Prevalence of cranial cruciate ligament rupture in a population of dogs with lameness previously attributed to hip dysplasia: 369 cases (1994-2003)

Effect of Nail Grips on Weight Bearing and Limb Function in 30 Dogs 2 Weeks Post Tibial Plateau Leveling Osteotomy

Simple Summary

Devices made to improve mobility are becoming increasingly popular among owners of dogs with orthopedic conditions, but there are few studies investigating their efficacy. Nail grips are commonly used by veterinary rehabilitation practitioners to improve the security of foot placement by increasing nail traction. This study aimed to assess if nail grips would improve mobility outcomes in dogs recovering from knee surgery. The results did not show a significant effect on outcomes during the initial 2-week post-operative period; however, further research is needed to determine if they are useful for other applications.

Abstract

The objective of this study was to assess the functional outcomes of dogs wearing nail grips in the first 2 weeks following tibial plateau leveling osteotomy (TPLO). Thirty dogs were included (n = 13 nail grips and n = 17 sham grips). Visual lameness scores (VLS), total pressure index (TPI), and client-specific outcome measures (CSOMs) were obtained by blinded observers on day 1 and day 14 +/− 3 post TPLO. CSOMs were also obtained on day 7. There were no differences in VLS and TPI between the treatment and sham group on day 14 (p = 0.44 and p = 0.59, respectively) or at any time point. CSOMs assessing walking on slippery flooring, ability to rise, and consistent use of surgical limb on a 5 min walk were also not different between groups (p = 0.78, p = 0.80, and p = 0.63) at any time point. Nail grips were well tolerated in dogs after orthopedic surgery. This study did not demonstrate a benefit for dogs wearing nail grips during the first two weeks after TPLO; however, further studies are warranted.

Genomic Prediction of Two Complex Orthopedic Traits Across Multiple Pure and Mixed Breed Dogs

Canine hip dysplasia (CHD) and rupture of the cranial cruciate ligament (RCCL) are two complex inherited orthopedic traits of dogs. These two traits may occur concurrently in the same dog. Genomic prediction of these two diseases would benefit veterinary medicine, the dog’s owner, and dog breeders because of their high prevalence, and because both traits result in painful debilitating osteoarthritis in affected joints. In this study, 842 unique dogs from 6 breeds with hip and stifle phenotypes were genotyped on a customized Illumina high density 183 k single nucleotide polymorphism (SNP) array and also analyzed using an imputed dataset of 20,487,155 SNPs. To implement genomic prediction, two different statistical methods were employed: Genomic Best Linear Unbiased Prediction (GBLUP) and a Bayesian method called BayesC. The cross-validation results showed that the two methods gave similar prediction accuracy (r = 0.3–0.4) for CHD (measured as Norberg angle) and RCCL in the multi-breed population. For CHD, the average correlation of the AUC was 0.71 (BayesC) and 0.70 (GBLUP), which is a medium level of prediction accuracy and consistent with Pearson correlation results. For RCCL, the correlation of the AUC was slightly higher. The prediction accuracy of GBLUP from the imputed genotype data was similar to the accuracy from DNA array data. We demonstrated that the genomic prediction of CHD and RCCL with DNA array genotype data is feasible in a multiple breed population if there is a genetic connection, such as breed, between the reference population and the validation population. Albeit these traits have heritability of about one-third, higher accuracy is needed to implement in a natural population and predicting a complex phenotype will require much larger number of dogs within a breed and across breeds. It is possible that with higher accuracy, genomic prediction of these orthopedic traits could be implemented in a clinical setting for early diagnosis and treatment, and the selection of dogs for breeding. These results need continuous improvement in model prediction through ongoing genotyping and data sharing. When genomic prediction indicates that a dog is susceptible to one of these orthopedic traits, it should be accompanied by clinical and radiographic screening at an acceptable age with appropriate follow-up.

