Publications by authors named "Antonio Pozzi"

103 Publications

Ultrasound-guided paravertebral perineural glucocorticoid injection for signs of refractory cervical pain associated with foraminal intervertebral disk protrusion in four dogs.

J Am Vet Med Assoc 2021 May;258(9):999-1006

Case Description: 4 dogs, 7.5 to 10 years of age, were presented for evaluation of signs of chronic cervical pain and forelimb lameness secondary to cervical foraminal intervertebral disk protrusion (IVDP). All dogs were refractory to ≥ 2 weeks of conservative management including strict rest and pain management with anti-inflammatory drugs, methocarbamol, and gabapentin.

Clinical Findings: The MRI findings included left foraminal IVDP at C2-3 causing mild C3 nerve root compression (dog 1), multifocal degenerative disk disease with mild focal left-sided disk protrusion at C6-7 without associated spinal cord or nerve root compression (dog 2), left foraminal C6-7 IVDP with suspected focal spinal cord atrophy or mild compression (dog 3), and right foraminal C6-7 IVDP and multifocal cervical intervertebral disk degeneration with annulus fibrosus protrusion (dog 4).

Treatment And Outcome: Ultrasound-guided paravertebral perineural injections with methylprednisolone acetate (1 mg/kg [0.45 mg/lb]) at the C3 nerve root in dog 1 and at the C7 nerve root in the other 3 dogs were performed. Injections were repeated at intervals of 4 weeks to 3 months on the basis of clinical response. None of the dogs had any complications from the procedures. For dogs 1 and 4, there was complete resolution of lameness and signs of cervical pain following perineural injections, and for dog 3, there was complete resolution of lameness and only minimal residual cervical pain. Dog 2 did not have long-lasting improvement.

Clinical Relevance: Findings indicated that ultrasound-guided paravertebral perineural injection can be an effective treatment of cervical foraminal IVDP for some dogs. Additional studies to determine appropriate case selection and better assess the overall success rate and risks associated with this technique are warranted.
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http://dx.doi.org/10.2460/javma.258.9.999DOI Listing
May 2021

Femorotibial joint kinematics in nine dogs treated with lateral suture stabilization for complete cranial cruciate ligament rupture.

J Am Vet Med Assoc 2021 Mar;258(5):493-501

Objective: To quantify 3-D femorotibial joint kinematics during ambulation in dogs with cranial cruciate ligament (CCL) rupture treated with lateral fabellotibial suture stabilization (LFTS).

Animals: 9 adult dogs (body weight, 15 to 35 kg [33 to 77 lb]) with unilateral complete CCL rupture.

Procedures: Digital 3-D bone models of the femur and fabellae and tibia and fibula were created from CT scans. Lateral fluoroscopic images of stifle joints were collected during treadmill walking before surgery and 6 months after LFTS. The LFTS was performed with nylon leader material secured with knots. Gait cycles were analyzed with a 3-D to 2-D image registration process. Femorotibial joint kinematics (craniocaudal translation, internal-external rotation, and flexion and extension angles) were compared among CCL-deficient stifle joints before LFTS, CCL-deficient stifle joints 6 months after LFTS, and unaffected contralateral (control) stifle joints. Owners and veterinarians subjectively assessed lameness by use of a visual analog scale and gait examination, respectively, at each time point.

Results: At midstance phase, medial cranial tibial translation decreased from 9.3 mm before LFTS to 7.6 mm after LFTS but remained increased when compared with control stifle joint values. Following LFTS, axial rotation and stifle joint flexion and extension angles were not significantly different from control stifle joints. On the owner survey, the median walking lameness score improved from 9.3 of 10 before surgery to 0.3 after surgery. On gait examination, median walking lameness score improved from 2 of 4 before surgery to 0 after surgery.

Conclusions And Clinical Relevance: Stifle joint instability was only slightly mitigated at 6 months following LFTS performed with knotted nylon leader material in medium to large dogs with CCL rupture, despite improvement in lameness.
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http://dx.doi.org/10.2460/javma.258.5.493DOI Listing
March 2021

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study.

Front Vet Sci 2020 18;7:580256. Epub 2020 Sep 18.

Department of Neurology, Small Animal Clinic, Vetsuisse Faculty Zurich, University of Zurich, Zurich, Switzerland.

Bilateral carotid artery ligation has been reported as a lifesaving procedure to control severe hemorrhage. However, reports are sparse and little information is available regarding the potential risks associated with this procedure. We report an ischemic brain infarct as a complication after vascular surgery. A 3-year old, male intact border collie was presented for acute onset of forebrain signs 5 days after bilateral carotid artery ligation. Multimodal brain MRI including morphologic sequences, MR angiography, diffusion- and perfusion-weighted images were performed. MRI revealed a well-defined intra-axial lesion of the left caudate nucleus, with increased T2 and decreased T1 signal intensity and moderate heterogeneous peripheral contrast enhancement. The cerebral blood flow was reduced relative to the contralateral caudate nucleus. Images were consistent with a subacute lacunar ischemic infarct of the left striate artery. Additionally, multiple arterio-arterial anastomosis arising from the vertebral arteries were visible in the angiography sequences. Ischemic infarct due to thromboembolism should be considered as a possible complication associated with bilateral carotid artery ligation. Collateral blood supply can develop as early as 5 days after surgery.
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http://dx.doi.org/10.3389/fvets.2020.580256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533532PMC
September 2020

A three-dimensional computed tomographic volume rendering methodology to measure the tibial torsion angle in dogs.

Vet Surg 2021 Feb 26;50(2):353-364. Epub 2020 Oct 26.

Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Italy.

Objective: To describe a three-dimensional (3D) computed tomographic (CT) methodology to measure the tibial torsion angle (TTa) and to evaluate intrarater and interrater agreements and accuracy through comparison with anatomic measurements.

Study Design: Ex vivo cadaveric study.

Sample Population: Thirty-six tibiae from 18 dogs.

Methods: Tibial torsion angle of each tibia was measured by using two CT techniques (axial and 3D volume rendering) by three raters who blindly measured TTa in duplicate. A semitransparent bone filter was used to enhance the visibility of the target anatomical landmarks for the 3D volume rendering CT technique. Tibial torsion angle was also quantitated in tibial specimens. Intrarater and interrater agreements were analyzed by using intraclass coefficients (ICC). Accuracy was evaluated by using adjusted R coefficients (R  > 80% was considered acceptable).

