees valgus (median, 12 degrees). Angular correction ranged from 20 degrees to 51 degrees (mean, 36+/-8 degrees; median, 36 degrees). Mean TTJO after fixator removal was 7 degrees valgus (median, 7 degrees). Two dogs had minor transient postoperative complications whereas 3 had major complications; only 1 of which was resolved. CONCLUSIONS: Pes varus deformity in Dachshunds can be corrected by acute medial opening wedge osteotomy of the distal aspect of the tibia stabilized by HESF. Technique modifications are needed to improve correction precision. CLINICAL RELEVANCE: Visual inspection of limb alignment during surgery resulted in good to excellent clinical outcomes; however, 91% of tibiae were under- or overcorrected (mean, 6 degrees; median, 5 degrees). Limb alignment should be based on evaluation of immediate postoperative TTJO measurements, not solely on intraoperative visual assessment.

Use of polypropylene mesh in addition to internal obturator transposition: a review of 59 cases (2000-2004).

Fifty-nine dogs with a total of 69 perineal hernias that were repaired by internal obturator transposition and polypropylene mesh reinforcement were reviewed. Thirty-six dogs were available for follow-up at a mean of 29.4 months postoperatively. Six dogs had complications within the first 60 days of surgery, such as perineal swelling, persistent tenesmus, and incisional infections. Twenty-two dogs had excellent outcomes; seven dogs needed continued medical treatment after surgery; and seven dogs had poor outcomes. Hernias recurred in five dogs. The incisional infection rate was 5.6%; the recurrence rate was 12.5%; and the overall success rate was 80.5% for the 36 dogs with long-term follow-up.

A clinical evaluation of pancarpal arthrodesis in nine dogs using circular external skeletal fixation.

OBJECTIVE: To report clinical outcome and complications after pancarpal arthrodesis using circular external skeletal fixation (CESF) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=9) with carpal injury. METHODS: Medical records including radiographs (10 limbs) with underlying severe carpal injury that had pancarpal arthrodesis with CESF were reviewed. Short-term follow-up (>6 months) was obtained by phone interview of owners. RESULTS: Mean weight was 24.5 kg (range, 10.1-69.5 kg). Mean duration until CESF removal was 110.6 days (range, 72-149 days). Complications in all dogs were mild postoperative edema of the distal aspect of the limb and initial mild serous discharge form exit points of CSEF wires. Follow-up (mean, 328 days; range, 190-541 days) was available for 8 dogs. All owners reported limb function and cosmesis as being excellent, and perceived that their animals were pain free. Perception of fixator care difficulty, as reported by owners, varied significantly based on previous splint management experience; owners who had experienced splint management for >1 month found fixator care equal to or easier than splint management. CONCLUSION: Pancarpal arthrodesis with a CESF produces a favorable clinical outcome with high owner acceptance. CLINICAL RELEVANCE: Pancarpal arthrodesis by use of CESF is a clinically applicable technique and may offer advantages over internal fixation with respect to postoperative complications.

Circular external skeletal fixation stabilization of antebrachial and crural fractures in 25 dogs.

Fracture stabilization using circular external skeletal fixation was evaluated in 14 dogs with antebrachial fractures and 11 dogs with crural fractures. Most dogs were consistently weight bearing on the stabilized limb by 3 days following surgery. Although all dogs developed minor wire/pin tract inflammation and eight dogs developed major wire/pin tract inflammation, postoperative lameness was not consistently associated with wire/pin tract complications. Fractures in 23 dogs achieved radiographic union (mean +/- standard deviation [SD], 61 +/- 21 days; median, 57 days) without additional surgery; two dogs required restabilization of their fractures with linear fixators. Twenty of the 21 owners that could be contacted felt their dog had no (n=15) or only a mild (n=5) intermittent lameness at the time of final, long-term (mean +/- SD, 37 +/- 17 months; median, 42 months) assessment.