Accuracy of needle arthroscopy for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture.

OBJECTIVE: To determine the accuracy of needle arthroscopy (NA) for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture (CCLR). STUDY DESIGN: Prospective clinical trial. ANIMALS: Twenty-six client-owned dogs. METHODS: Dogs with CCLR and scheduled to undergo tibial plateau leveling osteotomy were recruited for the study. Needle arthroscopy was performed by an experienced surgeon; the same dog subsequently underwent standard arthroscopy (SA) by another experienced surgeon who was blinded to the NA findings. The SA arthroscopy findings were used as the gold standard. Arthroscopy time, visibility of the menisci, ability to probe the menisci, and the presence of meniscal tears were recorded for both arthroscopies. The degree of lameness before and after NA was subjectively quantified. RESULTS: The sensitivity and specificity to diagnose medial meniscal tears with NA was 95% and 100%, respectively. Visibility of the menisci was lower (P < .01), probing of the lateral meniscus was harder (P = .0017), and procedure time was shorter (P = .073) with NA when compared to SA. The lameness scores did not differ before and after NA (P = .25). CONCLUSION: Needle arthroscopy could be performed rapidly with low morbidity, and had high accuracy for detecting medial meniscal tears in dogs with CCLR. CLINICAL SIGNIFICANCE: Needle arthroscopy is a promising minimally invasive technique for diagnosing medial meniscal tears in dogs with CCLR.

Use of a bone-to-tendon plate to stabilize a comminuted calcaneus fracture in a dog.

OBJECTIVE: To report the use of an ancillary plate spanning from the calcaneus to the common calcaneal tendon to stabilize a comminuted fracture in a dog. STUDY DESIGN: Case report ANIMALS: Two year old male neutered mix-breed dog. METHODS: The dog presented for a grade IIIa open highly comminuted fracture of the shaft and tuber of the left calcaneus from a suspected gunshot wound. Plantar and lateral locking plates were applied to the calcaneus, with the lateral plate extending proximally and sutured directly to the common calcaneal tendon. Autogenous cancellous and allogenic corticocancellous bone grafts were placed into the fracture site, and a human placental matrix was injected after closure. A lateral tarsal splint was applied for 17 weeks postoperatively. The lateral bone-to-tendon plate was replaced with a smaller lateral plate spanning only the calcaneus 9 weeks after the initial surgery. RESULTS: Radiographic union was documented at 17 weeks. At 25 weeks, both plates were removed due to suspected implant associated infection. At the final follow-up assessment, 36 weeks after initial surgery, the dog had returned to normal function with no observable lameness. CONCLUSION: Incorporation of the common calcaneal tendon as a proximal segment for plate fixation led to successful union of a highly comminuted calcaneal fracture.

Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study.

OBJECTIVE: To evaluate the short- and mid-term effects of tibial tuberosity advancement (TTA) and tibial plateau leveling osteotomy (TPLO) on subsequent meniscal tears. STUDY DESIGN: Experimental in vivo study. ANIMALS: Purpose-bred beagle dogs (n = 15). METHODS: For each dog, the cranial cruciate ligaments were transected; one limb underwent TTA and the other limb underwent TPLO. Orthopedic and radiographic examinations were performed preoperatively and at 12 and 32 weeks postoperatively. Gross evaluation of the stifle joint was performed after euthanasia at 12 (n = 10) and 32 (n = 5) weeks. RESULTS: Lameness scores were not different between TTA and TPLO limbs at any time point. Radiographic osteoarthritis scores of TTA stifles (1.33 ± 0.49) were higher than TPLO stifles (0.67 ± 0.49) (p = .002) at 12 weeks postoperatively, but there was no difference between groups at 32 weeks postoperatively. Subsequent medial meniscal tears occurred in 6/10 TTA stifles, and 0/10 TPLO stifles at 12 weeks postoperatively and in 5/5 TTA stifles, and 1/5 TPLO stifles at 32 weeks postoperatively. Subsequent lateral meniscal tears occurred in 4/5 TTA stifles at 32 weeks postoperatively. Medial meniscal total gross pathology score was higher in TTA than TPLO stifles. TTA stifles had more articular cartilage damage when compared with TPLO stifles at 32 weeks postoperatively. CONCLUSION: In this within-dog experimental comparison, subsequent medial meniscal tears and cartilage injury was more prevalent following TTA when compared to TPLO. CLINICAL SIGNIFICANCE: In an experimental model, TPLO protects the medial meniscus and articular cartilage better than TTA in stifles with complete cranial cruciate ligament deficiency.