Results: The 3D volume rendering CT technique had excellent intrarater and interrater agreements (ICC > 0.94) and an R value of 97%. The axial CT technique had good to excellent intrarater and interrater agreements (0.8 < ICC < 0.95) and an R of 86%. No difference was found between axial and 3D CT techniques. A mean internal TT angle of approximately -6° was found with CT and anatomic measurements.

Conclusion: The 3D volume rendering and axial CT techniques were precise and accurate for measuring TTa in dogs unaffected by patellar luxation.

Clinical Relevance: Combining 3D bone manipulation with application of a semitransparent filter allows simultaneous visualization of anatomic landmarks, which may facilitate the evaluation of complex bone deformations. Internal tibial torsion may be present in nonchondrodystrophic dogs without patella luxation.
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http://dx.doi.org/10.1111/vsu.13531DOI Listing
February 2021

Biomechanical comparison of ex vivo lumbar vertebral fracture luxations stabilized with tension band or polymethylmethacrylate in cats.

Vet Surg 2020 Dec 30;49(8):1517-1526. Epub 2020 Sep 30.

Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Objective: To evaluate spinal stabilization with tension band stabilization (TS) in cats compared to screw and polymethylmethacrylate fixation (SP).

Study Design: Ex vivo study.

Sample Population: Sixteen feline thoracolumbar spinal specimens.

Methods: The intact specimens were mounted in a six-degree-of-freedom biaxial testing machine for nondestructive testing to obtain the neutral zones (NZ) and range of motion (ROM) in flexion and extension. Thereafter, nondestructive testing was consecutively performed after destabilization by disc fenestration and partial L1 corpectomy and after treatment with either TS or SP. Load to failure was compared after surgical treatment in flexion. Significance was assessed by Student's t test or Wilcoxon signed-rank test.

Results: Range of motion was 26.4° ± 2.2° in TS constructs and 13.4° ± 2.1° in SP constructs (P = .0005). When flexion and extension were analyzed separately, no difference was found for ROM in flexion (SP, 7.0° ± 3.7°; TS, 8.3° ± 2.1°; P = .38). In extension, the mean displacement was 6.4° ± 2.7° and 18.1° ± 5.1° in SP and TS constructs, respectively (P = .0001). Neutral zone was 2.9° ± 0.6° and 7.5° ± 0.8° for the SP and TS groups, respectively (P = .0003). Screw and polymethylmethacrylate fixation constructs were two times stiffer (P = .045).

Conclusion: Tension band stabilization provided stability comparable to SP in flexion. In extension, ROM of SP constructs was half that of TS constructs. The mode of failure of TS was related to the limited dorsal bone stock of feline lumbar vertebrae.

Clinical Significance: Surgeons should be aware of the limited stability in extension provided by TS when it is used to stabilize thoracolumbar spinal injuries. Our results provide evidence to justify additional studies to clarify the type of fractures amenable to TS.
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http://dx.doi.org/10.1111/vsu.13516DOI Listing
December 2020

Influence of a customized three-dimensionally printed drill guide on the accuracy of pedicle screw placement in lumbosacral vertebrae: An ex vivo study.

Vet Surg 2020 Jul 7;49(5):977-988. Epub 2020 Apr 7.

Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Objective: To compare the accuracy of pedicle screw insertion (PSI) into canine lumbosacral vertebrae with custom-made three-dimensionally (3D)-printed drill guides or freehand insertion.

Study Design: Ex vivo study.

Sample Population: Nineteen canine lumbosacral specimens.

Methods: Drill guides for PSI were designed on the basis of safe screw insertion trajectories by using preoperative computed tomography (CT) and produced by 3D printing of templates. Right and left sides of the specimens were randomly allocated to two groups; 4-mm pedicle screws were inserted in L5-L6 and L7-S1 spinal segments either freehand (control group) or with custom-made drill guides (guide group). Sixty-six screws were inserted with each method. Insertion angles (α, β), bone stock, and vertebral canal breach were assessed according to postoperative CT. χ Tests were used to compare vertebral canal breach between groups and vertebrae.

Results: Breaches in the vertebral canal were less common (P < .001) when screws were placed with a guide in the guide group (9/66, 14%) than without a guide (30/66, 45%). The rate of vertebral canal breach differed at L5 (P = .021) but not at L6 (P = .05), L7 (P = .075) or S1 (P = .658). The angle of insertion (α) did not differ between specimens with and without breaches (guide, P = .068; control, P = .394).

Conclusion: The use of a customized 3D-printed guide generally improved the accuracy of PSI in canine lumbosacral vertebrae, although statistical significance was reached only at L5.

Clinical Significance: The use of customized drill guides may be considered as an alternative to freehand PSI in the lumbosacral area, especially for L5-L6 vertebrae.
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http://dx.doi.org/10.1111/vsu.13417DOI Listing
July 2020

Evaluation of agreement and correlation of results obtained with MRI-based and macroscopic observation-based grading schemes when used to assess intervertebral disk degeneration in cats.

Am J Vet Res 2020 Apr;81(4):309-316

Objective: To evaluate agreement in results obtained with an MRI-based grading scheme and a macroscopic observation-based grading scheme when used to assess intervertebral disk (IVD) degeneration in cats.

Sample: 241 MRI and 143 macroscopic images of singular IVDs in 44 client-owned cats (40 cadaveric and 4 live).

Procedures: Singular images of IVDs were obtained of live cats admitted for treatment of suspected neurologic disease (MRI images of IVDs) and of cadavers of cats euthanized for reasons unrelated to spinal disease (MRI and macroscopic images of IVDs) at the Small Animal Hospital, Vetsuisse Faculty, Zurich, Switzerland, between January 12, 2015, and October 19, 2015. The IVD images were randomized and evaluated twice by 4 observers for each grading scheme. Inter- and intraobserver reliability for the grading schemes was assessed with Cohen weighted κ analysis. Agreement and correlation between results obtained with the 2 grading schemes were determined with Cohen weighted κ and Spearman correlation coefficient (ρ) analyses, respectively.

Results: Inter- and intraobserver agreement between results was substantial to almost perfect (mean weighted κ, 0.66 to 0.83 and 0.71 to 0.86, respectively) for the MRI-based grading scheme and moderate to substantial (mean weighted κ, 0.42 to 0.80 and 0.65 to 0.79, respectively) for the macroscopic observation-based grading scheme. Between the 2 grading schemes, agreement in results was moderate (mean ± SE weighted κ, 0.56 ± 0.05), and the correlation was strong (ρ = 0.73).

