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InFocus

A look through the latest literature: orthopaedics

What’s new in veterinary orthopaedics? This summary of the latest academic publications covers this month’s spotlight topic of orthopaedics

Euthanasia, caregiver burden and treatment satisfaction in canine osteoarthritis

Mary-Beth Spitznagel and others, Kent State University, Ohio

Data from a major corporate vet group has shown that 5 percent of dogs identified as having osteoarthritis (OA) are euthanised within six months of diagnosis. In more than 40 percent of those cases, the owners attributed their decision to concerns about the pet’s prognosis. The authors questioned the owners of 277 dogs with OA to assess the “caregiver burden” they experienced when dealing with their pet’s condition and the level of satisfaction with the veterinary treatment provided for the dog. The findings confirm that “caregiver burden” is strongly associated with any decision around euthanasia. However, the results do suggest that satisfaction with the veterinary treatment provided for the pet mitigates concerns over the progress of the disease and reduces the likelihood of early euthanasia.

The Veterinary Journal, 286, 105868

Outcomes and cost-benefit analysis of pre-closure lavage in total hip replacement surgery

Sarah Israel and others, Blue Pearl Stone Oak, San Antonio, Texas

Revision surgery can add considerably to the already sizeable financial investment made by owners seeking total hip replacement surgery for their pets. Complications such as surgical site infections are the leading reason for further procedures. The authors investigated the efficacy of pre-closure povidone-iodine lavage in reducing the infection risk and assessed the economic feasibility of such treatment. Their results indicate that lavage was effective at lowering the risk of infection. At current costs, this method could be used in 2,415 total hip replacement procedures at a similar cost to a single case of infection requiring revision surgery.

Veterinary Surgery, 51

Ultrasonography in the detection of femoral fractures in large animals

Susan Jones and others, University of California, Davis

Femoral fractures are often catastrophic in large animals such as horses and cattle. A definitive diagnosis of femoral fractures in these species depends on radiography, requires transportation to a veterinary clinic with appropriate equipment and involves both considerable cost and potential risks for the patient. The authors investigated using ultrasound to identify femoral fractures in six horses, five cattle and one elephant. In each case, evidence of a fracture was apparent on ultrasound, and every patient was euthanised or slaughtered. The findings support the use of ultrasonography for rapid patient-side detection of femoral fractures and in guiding decisions on appropriate management.

Journal of the American Veterinary Medical Association, 260, 1657-1682

Intralesional bone marrow and superior check desmotomy in equine tendon repair

David Murphy and others, Murdoch University, Perth

Superficial digital flexor tendon (SDFT) injury is a frequent cause of lost training days and wastage in racehorses. A wide range of medical and surgical methods have been used in these cases, including the intralesional administration of autologous bone marrow cells and transection of the accessory ligament of the SDFT (known as superior check desmotomy), intended to improve the elasticity of the muscle-tendon unit. The authors retrospectively compared the outcomes of these methods with those achieved through conservative treatment in 114 horses. Their findings suggest that these surgical interventions did improve the likelihood of a return to racing in horses with SDFT tendonitis.

Equine Veterinary Journal, 54, 1047-1054

Incidence of meniscal injuries in large and small dogs undergoing cruciate surgery

Stephanie Colthurst and others, Veterinary Specialist Services, Jindalee, Queensland

Cranial cruciate ligament injury is the most common orthopaedic condition involving the canine stifle. Studies in larger dog breeds indicate that meniscal lesions will often occur as a secondary injury due to the altered kinematics of the joint. Tibial plateau levelling osteotomy is the most frequently used surgical treatment method in such cases. The authors examined records from 76 surgical procedures in small dogs and 504 in medium to large-breed dogs, comparing the incidence of medial meniscal tears. They found no significant difference in the incidence of tears either at initial surgery or follow-up between the different-sized breeds.

Journal of Small Animal Practice, 63, 686-691

CT and MRI imaging in the diagnosis of feline carpal injuries

Rachel Basa and others, University of Sydney, Australia

Cats will often experience carpal injuries due to falls or road traffic accidents. Diagnosis is usually based on radiographic examination, including stress views and computed tomography; however, these techniques do not allow the direct evaluation of the carpal ligaments. The authors employed a combination of computed tomography arthrography and magnetic resonance arthrography (CTA and MRA) using a single contrast mixture to examine the carpal ligaments of feline cadavers. Their findings suggest that this combination of imaging modalities was effective in enhancing the appearance of feline carpal ligaments and may provide a foundation for future studies on the diagnosis of feline carpal injuries.

BMC Veterinary Research, 18, 368

Outcomes of surgical treatment for degenerative lumbosacral stenosis

Hirofumi Tanoue and others, Nippon Veterinary University, Musashino, Japan

Degenerative lumbosacral stenosis is a condition mainly seen in larger-breed dogs. It is characterised by compression and damage to the spinal cord due to the narrowing of the spinal canal and intervertebral foramen. The authors investigated the efficacy of surgical treatment involving dorsal laminectomy and dorsal fixation using screws and polymethyl methacrylate. In all 21 cases, clinical signs were alleviated, and proprioceptive deficits were improved three months after surgery. The only complications noted were minor, and there was no evidence of the recurrence of clinical signs during the observation period.

Journal of the American Veterinary Medical Association,260

Comparison of the biomechanical properties of three total hip replacement implants

Charles Saban and others, VetAgro-Sup, Lyon, France

Total hip replacement is the surgical treatment of choice in larger dogs when medical treatment is no longer effective. The complication rate is estimated at between 7 and 22 percent and usually involves the loosening of the implant in devices fixed using polymethyl methacrylate cement. The authors compared the stability of three different implant types: a cementless press-fit femoral stem with a pin in the femoral neck, a press-fit cementless femoral stem without a pin and a cemented femoral stem. Tests on canine cadavers showed that the cementless femoral stems with transfixation pins provided greater immediate resistance to failure than that achieved with cemented stems, and comparable stability.

American Journal of Veterinary Research, 83, 1-8

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