Short communication: Accuracy of estimation of lameness, injury, and cleanliness prevalence by dairy farmers and veterinarians.

Lameness, injuries, and cleanliness are considered important indicators of dairy cow welfare, milk production, and milk quality. Previous research has identified that farmers globally underestimate the prevalence of these cow-based measurements, but no information on the perceptions of veterinarians is available. Because veterinarians are often perceived as the main providers of health advice on farms, the objective of the present study was to evaluate the relationship between the true prevalence of lameness, injury (hock, knee, neck), and cleanliness (udder, legs, flanks), and the estimated prevalence of these issues by farmers and their herd veterinarians. A cross-sectional study was conducted between February 2016 and July 2017. First, the farm owner and the herd veterinarian were asked to estimate the prevalence of lameness, of neck, knee and hock injuries, and of udder, leg, and flank cleanliness on the farm. The research team then visited the farm and scored all lactating cows in the herd for each measurement. Linear regression models were used to assess the relationship between the prevalence estimated by the veterinarians and the farmers, of each cow-based measurement, and the true prevalence on the farm. The 93 herds enrolled had a median of 55 milking cows and were housed in tiestall (90%) and freestall (10%) barns. Ten herd veterinarians participated and were involved with 2 to 22 enrolled farms each. A wide variation was detected in the true prevalence of the different cow-based measurements among herds (lameness: range = 19-72%, median = 36%; neck injuries: range = 0-65%, median = 14%; knee injuries: range = 0-44%, median = 12%; hock injuries: range = 0-57%, median = 25%; dirty udder: range = 0-55%, median 13%; dirty legs: range = 0-91%, median = 18%; and dirty flanks: range = 0-82%, median = 20%). For both veterinarians and farmers, the perception of each cow-based measurement prevalence increased incrementally as the herd's true prevalence increased. Overall, farmers and veterinarians underestimated cow-based measurements. Farmers and veterinarians more accurately estimated lameness prevalence in herds with higher prevalence than in herds with low prevalence, suggesting a better awareness of the issue on farms with lameness problems. Injuries were less accurately estimated in herds with higher injury prevalence compared with herds with lower prevalence, suggesting an opportunity for better knowledge transfer in this area.

Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model.

Multipotent Mesenchymal Stem/Stromal Cells (MSCs) are widely used in cellular therapy for joint repair. However, the use of MSC therapies is complicated by a lack of understanding of the behaviour of cells and repair within the joint. Current methods of MSC tracking include labelling the cells with Super Paramagnetic Iron Oxide nanoparticles (SPIOs). However, standard acquisition sequences (T2 and T2*) give poor anatomical definition in the presence of SPIOs. To avoid anatomical compromise in the presence of SPIOs, we have investigated the use of Ultra-short Echo Time (UTE) MRI, using a 3D cones acquisition trajectory. This method was used to track SPIO labelled MSC injected into joints containing osteochondral defects in experimental sheep. This study demonstrates that multiple echo times from UTE with 3 T MRI can provide excellent anatomical detail of osteochondral defects and demonstrate similar features to histology. This work also monitors the location of SPIO-labelled cells for regenerative medicine of the knee with MRI, histology, and Prussian blue staining. With these methods, we show that the SPIOs do not hone to the site of defect but instead aggregate in the location of injection, which suggests that any repair mechanism with this disease model must trigger a secondary process.

Meniscal click in cranial cruciate deficient stifles as a predictor of specific meniscal pathology.