Conclusions And Clinical Relevance: Results indicated that the MRI-based and macroscopic observation-based grading schemes used in the present study could be used reliably for classifying IVD degeneration in cats.
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http://dx.doi.org/10.2460/ajvr.81.4.309DOI Listing
April 2020

Complications and short-to-midterm results in a case series of 52 CUE procedures using a modified caudo-medial approach.

Open Vet J 2019 10 1;9(3):205-215. Epub 2019 Aug 1.

Small Animal Clinic, Free University of Berlin, Berlin, Germany.

Background: Medial coronoid process disease is the most common manifestation of canine developmental elbow disease which can progress to a more severe medial compartment disease (MCompD) characterized by full-thickness cartilage loss of the medial coronoid process and the medial humeral condyle. Among others, the "Canine Unicompartmental Elbow" (CUE) has been reported to be an effective treatment strategy for MCompD, with full in 47.6% and acceptable function in 43.7% at 6 months or later of follow-up.

Aim: To report on our clinical experiences with the CUE system using the caudo-medial approach in terms of both complications and functional outcome.

Methods: Medical records of dogs that underwent CUE procedure using a caudo-medial approach over a 3-year period were retrospectively reviewed. This covered epidemiological data, bi-planar radiographs, subjective gait analysis, owner questionnaire, surgical reports, as well as second-look arthroscopic findings when available.

Results: In total, 52 CUE procedures were performed in 44 dogs with a median age of 8.0 years (IQ: 5.0-10.0) and a median bodyweight of 31.9 kg (ranging 20-48 kg) at the surgery. Four cases never return for follow-up, but were included in the analysis to increase the number of cases with pre- and intra-operative data. Mean follow-up time available for the remaining 48 cases was 7.1 (SD: 5.2) months. Radiographic derived implant positioning and alignment proved to be satisfactory in the sagittal plane but parallelism in the frontal plane was only present in three cases. Second-look arthroscopy in five cases with delayed or disappointing functional improvement showed evidence of implant-related contact lesions and progressive erosion of the medial coronoid area in three elbows. Overall, complications occurred in 11 cases (21%), being major in eight (15%) and minor in three (6%). Major complications included refractory pain and lameness 6 to 12 months postoperatively in five cases. At last follow-up, 12 cases (25%) were considered to have full function, 35 cases (73%) acceptable function, and in one case, the function was considered unacceptable. As the only variable related to functional outcome, age had a negative predictive value for full function.

Conclusion: The CUE procedure appears to be an effective treatment option for patients with MCompD. Older dogs might be at risk of having an inferior clinical outcome when compared to young patients. The reason for this is unknown and will have to be evaluated in future studies. Compared to a CUE case series of 103 elbows operated through a medial approach, using a caudo-medial approach decreased the incidence of approach-related complication. Nevertheless, the functional outcome in the current case series was less favorable than previously reported. These conflicting findings as well as the occurrence of potentially implant mechanical conflict at the medial joint compartment despite CUE warrants further studies.
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http://dx.doi.org/10.4314/ovj.v9i3.4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794397PMC
October 2019

Intra-Articular Umbilical Cord Derived Mesenchymal Stem Cell Therapy for Chronic Elbow Osteoarthritis in Dogs: A Double-Blinded, Placebo-Controlled Clinical Trial.

Front Vet Sci 2019 20;6:474. Epub 2019 Dec 20.

Animal Cell Therapies, San Diego, CA, United States.

Intra-articular stem cell therapy may help alleviate lameness caused by osteoarthritis in dogs. Umbilical cord-derived stem cell (UMSC) therapy has not yet been investigated in a veterinary clinical study. We hypothesized that dogs treated with intra-articular UMSC will have improved limb function and quality of life when compared to dogs treated with a saline placebo injection. This was a prospective, double-blinded, placebo-controlled clinical trial in client-owned dogs with chronic elbow osteoarthritis with a follow-up time of 6 months. Dogs were assigned to receive intra-articular UMSC ( = 38) or a saline placebo intra-articular injection ( = 30). Outcome measures included the Canine Brief Pain Inventory score (CBPI) and peak vertical force (PVF) from force-platform gait analysis. Treatment was considered successful when there was a decrease in the Pain Severity Score of at least one and a decrease in the Pain Interference Score of at least one from baseline. Success rates and PVF were compared between groups. No adverse effects associated with UMSC were noted. Of the dogs completing the study, treatment success in the UMSC ( = 28) vs. placebo groups ( = 23) was observed in 54 vs. 28% of dogs at 1 month, 50 vs. 27% at 3 months, and 46 vs. 14% at 6 months, respectively. Success rate in the UMSC group was significantly higher than the placebo group at 1 and 6 months after treatment. However, no differences in PVF of the affected limb over time was observed in either group. Intra-articular UMSC for osteoarthritis may improve clinical signs based on owner observations.
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http://dx.doi.org/10.3389/fvets.2019.00474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932969PMC
December 2019

Predictors of comorbidities and mortality in cats with pelvic fractures.

Vet Surg 2020 Feb 26;49(2):281-290. Epub 2019 Dec 26.

Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To characterize and evaluate risk factors for comorbidities and death of cats with pelvic fractures.

Study Design: Retrospective case study.

Animals: Cats (n = 280).

Methods: Medical records were reviewed for cats in which pelvic fractures had been diagnosed (January 2003 to November 2016). Retrieved data included signalment, mechanism of injury, clinical findings, diagnostic imaging investigations, type and number of concurrent injuries based on anatomical location, type of therapy, and survival. Pelvic fractures were classified according to location and severity. Descriptive statistics were performed, and logistic regression models were constructed to examine associations between risk factors and outcome.

Results: Cases consisted of 280 cats with no (9%), unilateral (43%), and bilateral (48%) involvement of the weight-bearing axis. Sacral fractures were found in 12% of cats. Surgical treatment and mortality rates increased progressively with the severity of the pelvic fractures (P < .001). Mean number of concurrent body regions injured was 2.4 ± 1.2 and was associated with mortality (P < .01). Twenty percent of cats did not survive to discharge. Cats with neurologic injuries were more likely not to survive (P = .02).

Conclusion: Concurrent injuries to at least one body region, especially the abdomen and thorax, were observed in cats sustaining pelvic fractures. Mortality was associated with increased severity of the fractures, neurologic injuries, and increased number of concurrent injuries.

Clinical Significance: Concurrent injuries are common in cats with pelvic fractures, and comorbidities may be associated with mortality.
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http://dx.doi.org/10.1111/vsu.13369DOI Listing
February 2020

Biomechanical comparison of knotted and knotless stabilization techniques of the tarsal medial collateral ligament in cats: A cadaveric study.

