Biomechanical comparison of canine femurs implanted with either cemented (CFX®) or cementless (with lateral bolt) (BFX®+lb) total hip replacement under 4-point bending or torsional loads.

Objective: Compare biomechanical properties of femurs implanted with either BioMedtrix™ biological fixation with interlocking lateral bolt (BFX®+lb) or cemented (CFX®) stems when subjected to 4-point bending or axial torsional forces. Study Design: Twelve pairs of normal medium to large cadaveric canine femora were implanted with a BFX + lb (n = 12) and a CFX (n = 12) stem-one in the right and one in the left femora of the pair. Pre- and post-operative radiographs were made. Femora were tested to failure in either 4-point bending (n = 6 pairs) or axial torsion (n = 6 pairs), and stiffness, load or torque at failure, linear or angular displacement, and fracture configuration were noted. Results: Implant position was acceptable in all included femora, but CFX stems were placed in less anteversion than BFX + lb stems in the 4-point bending group (median (range) 5.8 (-1.9-16.3) vs. 15.9 (8.4-27.9) anteversion, respectively (p = 0.04)). CFX implanted femora were more stiff than BFX + lb implanted femora in axial torsion (median (range) 2,387 (1,659-3,068) vs. 1,192 (795-2,150) N*mm/o, respectively (p = 0.03)). One of each stem type, from different pairs, did not fail in axial torsion. There was no difference in stiffness or load to failure in 4-point bending, or in fracture configuration for either test, between implant groups. Conclusion: Increased stiffness of CFX implanted femurs under axial torsional forces may not be clinically relevant as both groups withstood expected in vivo forces. Based on this acute post-operative model using isolated forces, BFX + lb stems may be a suitable replacement for CFX stems in femurs with normal morphology (stovepipe and champagne flute morphology were not tested).

Caudal cruciate ligament disease in three Basset Hounds.

CASE DESCRIPTION: 3 adult Basset Hounds were referred for evaluation of chronic, unilateral, pelvic limb lameness with no history of trauma. CLINICAL FINDINGS: On examination, all dogs had mild lameness of the affected limb; signs of pain were evident during manipulation of the stifle joint in the affected limb, along with effusion of that joint. No stifle joint instability was palpable. Radiographs were available for review for 2 of the 3 dogs. Effusion was confirmed radiographically, but severity of degenerative joint disease varied. Central intercondylar notch width ratios for the 2 dogs were 0.16 and 0.17, and tibial plateau angles were -10° and 15°; relative tibial tuberosity width was 1.1 for both dogs. Exploratory arthroscopy revealed moderate degeneration of the caudal cruciate ligament in all 3 dogs; the cranial cruciate ligaments were grossly normal. TREATMENT AND OUTCOME: Corrective osteotomy to increase the tibial plateau angle was performed in 1 dog, and the lameness resolved by 2 months after surgery. The 2 other dogs were managed without additional surgery. One dog was persistently lame. The other dog reportedly had normal limb function 2.5 years after undergoing exploratory arthroscopy. CLINICAL RELEVANCE: Morphological characteristics of the tibia in Basset Hounds may predispose to abnormal stresses on the caudal cruciate ligament. Isolated degeneration of the caudal cruciate ligament should be considered as a differential diagnosis for Basset Hounds with lameness originating from the stifle joint. Without direct inspection of the joint, caudal cruciate ligament disease could be confused for cranial cruciate ligament injury.

Investigation of burnout syndrome and job-related risk factors in veterinary technicians in specialty teaching hospitals: a multicenter cross-sectional study.

OBJECTIVES: To investigate veterinary technician burnout and associations with frequency of self-reported medical error, resilience, and depression and job-related risk factors. DESIGN: Cross-sectional observational study using an anonymous survey conducted between November 2017 and June 2018. SETTING: Four referral teaching hospitals in the United States and Canada. SUBJECTS: A total of 344 veterinary technicians were invited to participate. Response rate was 95%. Overall 256 surveys were ultimately analyzed. INTERVENTIONS: Burnout, depression, and resilience were measured using validated instruments. Respondents reported perceptions of workload, working environment, and medical error frequency. Associations between burnout and factors related to physical work environment, workload and schedule, compensation package, interpersonal relationships, intellectual enrichment, and exposure to ethical conflicts were analyzed. MEASUREMENTS AND MAIN RESULTS: Burnout, characterized by high emotional exhaustion, depersonalization, and low sense of personal accomplishment was common, and was positively associated with perceived medical errors, desire to change career, and depression. Burnout levels on all 3 burnout subscales were higher in this population than previously reported for a contemporaneous group of trauma nurses working with human patients (P < 0.05). Burnout was negatively associated with resilience. Respondents' feelings of fear or anxiety around supervisor communications, perception that patient load was too high to allow for excellent patient care, and perceived lack of available assistance during sudden workload increases were all associated with burnout. CONCLUSIONS: Burnout in veterinary technicians is common and is associated with numerous undesirable outcomes. Work-related interventions to reduce burnout should focus on improving supervisor relationships and maintaining an appropriate patient:caregiver ratio.

Equine Dental Pulp Connective Tissue Particles Reduced Lameness in Horses in a Controlled Clinical Trial.

OBJECTIVE: To assess if injection of allogeneic dental pulp tissue particles would improve lameness in horses with naturally occurring osteoarthritis (OA) or soft tissue (ST) injury. DESIGN: Prospective, randomized, blinded, and controlled clinical trial and client survey assessment. ANIMALS: Forty lame client-owned horses. PROCEDURES: Sterile dental pulp, recovered from otherwise healthy foals that perish during dystocia, was processed under good manufacturing processing to produce mechanically manipulated, unexpanded pulp tissue particles containing viable cells surrounded in extracellular matrix. Forty lame client-owned horses with confirmed OA (n = 20), or ST injury (desmitis or tendonitis) received a 2 mL intra-articular (n = 20 OA) or intra-lesional (n = 20) injection of control transport vehicle (n = 20) or 10 × 106 dental pulp tissue particles (n = 20). Acclimatized horses had baseline measurements performed and were then injected on day 0. Horses were treadmill exercised for 2 weeks, evaluated by clinical parameters, lameness score, edema (score and circumference), pain on flexion (OA) or pressure (ST), and clients' scores for pain and discomfort before and through 45 days after pulp injection. Twenty horses were available for >2.5-year follow-up. RESULTS: Pulp-treated horses showed decrease in lameness compared to baseline (P < 0.009) or placebo controls (P < 0.013) for at least 2 weeks. Client assessments of comfort were improved between before and 45 days after pulp injection (P < 0.001). Clinical improvement with ST injury was significantly greater than OA (P < 0.001). At >2.5-year follow-up, at least 10 horses were in work. CONCLUSION AND CLINICAL RELEVANCE: Dental pulp tissue particles can be considered as a treatment option for equine lameness due to OA, desmitis, or tendonitis.