Cranial Cruciate Ligament Rupture in Dogs: Review on Biomechanics, Etiopathogenetic Factors and Rehabilitation

Cranial cruciate ligament (CrCL) rupture is one of the most common orthopaedic conditions in veterinary medicine. CrCL plays a fundamental role in the stability and biomechanics of the femoral-tibio-patellar joint, and its incorrect functionality severely impacts on the quality of life of patients. In dogs, the structural weakening of this joint due to the progressive degeneration of the ligament is the most accredited etiopathogenetic hypothesis in relation to the dog signalment (breed, sex and age) and the stifle joint conformation. In humans, this injury is often traumatic and generally occurs during sporting activities. CrCL rupture can be managed conservatively or surgically, and decisions regarding treatment are due to numerous factors: the patient’s age and health, the degree of stifle instability, and cost. Physiotherapy protocols play an important role in rehabilitation, with similar goals in humans and dogs: pain management, physiological articular range of motion recovery, periarticular and core muscle strengthening, and proprioceptive deficit correction. Physiotherapy, even if often neglected in veterinary medicine, is mandatory for the recovery of the correct functionality of the injured limb and for the return to normal daily and sporting activities.

Double plating technique for fixing tibial plateau leveling osteotomy and modified cranial closing wedge ostectomy of the tibia in a dog with cranial cruciate ligament disease and excessive plateau angle: case report

ABSTRACT Tibial plateau leveling osteotomy (TPLO) associated to cranial wedge closing ostectomy (CCWO) has been one of the best options to manage cranial cruciate ligament (CCL) disease and excessive tibial plateau angle (TPA) in large dogs, however, the complication rate is potentially high. It is believed that a more robust fixation is necessary to stabilize them and decrease the risk of implant failure. A 6-year-old male American Pit Bull, weighing 36kg, with 90-day history of right hind limb lameness, was diagnosed with CCL disease. Due to the excessive tibial plateau angle (42°), TPLO was associated with a modified CCWO using a double plating technique. A final TPA of 12⁰ was accomplished, and a restricted level of exercises and physiotherapy were recommended. The patient was followed monthly until the fifth month postoperatively, when radiographic bone consolidation and no lameness were observed. By the date of this submission, 3 years after the procedure, the owner has reported no complications. The double plating technique for fixing TPLO and modified CCWO proved to be effective for the treatment of CrCL deficiency in a large dog with an excessive TPA.

Epidemiology of Cranial Cruciate Ligament Rupture and Patellar Luxation in Dogs from the Province of Buenos Aires, Argentina

OBJECTIVE

 The aim of this study was to investigate the prevalence of cranial cruciate ligament rupture and patellar luxation and the associated risk factors in dogs.

MATERIALS AND METHODS

 A total of 13,072 clinical records of dogs were reviewed from School Hospital (Faculty of Veterinary Sciences, National University of La Plata). Data of age, breed, sex, body weight, patellar luxation and cranial cruciate ligament rupture condition were registered. Chi-squared and Fisher's exact tests were used to compare the prevalence of cranial cruciate ligament rupture and patellar luxation with the variables and then univariable logistic regression was used to evaluate the risk of having cranial cruciate ligament rupture and patellar luxation. Multivariable logistic regression was used including all variables to assess the odds of having patellar luxation and cranial cruciate ligament rupture.

RESULTS

 Of 13,072 patients treated, 72 and 51 had cranial cruciate ligament rupture and patellar luxation respectively. Sex was not a major risk factor for either condition. Adult (odds ratio [OR] = 8.2) and senior (OR = 4.3) patients had increased risk of having cranial cruciate ligament rupture, while for patellar luxation age was not a risk factor. Groups 2, 3 and 8 were more likely to have cranial cruciate ligament rupture (OR = 5.5, OR = 9.1 and OR = 2.6), and group 11 had lower risk of having patellar luxation (OR = 0.08). Maxi (OR = 2.4) and giant (OR = 6.0) breeds had higher risk of having cranial cruciate ligament rupture, and medium and maxi breeds had higher risk of patellar luxation (OR = 0.05 and OR = 0.3). Multivariate OR test confirmed that age (adult), body size (giant and maxi) and breed group (Group 3) were significantly associated with having cranial cruciate ligament rupture, and age was associated with having patellar luxation.