Vet Surg 2020 Feb 18;49(2):390-400. Epub 2019 Dec 18.

Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Objective: To compare mechanical properties of intact feline medial collateral ligaments and three techniques for treatment of feline medial tarsal instability.

Study Design: Controlled laboratory study.

Sample Population: Forty-eight normal, adult feline tarsi.

Methods: Three repairs were tested: a bone tunnel with polypropylene (PP) suture, a bone tunnel with polyethylene (PE) cord, and a knotless anchor technique with PE cord. A cyclic (6-N preload; 5-N amplitude; 2-Hz frequency) tensile test (600 cycles) was performed on feline tarsi with either the long or the short medial tarsal ligament intact, with each reconstruction technique followed by a single-cycle load-to-failure test (0.5 mm/s) with a failure point at 2 mm of displacement. Total elongation, peak-to-peak elongation, stiffness, and maximum load to failure point were compared with the intact condition.

Results: No differences in stiffness, total elongation, or peak-to-peak elongation were found between specimens repaired with the knotless technique and intact controls (P > .04), whereas tarsi repaired with the tunnel technique and PP were weaker (P < .008). Total and conditioning elongation were greater after tunnel reconstruction with PP than after knotless reconstruction (P = .005). Mean load to 2 mm of displacement tended (P = .03) to be higher after knotless than after knotted PP repairs and did not differ (P = .47) between tarsi repaired with the tunnel or anchor repairs with PE.

Conclusion: The mechanical properties of intact tarsi were superior to those of tarsi repaired with tunnel techniques and PP but were similar to those of tarsi repaired with knotless techniques with PE.

Clinical Significance: Feline tarsal stabilization with the knotless technique for tarsal medial collateral ligament insufficiency may reduce the requirement for or duration of postoperative coaptation.
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http://dx.doi.org/10.1111/vsu.13366DOI Listing
February 2020

Femorotibial kinematics in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament insufficiency: An in vivo fluoroscopic analysis during walking.

Vet Surg 2020 Jan 28;49(1):187-199. Epub 2019 Nov 28.

Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida.

Objective: To determine the ability of tibial plateau leveling osteotomy (TPLO) to address abnormal femorotibial kinematics caused by cranial cruciate ligament (CCL) rupture during walking in dogs.

Study Design: Prospective, clinical.

Animals: Sixteen dogs (20-40 kg) with unilateral complete CCL rupture.

Methods: Lateral view fluoroscopy was performed during treadmill walking preoperatively and 6 months after TPLO. Digital three-dimensional (3D) models of the femora and tibiae were created from computed tomographic (CT) images. Gait cycles were analyzed by using a 3D-to-2D image registration process. Craniocaudal translation, internal/external rotation, and flexion/extension of the femorotibial joint were compared between preoperative and 6-month postoperative time points for the affected stifle and 6-month postoperative unaffected contralateral (control) stifles.

Results: In the overall population, CCL rupture resulted in 10 ± 2.2 mm (mean ± SD) cranial tibial translation at midstance phase, which was converted to 2.1 ± 4.3 mm caudal tibial translation after TPLO. However, five of 16 TPLO-treated stifles had 4.1 ± 0.3 mm of cranial tibial subluxation during mid-to-late stance phase, whereas 10 of 16 TPLO-treated stifles had 4.3 ± 0.4 mm of caudal tibial subluxation throughout the gait cycle. Overall, postoperative axial rotational and flexion/extension patterns were not different from control, but stifles with caudal tibial subluxation had more external tibial rotation during mid-to-late stance phase compared with stifles with cranial tibial subluxation.

Conclusion: TPLO mitigated abnormal femorotibial kinematics but did not restore kinematics to control values in 15 of 16 dogs during walking.

Clinical Significance: Tibial plateau leveling osteotomy reduces cranial tibial subluxation during walking, but persistent instability is common.
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http://dx.doi.org/10.1111/vsu.13356DOI Listing
January 2020

Percutaneous Pinning for Fracture Repair in Dogs and Cats.

Vet Clin North Am Small Anim Pract 2020 Jan 22;50(1):101-121. Epub 2019 Oct 22.

Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich CH-8057, Switzerland.

This article describes the technique of percutaneous pinning in dogs and cats. Only acute fractures evaluated within the first 48 hours after trauma are selected for percutaneous pinning. Reduction is performed with careful manipulation of the fracture to minimize the trauma to the growth plate. After ensuring the fracture is reduced anatomically, smooth pins of appropriate size are inserted through stab incisions or through large-gauge needles. Depending on the anatomic location, the pins are cut flush with the bone or bent over. The main advantages of this technique are the minimal surgical trauma and lower perioperative morbidity.
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http://dx.doi.org/10.1016/j.cvsm.2019.09.001DOI Listing
January 2020

Percutaneous Plate Arthrodesis.

Vet Clin North Am Small Anim Pract 2020 Jan 22;50(1):241-261. Epub 2019 Oct 22.

Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 258c, Zurich 8057, Switzerland.

Arthrodesis is an elective surgical procedure that aims at eliminating pain and dysfunction by promoting deliberate osseous fusion of the involved joint(s). Percutaneous plating can be used to perform carpal and tarsal arthrodeses in dogs and cats. After cartilage debridement is performed, the plate is introduced through separate plate insertion incisions made remote to the arthrodesis site and advanced along an epiperiosteal tunnel, and screws are inserted through the 3 existing skin incisions. The primary advantage of this technique is a decreased risk of soft-tissue complications, including postoperative swelling, ischemia, and wound dehiscence. Preliminary clinical results have been promising.
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http://dx.doi.org/10.1016/j.cvsm.2019.08.014DOI Listing
January 2020

Minimally Invasive Plate Osteosynthesis: Radius and Ulna.

Vet Clin North Am Small Anim Pract 2020 Jan 18;50(1):135-153. Epub 2019 Oct 18.

Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich CH-8057, Switzerland.

Minimally invasive plate osteosynthesis (MIPO) is a biologically friendly approach to fracture reduction and stabilization that is applicable to many radius and ulna fractures in small animals. An appropriate knowledge of the anatomy of the antebrachium and careful preoperative planning are essential. This article describes the MIPO technique, which entails stabilization of the fractured radius with a bone plate and screws that are applied without performing an extensive open surgical approach. This technique results in good outcomes, including a rapid time to union and return of function.
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http://dx.doi.org/10.1016/j.cvsm.2019.08.006DOI Listing
January 2020

Unique Differences of Minimally Invasive Fracture Repair in the Feline.