OBJECTIVE: To determine the predictive value of meniscal click for specific meniscal tear morphology. STUDY DESIGN: Prospective cohort. ANIMALS: Client-owned dogs (104) with cranial cruciate ligament (CCL) deficiency treated with stifle arthroscopy (111). METHODS: All stifles underwent a standardized examination for meniscal click before anesthesia (EBA) and during anesthesia (EDA). Presence or absence of a medial meniscal tear and diagnosis of tear morphology were confirmed with arthroscopic examination. RESULTS: Complete CCL tears were noted in 93 dogs, and incompetent partial tears were noted in 18 dogs. Medial meniscal tears were noted in 40.5% (55/111) of dogs, including bucket handle tears (BHT) in 65.6% (36/55) of tears. Frays of the lateral meniscus were noted in 6.3% of dogs (7/111). Examination for meniscal click before anesthesia was 38% sensitive and 94.5% specific, and EDA was 38% sensitive and 98.2% specific for all meniscal tear morphologies. Positive meniscal click at EBA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .3515, respectively). Positive meniscal click at EDA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .1909, respectively). CONCLUSION: A meniscal click is more commonly associated with a meniscal BHT than with a non-BHT. CLINICAL SIGNIFICANCE: Meniscal tear morphology influences the presence or absence of meniscal click. Because of the high incidence of meniscal disease, this study provides evidence to support joint exploration in the treatment of CCL disease.

Prevalence of and risk factors for hock and knee injuries on dairy cows in tiestall housing in Canada.

Leg injuries on dairy cows are a common and highly visible welfare concern on commercial dairy farms. With greater attention being placed on food animal welfare and limited research being conducted on tiestall farms, this study aimed to identify prevalence and risk factors for hock and knee injuries on dairy cows housed in tiestall barns in Ontario (n=40) and Quebec (n=60). A sample of 40 cows was purposively selected per farm and several animal- and farm-based measures were taken. Both hocks and both knees on each cow were scored as injured (presence of lesions or swelling) or not injured (no alterations or hair loss), and the highest score of each of the 2 knees and the 2 hocks was considered the cow's hock or knee score. Possible animal- and farm-based risk factors were incorporated into 2 separate multivariable logistic models for hock injuries and knee injuries respectively at the cow level. Mean (±SD) percentage of cow with hock injuries per farm was found to be 56±18% and mean percentage of knee injuries per farm was found to be 43±23%. Animal-based factors found to be associated with a greater odds of hock injuries at the cow level were increased days in milk (DIM), lower body condition score (BCS), lameness, higher parity, higher cow width, median lying bout duration, and median number of lying bouts. Environmental factors found to be associated with hock injuries at the cow level were province, stall width, tie rail position, stall base, chain length, and age of stall base. Animal-based factors found to be associated with knee injuries at the cow level were DIM, BCS, and median lying time. Environmental factors found to be associated with knee injuries at the cow level were stall width, chain length, province, stall base, and bed length. Quadratic and interaction terms were also identified between these variables in both the hock and knee models. This study demonstrates that hock and knee injuries are still a common problem on tiestall dairy farms in Canada. Several animal- and housing-based factors contribute to their presence. Further research to confirm causal relationships between these factors would help identify the cause of knee and hock injuries and determine how to best reduce the incidence of injuries in cows on commercial tiestall dairy farms in Canada.

Regeneración de defectos osteocondrales a partir de células madre mesenquimales autólogas embebidas en geles de alginato / Osteochondral defect regeneration from autologous mesenchymal stem cells embedded in alginate gels