CLINICAL SIGNIFICANCE

 This is the first epidemiological study of cranial cruciate ligament rupture and patellar luxation in dogs from School Hospital (Faculty of Veterinary Sciences, National University of La Plata). Giant and large adult dogs from the Molossoid and Terrier breeds were more likely to have cranial cruciate ligament rupture, while mixed and large dog breeds showed the lowest risk of having patellar luxation.

Contribution of Habitual Activity to Cruciate Ligament Rupture in Labrador Retrievers

OBJECTIVE

 The aim of this study was to describe the contribution of signalment and habitual activity in the development of cruciate ligament rupture (CR) in Labrador Retrievers.

STUDY DESIGN

 Four hundred and twelve client-owned purebred Labrador Retrievers were recruited. Dogs were assigned either as affected with CR or as controls based on signalment, physical examination and radiographic evidence of disease. Clients were asked to complete a questionnaire related to signalment, concurrent disease and a questionnaire pertaining to their dog's activity before development of CR or general activity during the dog's most active years.

RESULTS

 Habitual activity was not significantly different between dogs affected with CR and controls. There was no significant difference in neuter status or body weight between CR affected dogs and controls. Labrador Retrievers with a yellow coat, and Labradors that did not maintain an optimal body weight in the opinion of their veterinarian were at increased risk of developing CR.

CONCLUSIONS

 Habitual activity level is not a risk factor for development of CR in Labrador Retrievers. Our study did not show neuter status, sex or body weight to be risk factors for CR. However, coat colour and not sustaining optimal body condition are significant risk factors for CR.

High energy focused shock wave therapy accelerates bone healing

Objectives: To evaluate the influence of shock wave therapy (SWT) on radiographic evidence of bone healing after tibial plateau leveling osteotomy (TPLO).

Methods: Healthy dogs between two to nine years of age that underwent TPLO were randomly assigned to receive either electro- hydraulic SWT (1,000 shocks) or sham treatment (SHAM). Treatment or SHAM was administered to the osteotomy site immediately postoperatively and two weeks postoperatively. Three blinded radiologists evaluated orthogonal radiographs performed eight weeks postoperatively with both a 5-point and a 10-point bone healing scale. Linear regression analysis was used to compare median healing scores between groups.

Results: Forty-two dogs (50 stifles) were included in the statistical analysis. No major complications were observed and all osteo -tomies healed uneventfully. The median healing scores were significantly higher at eight weeks postoperatively for the SWT group compared to the SHAM group for the 10-point (p <0.0002) and 5-point scoring systems (p <0.0001).

Clinical significance: Shock wave therapy applied immediately and two weeks post -operatively led to more advanced bone healing at the eight week time point in this study population. The results of this study support the use of electro-hydraulic SWT as a means of accelerating acute bone healing of canine osteotomies. Additional studies are needed to evaluate its use for acceleration of bone healing following fracture, or with delayed union.

A novel iterative mixed model to remap three complex orthopedic traits in dogs

Hip dysplasia (HD), elbow dysplasia (ED), and rupture of the cranial (anterior) cruciate ligament (RCCL) are the most common complex orthopedic traits of dogs and all result in debilitating osteoarthritis. We reanalyzed previously reported data: the Norberg angle (a quantitative measure of HD) in 921 dogs, ED in 113 cases and 633 controls, and RCCL in 271 cases and 399 controls and their genotypes at ~185,000 single nucleotide polymorphisms. A novel fixed and random model with a circulating probability unification (FarmCPU) function, with marker-based principal components and a kinship matrix to correct for population stratification, was used. A Bonferroni correction at p<0.01 resulted in a P< 6.96 ×10-8. Six loci were identified; three for HD and three for RCCL. An associated locus at CFA28:34,369,342 for HD was described previously in the same dogs using a conventional mixed model. No loci were identified for RCCL in the previous report but the two loci for ED in the previous report did not reach genome-wide significance using the FarmCPU model. These results were supported by simulation which demonstrated that the FarmCPU held no power advantage over the linear mixed model for the ED sample but provided additional power for the HD and RCCL samples. Candidate genes for HD and RCCL are discussed. When using FarmCPU software, we recommend a resampling test, that a positive control be used to determine the optimum pseudo quantitative trait nucleotide-based covariate structure of the model, and a negative control be used consisting of permutation testing and the identical resampling test as for the non-permuted phenotypes.