Vet Clin North Am Small Anim Pract 2020 Jan 18;50(1):263-271. Epub 2019 Oct 18.

Department for Small Animals, Vetsuisse Faculty, Tierspital Zurich, Kleintierchirurgie, Winterthurerstrasse 260, 8057 Zurich, Switzerland.

As the saying goes, "cats are not small dogs." Throughout veterinary medicine history, most of the literature focus has been on the canine. Feline patients, however, now constitute a larger proportion of the pet population and are unique in many aspects. They differ anatomically and biomechanically from canines and have specific recovery needs and different pain-related behaviors. It is important that veterinary surgeons understand these differences and improve their knowledge base in the treatment of cats. This article highlights the differences in cats relevant to minimally invasive fracture repair and how they affect a surgeon's approach to fractures in cats.
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http://dx.doi.org/10.1016/j.cvsm.2019.08.016DOI Listing
January 2020

Custom acetabular prosthesis for total hip replacement: A case report in a dog with acetabular bone loss after femoral head and neck ostectomy.

Vet Surg 2019 Nov 23;48(8):1520-1529. Epub 2019 Aug 23.

Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To describe the application of a custom acetabular prosthesis (CAP) for total hip replacement (THR) in a dog 20 months after femoral head and neck ostectomy (FHNO).

Study Design: Case report.

Animal: A 10-year-old, male, castrated, Labrador retriever with progressive lameness and pain after FHNO.

Methods: Acetabular bone stock was assessed as insufficient for conventional THR, so a biflanged CAP was designed and three-dimensionally printed in titanium to bridge the bone defect. The CAP had a porous surface for long-term biologic fixation on the backside and was anchored to the ilium and ischium with screws. A polyethylene cup was cemented into the CAP, and a bolted cementless femoral stem was inserted.

Results: The loss of the conventional anatomic landmarks complicated intraoperative orientation and led to eccentric reaming and 5-mm malalignment of the CAP. Reduction of the prosthetic joint was difficult because of periarticular fibrosis, loss of functional muscle length, and thickness of the CAP, and intraoperative shortening of the stem neck was required. Postoperative complications included sciatic neurapraxia, which resolved with time and conservative management. Absence of pain and improvement of range of motion were observed at clinical examination 12 months after surgery; however, moderate hind limb lameness persisted due to muscle tension. No evidence of implant loosening was noted on radiographs acquired 24 months after surgery.

Conclusion: Femoral head and neck ostectomy with poor functional outcome was ameliorated by using a CAP in this dog.

Clinical Significance: Use of a CAP can be considered to treat acetabular defects in dogs.
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http://dx.doi.org/10.1111/vsu.13303DOI Listing
November 2019

Recommendations for rehabilitation after surgical treatment of cranial cruciate ligament disease in dogs: A 2017 survey of veterinary practitioners.

Vet Surg 2020 Jan 7;49(1):80-87. Epub 2019 Aug 7.

Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To report current recommendations made by veterinarians for rehabilitation after surgical treatment of cranial cruciate ligament (CrCL) disease.

Study Design: Anonymized electronic survey.

Sample Population: Veterinarians performing CrCL stabilization.

Methods: An electronic survey was created to collect information on general attitudes toward postoperative rehabilitation and recommendations regarding therapeutic modalities and bandaging. Quantitative data are reported by descriptive statistical analysis, percentage of responses, or mean (±SD). The recommendations for postoperative bandaging beyond 24 hours and for postoperative rehabilitation after extracapsular stabilization compared with after tibial osteotomy were tested by using Cochran-Mantel-Haenszel tests, with P < .05 considered statistically significant.

Results: The data analysis included 376 responses (13% response rate). Most (71%) respondents consistently recommended postoperative rehabilitation. Rehabilitation was more than twofold more likely to be recommended after extracapsular stabilization than after osteotomies (P = .0142). Most respondents did not recommend bandaging beyond 24 hours postoperatively (P = .00012).

Conclusion: Most respondents recommended either formal or informal postoperative rehabilitation therapy.

Clinical Significance: If the survey respondents are representative of veterinarians performing CrCL surgery, the current attitude is supportive of postsurgical rehabilitation. Most respondents would welcome evidence-based guidelines for rehabilitation protocols.
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http://dx.doi.org/10.1111/vsu.13294DOI Listing
January 2020

The effect of tibial plateau leveling osteotomy on patellofemoral kinematics in dogs: An in vivo study.

Vet Surg 2020 Jan 2;49(1):207-213. Epub 2019 Aug 2.

Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida.

Objective: To quantitatively evaluate patellofemoral (PF) kinematics during walking in dogs with cranial cruciate ligament (CrCL) deficiency treated by tibial plateau leveling osteotomy (TPLO).

Study Design: Longitudinal observational study.

Animals: Dogs with unilateral CrCL deficiency treated by TPLO (n = 10).

Methods: Horizontal beam fluoroscopic images of the stifles during treadmill walking were acquired 6 months after TPLO. Computed tomography was performed, and digitized bone models of both femurs and patellae were created. These digital models were superimposed over the fluoroscopic images with shape-matching software, and sagittal plane PF kinematics for TPLO-treated and normal contralateral stifles were calculated. Patellofemoral kinematics were described according to phase of gait cycle as well as relative to femorotibial flexion angle.

Results: In TPLO-treated stifles, there was an approximately 1-mm increase in cranial displacement of the patella (P < .05) compared with the normal stifle at equivalent femorotibial flexion angles between 120° and 140° and predominately during the stance phase. Proximal-distal translation and patellar flexion angle were mostly unaffected by TPLO when they were assessed according to either equivalent phase of gait cycle or femorotibial flexion angles.

Conclusion: In vivo PF kinematics in TPLO-treated stifles were subtly different from normal, characterized by slight cranial shifting of the patella relative to the trochlear groove.

Clinical Significance: The clinical significance of these results remains unknown. These results may provide further understanding into extensor mechanism abnormalities associated with TPLO.
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http://dx.doi.org/10.1111/vsu.13300DOI Listing
January 2020

Safety and Accuracy of Minimally Invasive Long Bone Fracture Repair Using a 2.5-mm Interlocking Nail: A Cadaveric Feline Study.

Vet Comp Orthop Traumatol 2019 Sep 6;32(5):351-361. Epub 2019 Jul 6.

Vetsuisse Faculty University of Zurich, Clinic for Small Animal Surgery, Zurich, Switzerland.