Objetivo: Evaluar y analizar la capacidad de reparación de células mesenquimales pluripotenciales autólogas embebidas en geles de alginato para favorecer la restauración completa de lesiones osteocondrales generadas en un modelo experimental. Material y método: Se intervinieron 40 rodillas procedentes de 20 conejos albinos machos de raza neozelandesa de 5 meses de edad y un peso de entre 2.500 y 4.500 g. Se seleccionó un grupo control (grupo I, n=10), y en el resto se generó un defecto osteocondral en el área de carga del cóndilo femoral interno, y en función de la reparación efectuada sobre el mismo obtuvimos tres grupos: solo defecto (grupo II, n =10), relleno con alginato (grupo III, n = 10) y relleno con alginato y células (grupo IV, n = 10). Transcurridas ocho semanas, se extraen los cóndilos para su análisis macroscópico (Escala de Moran) e histológico (escalas de O’Driscoll e ICRS). Resultados: Un fallecimiento intraoperatorio (grupo I) y una infección articular (grupo II) supusieron dos pérdidas. El grupo IV obtuvo una mejor reparación osteocondral a nivel macroscópico, con presencia de grupos de condrocitos en la histología y resultados significativos en cuanto a la reparación osteocondral en las escalas utilizadas. Conclusión: El aporte de células mesenquimales en transportadores de alginato demuestra mejores resultados en reparación de lesiones osteocondrales de manera estadísticamente significativa, con mínimas complicaciones en modelos experimentales (AU)

Objective: To evaluate and analyze the ability of autologous mesenchymal stem cells embedded in alginate gels to favor the complete restoration of osteochondral lesions generated in an experimental model. Material and method: 40 knees from 20 male New Zealand albino rabbit breed 5 months old and weighing between 2,500 and 4,500 g were operated. One control group (no defect; group I, n=10) was stablished. In the other groups, an osteochondral defect was generated in the weight bearing area of the medial femoral condyle, and depending on the material aported on it got three groups selected. Group II had only defect (n = 10), group III was filled with alginate (n = 10), and group IV was filled with alginate and cells (n = 10). After eight weeks, the condyles for macroscopic (Moran Scale) and histologic analysis (O'Driscoll and ICRS Scales) are extracted. Results: Intraoperative death (group I) and joint infection (group II) accounted for two losses. Group IV received a better macroscopic level osteochondral repair with chondrocyte groups present in histology and statiscally significant results regarding the osteochondral repair scales used. Conclusion: The contribution of mesenchymal cells in alginate carriers shows better results in restoration of osteochondral lesions with minimal complications in experimental models (AU)

Uso da técnica TightRope modificada em cães com ruptura do ligamento cruzado cranial / Use of modification TightRope technique in dogs with rupture of cranial crucial ligament

A ruptura do ligamento cruzado cranial (RLCCr) figura entre as principais enfermidades ortopédicas na espécie canina, sendo responsável por instabilidade da articulação do joelho, o que resulta em claudicação e desenvolvimento de doença articular degenerativa (DAD). O objetivo deste trabalho foi avaliar os resultados da técnica de TightRope modificada (TRM) na estabilização do joelho de cães com ruptura do ligamento cruzado cranial (RLCCr). O procedimento cirúrgico foi realizado em seis animais, os quais foram avaliados por 120 dias de pós-operatório. A modificação da técnica para estabilização extra capsular da RLCCr, consiste na utilização de fio de fluorcarbono, e fio de aço inoxidável de 1 mm como forma de fixação óssea. A TRM promoveu a estabilidade do joelho dos pacientes com ruptura do ligamento cruzado cranial no pós-operatório imediato e durante o acompanhamento clínico pós-cirúrgico demonstrou, aos 30 dias, progressiva melhora da marcha e suporte de peso à deambulação, estando todos os animais recuperados clinicamente aos 120 dias de pós-operatório.

Rupture of the cranial cruciate ligament is one of the leading orthopedic diseases in dogs. Thus aimed to evaluate the techniqueof “Tightrope” modified (TRM) in the knees of dogs with the purpose of providing less invasive and cost-effective surgery. Thesurgical procedure was performed in six animals, and these were evaluated up to 120 days postoperatively. The modification of thetechnique for stabilization of extra capsular CCL consists in using fluorocarbon and the stainless steel wire of 1 mm in order bonefixation. The “TRM” promoted the stability of the knee of patients diagnosed with cranial cruciate ligament rupture in the immediatepostoperative period. Clinical follow-up after surgery showed after 30 days postoperatively, improved gait and progressive weightsupport for ambulation, being all animals recovered clinically at 120 days postoperatively.