Etiopathogenesis of Canine Hip Dysplasia, Prevalence, and Genetics

First identified in 1935, canine hip dysplasia is thought to be the most common orthopedic condition diagnosed in the dog. It is most prevalent in large and giant breed dogs, with a complex polygenic mode of inheritance, and relatively low heritability. External factors including caloric intake when growing have a significant effect on phenotypic expression. Initial joint laxity progresses to osteoarthritis due to subluxation and abnormal wearing. Selective breeding programs to attempt to decrease prevalence have shown modest results so far.

Development and Efficacy of a Canine Pelvic Limb Model Used to Teach the Cranial Drawer and Tibial Compression Tests in the Stifle Joint

Canine cranial cruciate ligament rupture (CCLR) is the most common cause of pelvic limb lameness in dogs. CCLR results in palpable stifle instability secondary to cranial translation of the tibial relative to the femur, and it can be diagnosed during the orthopedic exam using the cranial drawer test (CDT) and tibial compression test (TCT). Accurate diagnosis of CCLR depends on the efficacy in performing these tests. In this study, two three-dimensional canine pelvic limb models were developed: one simulating a normal stifle and one simulating CCLR. Thirty-eight veterinary student participants answered questionnaires and performed both the CDT and TCT on a randomly assigned model. Twenty-one participants also manipulated the models one week later to assess skill retention in the short term. Mean levels of reported confidence in diagnosing CCLR and finding anatomic landmarks for CDT/TCT were significantly higher following model manipulation. Nearly all participants reported that they desired a model for teaching the diagnosis of CCLR. Most participants (92.5%) felt that the tested model would be useful for teaching CCLR diagnosis. Accuracy in diagnosing CCLR with the TCT significantly improved over time. Participant response indicated that while the tested model was effective and desirable, an ideal model would be more durable and lifelike. Further studies are needed to evaluate the developed models' effectiveness for teaching CCLR diagnosis compared to traditional teaching methods.

In vitro incidence of fibular penetration with and without the use of a jig during tibial plateau leveling osteotomy

OBJECTIVE

To determine the incidence of fibular penetration during placement of the Synthes® locking TPLO plate with and without the use of a jig.

STUDY DESIGN

Cadaveric, experimental study.

SAMPLE POPULATION

Cadaveric paired pelvic limbs (n = 8) from skeletally mature dogs.

METHODS

Limbs were assigned to 1 of 2 groups (jig-less-TPLO = no jig used; jig-TPLO = jig used). Synthes® locking TPLO plates were applied using proximal screws of excessive length to facilitate identification of fibular penetration. Screw tip locations were identified by dissection and frequency of fibular penetration was compared between groups.

RESULTS

None of the jig-TPLO limbs and 6 (75%) of jig-less-TPLO limbs had fibular penetration, a difference that was statistically significant. Fibular penetration was most frequently associated with the most proximal screw.

CONCLUSIONS

A significantly higher incidence of fibular penetration occurs when Synthes® locking TPLO is performed without use of a jig.

Inverse dynamics analysis evaluation of tibial tuberosity advancement for cranial cruciate ligament failure in dogs

OBJECTIVE

To evaluate, using inverse dynamic analysis, the biomechanical outcome from tibial tuberosity advancement (TTA) surgery in dogs affected by unilateral cranial cruciate ligament failure (CCLF).