Objectives:  The Targon Vet System (TVS) is a 2.5-mm interlocking nail that can be applied minimally invasively. The purpose of this study was to test if the TVS could be safely applied percutaneously to different feline long bones without fluoroscopic guidance.

Methods:  A gap fracture was created in 96 feline humeri, femora and tibiae ( = 32/group). Paired bones were randomly assigned to two treatment groups: (1) TVS inserted percutaneously with fluoroscopy and (2) TVS inserted percutaneously without fluoroscopy. Intraoperative evaluation (complications, procedure time, attempts), radiographs (pre-/postoperative alignment, length) and anatomical dissection (neurovascular injury, rotational alignment) were compared between treatment groups.

Results:  The use of fluoroscopy did not lead to significant differences in any of the outcome measures. Intraoperative complications predominantly occurred in the distal humerus (12/32) and the proximal femur (7/32). In total, 20/96 complications occurred with no complications for the tibia. Neurovascular structures were only damaged at the medial side of the distal humerus (10/32).

Clinical Significance:  We conclude that the TVS can be safely applied percutaneously to the tibia and with limitations to the femur in normal cadaveric cats without fluoroscopy. Despite the limitations of a cadaveric study, the high number of complications is leading us to consider the humerus not safe for the TVS. A learning curve has to be expected and technical recommendations should be respected to decrease complications.
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http://dx.doi.org/10.1055/s-0039-1691828DOI Listing
September 2019

Fundamental principles of rehabilitation and musculoskeletal tissue healing.

Vet Surg 2020 Jan 4;49(1):22-32. Epub 2019 Jul 4.

Department of Small Animal Surgery, University of Zurich, Zurich, Switzerland.

Objective: To review fundamental principles of tissue healing and physical rehabilitation as they apply to dogs recovering from cranial cruciate ligament (CCL) surgery.

Study Design: Invited Review.

Sample Population: None.

Methods: A multidisciplinary group of specialists in small animal surgery, rehabilitation/sports medicine, and human physical and occupational therapy reviewed the currently available evidence for rehabilitation post-CCL surgery. Because current evidence is limited, this group proposes guidelines for rehabilitation after CCL surgery based on the fundamental principles of tissue healing and physical therapy.

Results: This Review proposes four fundamental principles of small animal physical rehabilitation based on the foundations of tissue healing and patient-centric and goal-oriented therapy. Postoperative rehabilitation programs should be designed such that patient progress is based on individual assessment according to the degree of tissue healing, strength, and achievement of functional goals. Therapists must fully understand phases of tissue healing, reassess the patient frequently, and use clinical reasoning skills to progress treatment appropriately for the individual patient.

Conclusion: Until more robust evidence is available to guide treatment protocols, fundamental principles of rehabilitation should ideally be adhered to when providing rehabilitation, including after CCL surgery.

Clinical Significance: While this Review specifically addresses post-CCL surgery rehabilitation, these fundamental principles should be applied broadly to animals enrolled in rehabilitation programs.
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http://dx.doi.org/10.1111/vsu.13270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973127PMC
January 2020

Measurement of Shoulder Abduction Angles in Dogs: An Ex Vivo Study of Accuracy and Repeatability.

Vet Comp Orthop Traumatol 2019 Nov 21;32(6):427-432. Epub 2019 Jun 21.

Department of Veterinary Clinical Sciences, The Ohio State University, College of Veterinary Medicine, Columbus, Ohio, United States.

Objective:  The aim of this study was to determine the accuracy and repeatability of the shoulder abduction test and to assess the effect of transection of the medial shoulder support structures in canine cadavers.

Materials And Methods:  The shoulder abduction angle was measured by three separate observers, both with the shoulder extended and at a neutral angle. Shoulder abduction was then measured, using craniocaudal fluoroscopic images. Arthroscopy was performed in all shoulder joints, with the medial support structures transected in one shoulder of each dog. The three observers again measured shoulder abduction angles in all dogs. Shoulder abduction was measured again using fluoroscopy. Accuracy and repeatability of the abduction test were assessed using linear mixed models.

Results:  All three observers had different measured abduction angles when compared with fluoroscopy ( < 0.01); however, the experienced surgeon had an error of only 2.9°. Inter-observer repeatability was poor, with all three observers having different abduction measurements ( < 0.001). Intra-observer repeatability, however, indicated no differences on repeated measurements ( = 0.26). Placing the shoulder at a neutral standing angle, and transection of support structures caused an average increase in abduction by 8.2° ( < 0.001) and 4.4° respectively.

Conclusion:  Significant variation exists between observers performing this test, increased accuracy seen in the more experienced observer. Shoulder flexion angle can significantly affect measured abduction angles.
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http://dx.doi.org/10.1055/s-0039-1692410DOI Listing
November 2019

Comparison between high-field 3 Tesla MRI and computed tomography with and without arthrography for visualization of canine carpal ligaments: A cadaveric study.

Vet Surg 2019 May 3;48(4):546-555. Epub 2019 Mar 3.

Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To compare the quality of visualization of canine carpal ligaments by using computed tomography (CT), MRI, CT arthrography (CTA), and magnetic resonance arthrography (MRA).

Study Design: Prospective descriptive study.

Study Population: Cadavers from dogs weighing more than 20 kg.

Methods: A 16-slice CT scanner and a 3 Tesla MRI were used for the investigation. A dilute contrast medium was injected into the middle carpal and radiocarpal joints under fluoroscopic control, and CTA and MRA images were acquired. To evaluate the difference between imaging modalities, 3 observers graded carpal ligaments of clinical interest using a scale from 0 to 4 for their quality of visualization. Data were analyzed by using a random-effect ordinal logistic regression with Bonferroni adjustment. The interobserver agreement was calculated by using the weighted Cohen's κ.

Results: Normal carpal joints (n = 9) were investigated. Magnetic resonance arthrography improved visualization of the majority of carpal ligaments compared with MRI (P < .05) and offered the best visualization overall. Magnetic resonance imaging and MRA offered better visualization compared with both CT and CTA (P < .05). There was no difference between CT and CTA. Interobserver agreement was discrete (0.2 < κ ≤ 0.4) for all observers.

Conclusion: Arthrography improved the capabilities of MRI but not of CT for visualization of the canine carpal ligaments. Magnetic resonance arthrography was particularly useful for evaluation of the stabilizers of the antebrachiocarpal joint.