Prevalence of and factors associated with hock, knee, and neck injuries on dairy cows in freestall housing in Canada.

Injuries are a widespread problem in the dairy industry. The objective of this study was to determine the prevalence of and explore the animal-based and environmental factors associated with hock, knee, and neck injuries on dairy cows in freestall housing in Ontario and Alberta, Canada. Freestall dairy farms in the provinces of Ontario (n=40) and Alberta (n=50) were visited for cross-sectional data collection. A purposive sample of 40 lactating Holstein cows was selected for detailed observation on each farm. Cows were scored for hock, knee, and neck injuries on a 3- or 4-point scale, combining the attributes of hair loss, broken skin, and swelling and with a higher score indicating a more severe injury. The highest hock and highest knee score were used in the analysis. Animal-based and environmental measures were taken to explore which factors were associated with injury. Overall, the prevalence of cows with at least one hock, knee, and neck injury was 47, 24, and 9%, respectively. Lame cows had a greater odds of hock injury [odds ratio (OR)=1.46] than nonlame cows, whereas cows with fewer days in milk (DIM) had reduced odds of hock injury compared with those >120 DIM (OR=0.47, 0.64, and 0.81 for <50, 50-82, and 83-120 DIM, respectively). The odds of hock injury was lower on sand (OR=0.07) and concrete (OR=0.44) stall bases in comparison to mattresses. Conversely, the odds of knee injury was greater on concrete (OR=3.19) stall bases compared with mattresses. Cows in parity 1 (OR=0.45 and 0.27 for knee and neck injury, respectively) and 2 (OR=0.49 and 0.40 for knee and neck injury, respectively) had lower odds of knee and neck injury compared with cows in parity 4+. Low feed rail heights increased the odds of neck injury (OR=76.71 for rails between 128 and 140 cm and OR=43.82 for rails ≤128 cm). The odds of knee injury was greater on farms where any cows were observed slipping or falling when moving into the holding area for milking (OR=2.69) and lower on farms with rubber flooring in the alley along the feed bunk compared with bare concrete floors (OR=0.19). These results demonstrate that individual animal characteristics, as well as barn design and animal management, are associated with hock, knee, and neck injuries. These data can help to guide investigations into causes and prevention of injuries.

Patellar ligament-bone autograft for reconstruction of a distal patellar ligament defect in a dog.

A 3 · 5-year-old whippet was presented 4 weeks after sustaining a traumatic injury to the right stifle joint. A penetrating injury had resulted in patellar ligament (PL) rupture. Magnetic resonance imaging revealed a normal appearing proximal half of the PL and absence of normal fibres within the distal half of the ligament. Surgical repair involved reconstruction of the defect using an autogenous graft harvested from the medial third of the ipsilateral PL. This repair was augmented with a pedicle hamstring graft. A transarticular external skeletal fixator was used to protect the repair for 4 weeks. Seven months after surgery, the dog was able to exercise normally without lameness. To the author's knowledge, this is the first veterinary report of PL grafting of a PL defect, and the first report of surgical augmentation using a hamstring graft.

Effects of observer on the diagnostic accuracy of low-field MRI for detecting canine meniscal tears.

