Tibial tuberosity transposition advancement for treatment of concomitant cranial cruciate ligament rupture and medial patellar luxation in four feline stifles.

CASE SERIES SUMMARY: Three cats (four stifles) were diagnosed with varying grades of medial patellar luxation and stifle instability in cranial tibial thrust. Radiographs showed periarticular osteophytosis, intra-articular mineralization and opacification encroachment of the infrapatellar fat pad. Stifle exploration revealed either partial (n = 2) or complete (n = 2) cranial cruciate ligament tear and medial meniscal injury in all cases. Medial meniscectomy, partial parasagittal patellectomy, femoral trochleoplasty and tibial tuberosity transposition advancement using a 6 mm cage, two-fork plate and 4 mm spacer were performed in four stifles. Screws (2.0 mm) and washers were used in the cranial cage ears rather than conventional 2.4 mm screws. By the 2-week recheck, lameness was minimal and stifles were stable. Radiographic follow-up at 8 weeks showed appropriate progression of osseous union in all cases. One cat experienced a major complication, suffering tibial fracture following a lapse in exercise restriction, and revision surgery was performed successfully with subsequent osseus union of the osteotomy site. At the mid-term follow-up, all cats had a return to previous level of function, as assessed by both owner questionnaire and clinical evaluation. RELEVANCE AND NOVEL INFORMATION: Tibial tuberosity transposition and advancement has been shown to be successful in dogs for the treatment of concomitant medial patellar luxation and cranial cruciate ligament rupture. To date, there have been no reports of tibial tuberosity transposition and advancement in cats. A benefit of this approach is concomitant alignment of the extensor mechanism and neutralization of the femorotibial shear force. Our case series describes successful use of tibial tuberosity transposition advancement in cats.

Total hip arthroplasty to address chronic hip luxation with pseudoacetabulum formation in seven dogs.

OBJECTIVE: To compare the outcome of dogs treated with total hip arthroplasty (THA) for chronic hip luxation and pseudoacetabulum formation to that of dogs with simple hip dysplasia and secondary osteoarthritis. STUDY DESIGN: Retrospective, case-controlled study. ANIMALS: Seven dogs with pseudoacetabulum (group 1) and 21 matched control dogs (group 2). METHODS: Each dog in group 1 was matched with three control dogs, primarily according to similarity of THA implant type and size. Patterns of radiographic pathology were characterized in each dog. Outcome measures included operative time, acetabular cup position/orientation (inclination angle, angle of lateral opening, version angle) complications, and long-term outcomes. Outcome measures were compared between groups using linear regression (P = .05). RESULTS: The presence of a pseudoacetabulum was associated with ilial remodeling and heterotopic bone formation concentric to the luxated femoral head. Exposing the native acetabulum and reducing the prosthesis were surgically challenging. The mean (SD) operative time of dogs in group 1 (96 [18] minutes) was longer than that of dogs in group 2 (63 [14] minutes; P = .00002). Cup position/orientation was not different between dogs in group 1 and group 2. One intraoperative complication and two minor postoperative complications occurred in group 1 dogs. All dogs had good long-term outcomes. CONCLUSION: Total hip arthroplasty in dogs with a pseudoacetabulum was more challenging than in control dogs. However, the procedure provided good to excellent long-term clinical outcomes in all dogs. CLINICAL SIGNIFICANCE: Surgeons should be prepared for the specific surgical challenges associated with THA in dogs with pseudoacetabulum formation.

Comparison of tensile strength and time to closure between an intermittent Aberdeen suture pattern and conventional methods of closure for the body wall of dogs.

OBJECTIVE To compare tensile strength and time to completion of body wall closure among 3 suture patterns. SAMPLE Eighteen 5 × 5-cm leather specimens and sixty-eight 5 × 5-cm full-thickness tissue specimens from the ventral portion of the abdominal body wall of 17 canine cadavers. PROCEDURES During experiment 1 of a 2-experiment study, each leather specimen was cut in half and sutured with a simple interrupted or simple continuous pattern or continuous pattern with intermittent Aberdeen knots (intermittent Aberdeen pattern). During experiment 2, 4 tissue specimens were obtained from each cadaver; the linea alba of 3 specimens was incised and closed with 1 of the 3 suture patterns evaluated in experiment 1, and the fourth specimen was left intact as a control. All leather and tissue specimens underwent mechanical testing. Time to completion, mode of failure, and maximum force at failure (Fmax) were compared among the suture patterns. RESULTS In experiment 1, the mean Fmax for the simple continuous and intermittent Aberdeen patterns was significantly greater than that for the simple interrupted pattern. In experiment 2, the mean Fmax for specimens obtained cranial to the umbilicus was greater than that for specimens obtained caudal to the umbilicus, and the mean time to completion for both continuous suture patterns was significantly less than that for the simple interrupted pattern. Most (34/51) sutured tissue specimens failed because the suture cut through the tissue at the suture-tissue interface. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intermittent Aberdeen pattern may be an alternative for body wall closure in dogs.