Clinical Significance: 3 Tesla MRA and MRI allow excellent visualization of the ligamentous morphology and may be helpful in the diagnostic process of carpal sprains in dogs.
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http://dx.doi.org/10.1111/vsu.13186DOI Listing
May 2019

Use of a cerclage cable-plate system to stabilize a periprosthetic femoral fracture after total hip replacement in a dog.

Vet Surg 2019 Apr 28;48(3):437-443. Epub 2019 Feb 28.

Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To report the successful use of cerclage cables around the periprosthetic region of a femoral fracture after total hip replacement (THR) in a dog with bone stock too limited for other methods of fixation.

Study Design: Case report.

Animal: 6-year-old male neutered, golden retriever.

Methods: Locking plate fixation of a type-B1 diaphyseal periprosthetic femoral fracture (PFF) failed 14 days after cementless THR and 6 days after initial femoral fracture repair. Total hip replacement implants seemed unchanged on radiographs, but lateral retraction of the screw-plate construct from the proximal segment was evident. Bone stock was assessed as insufficient for adequate screw purchase, prompting revision of the fixation with cerclage cable fixation of the proximal segment; the cables were anchored to the original locking plate construct with threaded positioning pins that screwed into the locking holes.

Results: Acceptable union was documented on radiographs by 3 months after revision. No lameness and good range of motion of the hip were observed on clinical examination 13 months after surgery. Radiographs at 13 months documented static implant positioning and remodeling at the fracture site.

Conclusion: Use of a cable-plate construct to stabilize a type-B1 PFF led to successful long-term outcome in this dog.

Clinical Significance: Use of a cable-plate construct may be considered to treat type-B1 PFF with limited bone stock.
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http://dx.doi.org/10.1111/vsu.13185DOI Listing
April 2019

Ex vivo computed tomography evaluation of loading position on morphometry of the caudal cervical intervertebral disk spaces of dogs.

Am J Vet Res 2019 Mar;80(3):235-245

OBJECTIVE To provide an objective, quantitative morphometric description of the caudal cervical intervertebral disk (IVD) spaces of dogs. SAMPLE Vertebral specimens consisting of C4 through C7 from 5 medium-sized dogs. PROCEDURES CT images were obtained with the specimens positioned in neutral, flexion, extension, and lateral bending positions. Size and shape of the cranial and caudal end plates, angle between the end plates (IVD wedge angle), and craniocaudal distance (IVD width) between end plates for the 4 loading positions were measured and compared for the 3 segments (C4-5, C5-6, and C6-7). RESULTS End plate size and shape, IVD wedge angle, and IVD width were not significantly different among the 3 segments. Caudal cervical end plates were consistently larger than cranial cervical end plates. The IVD wedge angle ranged from -4.8° to 15.2°. Flexion induced a reduction in IVD width in the ventral portion of the IVD, whereas extension induced a decrease in width in the dorsal portion of the IVD. Central IVD width remained unchanged among the loading positions. CONCLUSIONS AND CLINICAL RELEVANCE Unique morphometric and dynamic characteristics of the caudal cervical IVD space of dogs were detected. These findings may help investigators when designing IVD prostheses for dogs with cervical spondylomyelopathy.
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http://dx.doi.org/10.2460/ajvr.80.3.235DOI Listing
March 2019

Biomechanical properties of plate constructs for feline ilial fracture gap stabilization.

Vet Surg 2019 Jan 13;48(1):88-95. Epub 2018 Nov 13.

Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Objective: To determine the biomechanical properties of plating techniques for comminuted feline ilial fractures.

Study Design: Ex vivo study on 40 paired feline hemipelves.

Sample Population: Forty paired fresh-frozen hemipelves that had been collected from 20 cats aged 2-6 years and weighing 4.0-5.5 kg.

Methods: A transverse 3-mm gap was created in each ilium. Hemipelves were fixed with one of the following methods (n = 10 per group): (1) a dorsal plate and nonlocking screws, (2) a lateral plate and nonlocking screws, (3) a lateral plate and locking screws, or (4) a lateral and dorsal locking compression plate using nonlocking screws. Each specimen was subjected to incremental, sinusoidal cyclic loading until failure, defined as 10-mm displacement. The initial stiffness and number of cycles required to reach 1-, 2-, 5-, and 10-mm axial displacement were statistically analyzed.

Results: The initial stiffness and number of cycles to failure were higher in specimens fixed with double nonlocking plates than in all other fixations (P < .05) except specimens fixed with lateral locking plate at 10-mm displacement (P = .44). Locking implants withstood more cycles to 5- (P < .05) and 10-mm (P < .05) displacement compared with other single-plate nonlocking groups. Screw loosening occurred only in the 3 nonlocking fixations.

Conclusion: Double plating improved stiffness and resistance to failure of comminuted feline ilial fracture constructs compared with all other fixations. Single locking plates produced superior constructs compared with single nonlocking constructs.

Clinical Significance: Locking implants are recommended to repair comminuted feline ilial fractures for their extended fatigue life and resistance to screw loosening. Orthogonal plating offers a strong nonlocking alternative.
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http://dx.doi.org/10.1111/vsu.13124DOI Listing
January 2019

Teaching and proficiency assessment for arthroscopy in veterinary surgery: A 2017 survey of diplomates and residents of the American and European College of Veterinary Surgeons.

Vet Surg 2018 Nov 29;47(8):E70-E78. Epub 2018 Sep 29.

Veterinary Specialists Ireland, Summerhill, County Meath, Ireland.

Objective: To determine current methods of arthroscopic skills training and proficiency assessment, identify skills considered fundamental to arthroscopy, and evaluate desire for a formal training and assessment program.

Study Design: Anonymized electronic survey.

Sample Population: Diplomates and residents of the American College of Veterinary Surgeons (ACVS) and European College of Veterinary Surgeons (ECVS).

Methods: An electronic survey was distributed in commercial software (Qualtrics, Provo, Utah). Questions were divided into 4 categories: (1) demographics, (2) arthroscopy experience, (3) teaching, and (4) proficiency assessment. Descriptive statistical analysis was performed. Comparisons between groups were performed by using χ , t tests, and 1-way ANOVA (P ≤ .05).

Results: In total, 429 diplomates and 149 residents responded (response rate 28%). Overall, 80% of respondents trained using clinical cases. Barriers to simulator training included cadaver/simulator availability and time. Skills deemed most fundamental included anatomic knowledge, precise portal placement, triangulation, and image orientation. Overall, 90% of respondents supported a formal training program with requirement to demonstrate proficiency; 80% believed this should be part of standard ACVS/ECVS residency training.