Low-field MRI (lfMRI) has become increasingly accepted as a method for diagnosing canine meniscal tears in clinical practice. However, observer effects on diagnostic accuracy have not been previously reported. In this study, 50 consecutive stifle joints with clinical and radiologic evidence of cranial cruciate ligament insufficiency were investigated by lfMRI and arthroscopy. Fifteen observers who had varying levels of experience and who were unaware of arthroscopic findings independently reviewed lfMRI studies and recorded whether lateral and medial meniscal tears were present. Diagnostic accuracy (sensitivity, specificity, positive (PPV) and negative predictive value (NPV)) was determined for each observer and median values were calculated for all observers, using arthroscopy as the reference standard. Interrater agreement was determined based on intraclass correlation coefficient (ICC) analysis. Observer level of experience was compared with diagnostic sensitivity and specificity using correlation analysis. Based on pooled data for all observers, median sensitivity, specificity, PPV, and NPV for lfMRI diagnosis of lateral meniscal tears were 0.00, 0.94, 0.05, and 0.94, respectively. Median sensitivity, specificity, PPV, and NPV for medial meniscal tears were 0.74, 0.89, 0.83, and 0.79, respectively. Interrater agreement for all menisci was fair (0.51). Menisci were less consistently scored as having no tears (ICC = 0.13) than those scored as having tears (ICC = 0.50). No significant correlations between observer experience and diagnostic sensitivity/specificity were identified. Findings indicated that the accuracy of lfMRI for diagnosing canine meniscal tears was poor to fair and observer-dependent. Future studies are needed to develop standardized and widely accepted lfMRI criteria for diagnosing meniscal tears.

Efecto de la radiofrecuencia en roturas parciales del ligamento cruzado anterior: estudio experimental ex vivo en cerdos / Effect of radiofrequency on partial tears of the anterior cruciate ligament. Ex vivo experimental study in pigs

Introducción. En roturas parciales del ligamento cruzado anterior (LCA) no existe consenso en relación a la mejor opción de tratamiento. El uso de radiofrecuencia (RF) es una alternativa empleada actualmente. Este tratamiento puede alterar negativamente la resistencia del LCA. Objetivo. Evaluar punto de fallo a carga máxima (PFCM) de muestras de LCA porcinos con lesiones parciales tratados con RF en haz indemne. Métodos. Se estudian dos grupos (N=40); A control y B tratada con RF. Fijamos muestras en equipo de tracción universal PASCO(R) y aplicamos tracción axial continua hasta fallo, registrando fuerza en Newtons (N) necesaria para PFCM. Resultados. PFCM fue A: 1951,9N (1144-2688) y B: 1457,1N (1070-2025) (p <= 0,001). Conclusión. El uso de RF de manera puntual en el haz indemne de secciones del fascículo PL del LCA porcino disminuye el PFCM en forma significativa respecto de las secciones del fascículo PL del LCA porcino sin tratamiento (AU)

Introduction. There is no consensus on the optimal treatment of partial tears in the anterior cruciate ligaments (ACL). Radiofrequency (RF) has been used to treat ACL partial tears. This treatment can be detrimental to ACL strength. Objective. To evaluate the ultimate failure at maximum load (UFML) of porcine ACL with partial tears. Methods. Two groups were evaluated, N=40, A control and B treated with RF. Samples were placed in a PASCO(R) universal traction machine and axial continuous tension was applied until failure; documenting necessary strength in Newtons (N) to produce UFML. Results. UFML for A: 1951,9N (1144-2688) and B: 1457,1N (1070-2025) (P<=.001). Conclusion. RF use for single bundle ACL partial tears treatment compromises the UFML when compared to single bundle ACL parcial tears without RF (AU)

Análisis biomecánico de la fijación del ligamento cruzado anterior / Biomechanical analysis of the anterior cruciate ligament fixation

Objetivo: Desarrollar la metodología experimental para analizar la biomecánica de la fijación del ligamento cruzado anterior. Material y métodología: Se realizó una plastia de LCA en 16 rodillas de cerdo, utilizando el tendón del músculo extensor lateral de los dedos del cerdo. Se ensayaron tres sistemas de fijación diferentes, clasificados como compresión, expansión y suspensión cortico-esponjosa. Todos los especímenes fueron ensayados a tracción hasta el fallo. Se calculó la carga de fallo, elongación y rigidez para cada fijación. Resultados: Atendiendo a la carga de fallo y a la rigidez, los mayores valores medios se obtuvieron para los dispositivos de expansión y suspensión operados con la técnica de doble injerto. Los dispositivos de compresión y expansión implantados con la técnica de un sólo injerto mostraron peores resultados. Conclusiones: El fallo siempre sobrevino en los injertos por lo que no se pudo evaluar ni comparar correctamente el comportamiento de los diferentes tipos de fijación utilizados (AU)