STUDY DESIGN

Retrospective case series.

ANIMALS

Dogs (n = 13) 11-20 months after surgery.

METHODS

Kinematic and force data were collected from 13 dogs 11-20 months after TTA and inverse dynamics analysis of the dogs' pelvic limb mechanical function performed. Angle, moment, and power were calculated for each joint. Total support moment (TSM) was calculated.

RESULTS

Six dogs were affected on the right side (Raff) and 7 on the left (Laff). Peak stifle flexor moment was significantly larger for the right stifle compared with the left in Laff dogs, but similar in Raff dogs. Peak stifle extensor moment was significantly larger for the left stifle compared with the right in Raff dogs, and was also larger for the left stifle compared with the right in Laff dogs. Stifle power in early stance was larger on the left in Raff dogs and significantly larger on the right in Laff dogs. TSM was larger on the right in Raff dogs and significantly larger on the right in Laff dogs.

CONCLUSIONS

Affected limbs had a reduction in power of the stifle flexors. Irrespective of the side of CCLF, TSM was larger on the right side and the stifle extensor moment in late stance was larger on the left, perhaps indicating a mechanical limb dominance effect.

An investigation into risk factors for bilateral canine cruciate ligament rupture

OBJECTIVES

To investigate the incidence of bilateral cranial cruciate ligament (CrCL) rupture and determine any associated risk factors.

METHODS

The patient information system and surgical database at the Queen Mother Hospital for Animals, Royal Veterinary College, were searched from March 1998 to March 2007. Patient files were reviewed and data recorded. The risk factors considered included: gender, neuter status, breed, body mass, age and concurrent orthopaedic disease.

RESULTS

In total, 511 dogs were identified as having cruciate rupture and included for analysis. Bilateral rupture of the CrCl was present in 38.7% (198/511) of the dogs. The mean (± SD) time that passed until the contralateral CrCL ruptured was 57.9 weeks (± 54.1; range 3 to 260 weeks). Dogs with bilateral cruciate rupture were younger (mean ± SD; 4.3 ± 2.7 years) than dogs with unilateral cruciate rupture (mean ± SD; 5.3 ± 2.8 years). In dogs with CrCL rupture, male dogs were more likely to have bilateral rupture than female dogs, overweight dogs were more likely to have bilateral rupture, Golden Retrievers were less likely to have bilateral rupture, and Rottweilers had the highest odds of bilateral rupture.

CLINICAL SIGNIFICANCE

In dogs with CrCL rupture, this study suggests possible relationships towards the incidence of a bilateral rupture also occurring as more likely in male dogs, young dogs with a mean age of four years (4.3 ± 2.7 years), Rottweiler dogs, and with an average elapsed time between ruptures of 57.9 weeks.

Hip dysplasia in Estrela mountain dogs: prevalence and genetic trends 1991-2005

Three hundred and thirteen Estrela mountain dogs were examined for hip dysplasia (HD) using the standard ventrodorsal hip extended view, and graded into five categories (A, B, C, D and E) using the Fédération Cynologique Internationale's (FCI) scoring system. The Ortolani method was performed to evaluate hip joint laxity. Pedigree information was obtained from the Portuguese Kennel Club and the genetic trend was evaluated by calculating the mean breeding values (BVs) for the last 15 years, using the threshold model. HD was found in 66% of the dogs. There was low-moderate correlation between the results of the Ortolani test and FCI hip scores (r(s)=0.386; P<0.001). Grades of hip dysplasia were equal in both males and females (P=0.14) and in the animals' right and left sides (P=0.51). The mean BVs for HD were stable in dogs born between 1991 and 2003, and showed an improvement in 2004 and 2005. The data confirm the high prevalence and severity of HD in predisposed breeds that do not have breeding programmes in place. It also confirms an initial favourable change in BVs that is a likely consequence of the voluntary radiographic hip-screening programme.