Conclusion: Arthroscopic skills are taught by using clinical cases, with subjective proficiency assessment. Fundamental skills are those that may be taught using simulators. There is enthusiasm for formal arthroscopic skills training and assessment.

Clinical Significance: Improved acquisition and assessment of fundamental arthroscopic skills is indicated. A validated methodology for formal training using simulators, minimizing morbidity, and facilitating objective evaluation is warranted. This is the first phase of a project to develop and validate a simulator program.
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http://dx.doi.org/10.1111/vsu.12951DOI Listing
November 2018

Feasibility and safety of arthroscopic medial glenohumeral ligament and subscapularis tendon repair with knotless anchors: A cadaveric study in dogs.

Vet Surg 2018 Aug 9;47(6):817-826. Epub 2018 Aug 9.

Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To test the feasibility and safety of an arthroscopic imbrication of the medial glenohumeral ligament (MGHL) and the subscapularis tendon with knotless anchors in dogs.

Study Design: Cadaveric study.

Sample Population: Ten limbs.

Methods: Cranial and caudal arms of the MGHL were imbricated with a 2.9- or a 2.4-mm knotless anchor. A horizontal mattress suture secured with a 3.5-mm knotless anchor was used to imbricate the subscapularis tendon. Computed tomography measurements included (1) the bone stock around the anchors, (2) the angle between the anchor and the joint surface (insertion angle), and (3) the angle formed by lines tangent to the cortices of the bones (safety angle). Limbs were dissected to assess the position of anchors. Safety and insertion angles and bone stock were compared among anchors with a Kruskal-Wallis test (P < .05).

Results: Surgical repairs were achieved in all limbs, with only 2 of 30 anchors incorrectly placed, both in the glenoid. The safety angle of the humeral anchor (HA; median, 89°) was greater than that of the cranial glenoid anchor (CrGA; P = .0017) and the caudal glenoid anchor (CdGA; P < .001). The insertion angle of the HA (median, 68°) was also greater than that of the other anchors (P < .001 and P = .001). The insertion angle of the CrGA (median, 26°) was greater (P = .0191) than that of the CdGA (median, 7°). All anchors were inserted at the MGHL and subscapularis footprint.

Conclusion: Arthroscopic imbrication of MGHL and subscapularis tendon was feasible. HA were safer to place than glenoid anchors.

Clinical Significance: The results of this feasibility study justify further evaluation of the indications and outcomes of this technique in dogs with shoulder instability.
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http://dx.doi.org/10.1111/vsu.12929DOI Listing
August 2018

Comparison of three imaging modalities used to evaluate bone healing after tibial tuberosity advancement in cranial cruciate ligament-deficient dogs and comparison of the effect of a gelatinous matrix and a demineralized bone matrix mix on bone healing - a pilot study.

BMC Vet Res 2018 May 22;14(1):164. Epub 2018 May 22.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA.

Background: Bone healing and assessment of the state of bone bridging is an important part of clinical orthopedics, whether for fracture healing or for follow up of osteotomy procedures. Tibial tuberosity advancement (TTA) is designed to restore stability in cruciate deficient stifle joints by advancing the tuberosity while creating an osteotomy gap. The current study aims to: 1) compare three different imaging modalities to assess bone healing: ultrasound, radiographs and computed tomography (CT) and, to 2) compare the effect of a gelatinous matrix (GM) versus a demineralized bone matrix mix (DBM mix) on bone healing and bridging of this osteotomy gap in 10 otherwise healthy client-owned dogs with cranial cruciate ligament insufficiency. Osseous union of the osteotomy gap was evaluated with ultrasound, radiographs and CT at one, two, and 3 months postoperatively. Dogs were randomly selected to receive GM or DBM mix to fill the osteotomy gap created during the TTA procedure. Bone healing was assessed subjectively on all modalities as well as scored on radiographs and measured using Hounsfield units (HUs) on CT. Time to heal based on ultrasound, radiographs and CT were statistically compared between groups with significance set at p < 0.05.

Results: All osteotomy gaps were bridged with bone within 3 months for all modalities. Bridging bone was diagnosed in 5.6 weeks, 10.4 weeks and 9.6 weeks based on ultrasound, radiographs, and CT, respectively, in dogs treated with DBM mix. In dogs treated with GM osseous union was diagnosed in a mean of 4.0 weeks, 9.6 weeks and 7.2 weeks based on ultrasound, radiographs and CT. Ultrasound diagnosed osseous union significantly faster than both CT and radiographs (p < 0.001). The dimensions of the newly formed bone differed between treatment groups with the central portion of the bone only providing a small bridge in GM cases. Although bridging of the osteotomy gap occurred earlier in the group that received GM, no significant statistical difference was found between the two groups.

Conclusions: Radiographs overestimate the time needed for osseous union of the osteotomy gap. All osteotomy sites healed radiographically within 3 months.
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http://dx.doi.org/10.1186/s12917-018-1490-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963028PMC
May 2018

The Pathobiology of the Meniscus: A Comparison Between the Human and Dog.

Front Vet Sci 2018 16;5:73. Epub 2018 Apr 16.

Small Animals Surgery, Tierspital, Zurich, Switzerland.

Serious knee pain and related disability have an annual prevalence of approximately 25% on those over the age of 55 years. As curative treatments for the common knee problems are not available to date, knee pathologies typically progress and often lead to osteoarthritis (OA). While the roles that the meniscus plays in knee biomechanics are well characterized, biological mechanisms underlying meniscus pathophysiology and roles in knee pain and OA progression are not fully clear. Experimental treatments for knee disorders that are successful in animal models often produce unsatisfactory results in humans due to species differences or the inability to fully replicate disease progression in experimental animals. The use of animals with spontaneous knee pathologies, such as dogs, can significantly help addressing this issue. As microscopic and macroscopic anatomy of the canine and human menisci are similar, spontaneous meniscal pathologies in canine patients are thought to be highly relevant for translational medicine. However, it is not clear whether the biomolecular mechanisms of pain, degradation of extracellular matrix, and inflammatory responses are species dependent. The aims of this review are (1) to provide an overview of the anatomy, physiology, and pathology of the human and canine meniscus, (2) to compare the known signaling pathways involved in spontaneous meniscus pathology between both species, and (3) to assess the relevance of dogs with spontaneous meniscal pathology as a translational model. Understanding these mechanisms in human and canine meniscus can help to advance diagnostic and therapeutic strategies for painful knee disorders and improve clinical decision making.
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http://dx.doi.org/10.3389/fvets.2018.00073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911564PMC
April 2018