Objective: The aim of the present study was to develop the experimental methodology for the biomechanical analysis of the anterior cruciate ligament reconstruction. Material and method: An ACL reconstruction was performed on 16 porcine knees. The graft used was the pig doubled lateral extensor of toes (DLET). Three different femoral fixation devices were tested and classified according to their fixation mechanism: compression, expansion and cortical-cancellous suspension. A fixation device was developed in order to analyze the unfavorable load case. All GFC were subjected to a load-to-failure test. Failure load, elongation and stiffness were calculated for each device. Results: Regarding stiffness and failure load, cortical-cancellous suspension and expansion, both with the double graft technique, showed the highest mean values. Compression and expansion, both with the single graft technique, showed worse results. Conclusions: Failure always took place in the graft, and thus was impossible to compare correctly the different fixation devices behavior (AU)

A retrospective study of the MRI findings in 18 dogs with stifle injuries.

OBJECTIVES: To make an objective assessment of the usefulness of magnetic resonance imaging in the diagnosis of meniscal damage and cranial cruciate ligament disease in the canine stifle by comparing magnetic resonance imaging findings with surgical findings. METHODS: Magnetic resonance images of 18 stifles from 18 dogs which had undergone magnetic resonance imaging for the investigation of stifle disease were reviewed. For every stifle, the menisci and cranial cruciate ligaments were assessed according to predetermined criteria. The magnetic resonance imaging findings were compared with the reported surgical findings and the sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated using the surgical findings as the gold standard. Kappa analysis was used as an objective measure of agreement between surgical and magnetic resonance imaging findings. For 11 stifles, meniscal evaluation by three different observers was used to measure interobserver agreement using Kappa analysis. RESULTS: Magnetic resonance imaging was demonstrated to be an accurate technique in the detection of meniscal injury (k=0.86), with excellent interobserver agreement (k=0.89 to 1.0). Disruption of cranial cruciate ligament continuity and an increase in ligament intensity were found to be useful criteria in the diagnosis of cranial cruciate ligament rupture. CLINICAL SIGNIFICANCE: Magnetic resonance imaging offers a non-invasive alternative to exploratory surgery in the evaluation of cranial cruciate ligament and meniscal disease.

The effects of preoperative extradural bupivacaine and morphine on the stress response in dogs undergoing femoro-tibial joint surgery.

OBJECTIVE: To evaluate the efficacy of preoperative extradural bupivacaine and morphine in attenuating the stress response in dogs undergoing femoro-tibial joint surgery. STUDY DESIGN: Prospective clinical study. Animal population Twelve client-owned dogs undergoing surgery for either repair of cruciate ligament rupture (ten) or correction of luxating patella (two). Body masses ranged from 12 to 45 kg (mean: 28.58 +/- 18.38). Age ranged from 19 to 121 months (mean: 66.5 +/- 49.5). MATERIALS AND METHODS: Six of the dogs received extradural bupivacaine (up to 1.5 mg kg(-1)) combined with morphine (0.1 mg kg(-1); ED) while the other six received no extradural analgesia (C). The levels of cortisol, acute phase proteins (APPs), and red and white blood cell variables were measured in both groups of dogs before, and at various times after surgery. Pain was also assessed at various times after surgery. The number of postoperative morphine doses required, and their time of administration, was recorded for each animal. Method of statistical analysis Data were analysed using anova for repeated measures with p-values of <0.05 considered significant. RESULTS: Cortisol levels in the ED group were significantly (p < 0.05) lower than those of the control group at the end of surgery. No statistically significant differences were found in APPs or red and white cell variables between dogs receiving, and those not receiving extradural bupivacaine and morphine. Four dogs in the control group and one in the ED group required postoperative morphine. CONCLUSIONS AND CLINICAL RELEVANCE: Pre-emptive extradural bupivacaine and morphine was effective in lowering the neuroendocrine stress response (cortisol) in the ED group but had no effect on the inflammatory response (acute phase response).