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Pinna S, Tassani C, Di Benedetto M. Treatment of Medial Instability of the Carpometacarpal and Tarsometatarsal Joints Using the Isolock ® System in Two Dogs. Animals (Basel) 2024; 14:577. [PMID: 38396544 PMCID: PMC10886066 DOI: 10.3390/ani14040577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
This case report describes a novel procedure using the Isolock Intrauma® implant system for treating medial instability of the carpometacarpal and tarsometatarsal joints, as demonstrated in in two dogs. A 9-year-old spayed female Spanish greyhound presented with a non-weight-bearing right hindlimb following a trauma. The clinical and radiological findings confirmed medial tarsometatarsal instability consistent with valgus deviation of the tarsus and the opening of the joint line on the medial aspect from the first to the third tarsometatarsal joints. A 4-year-old female Drahthaar presented with a non-weight-bearing left forelimb, swelling of the carpus and valgus instability. Radiological examination revealed a widening of the spaces between the intermedioradial carpal bone, second carpal bone and metacarpal bone II, confirming the medial carpometacarpal instability. In both cases, the Isolock system, an implant including ultra-high-molecular-weight polyethylene suture (UHMWPE), was used to reinforce the medial joint structures. Minor short-term complications were observed, such as swelling of the tarsal surgical site and hyperextension of the carpus, but these resolved spontaneously. No lameness or major complications were reported five months postoperatively. Carpometacarpal and tarsometatarsal instabilities are rare diseases in dogs as compared to subluxations of the other joints of the carpus and tarsus. There are no previous reports regarding the use of a UHMPWE implant for the treatment of these rare joint injuries, though the present case report suggests the validity and efficacy of the Isolock Intrauma® implant for restoring carpal and tarsal stability and preserving joint mobility.
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Affiliation(s)
- Stefania Pinna
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell’Emilia, Bologna, Italy; (C.T.); (M.D.B.)
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Kern T, Manfredi J, Tomlinson J. Ultrasonographic appearance of supraspinatus and biceps tendinopathy improves in dogs treated with low-intensity extracorporeal shock wave therapy: a retrospective study. Front Vet Sci 2023; 10:1238513. [PMID: 37609057 PMCID: PMC10440432 DOI: 10.3389/fvets.2023.1238513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/14/2023] [Indexed: 08/24/2023] Open
Abstract
Objective This study aimed to determine whether dogs with shoulder tendinopathy diagnosed via musculoskeletal ultrasound would show improvement in imaging after treatment using piezoelectric shockwave therapy and rest. Methods Medical records were reviewed for dogs diagnosed with biceps and/or supraspinatus tendinopathy via musculoskeletal ultrasound, treated using piezowave shockwave, and re-imaged post-treatment. Data collected included patient signalment, duration and grade of lameness, prior rest, piezowave dose, and patient outcome, including a return to sport where applicable. Images were scored using an adapted ultrasound grading scale, in addition to obtaining cross-sectional area measurements. Statistics included Shapiro-Wilk tests (normality), Wilcoxon matched pairs signed rank tests (pre- vs. post-treatment comparisons), and Spearman's correlation coefficients (lameness grade vs. ultrasound score) (significant at P < 0.05). Results In total, 26 of 30 dogs had pathology involving both the biceps and supraspinatus tendons in one limb, with 27 of 30 having tendon/s affected bilaterally. For both tendons, post-treatment cross-sectional area and ultrasound score were significantly lower than pre-treatment (P < 0.001). Lameness decreased clinically (P < 0.0001) following piezowave shockwave treatment regardless of the tendons involved, but the lameness score did not correlate with the ultrasound score for either tendon. Conclusion Dogs with tendinopathy of the biceps brachii and supraspinatus showed significant improvement on follow-up musculoskeletal ultrasound and lameness evaluation after the treatment of their tendons using piezoelectric shockwave therapy with rest. Clinical significance Canine biceps brachii and supraspinatus tendinopathy can cause variable lameness and ultrasonographic appearance, which improves after shockwave therapy and rest. The ultrasound scoring system and cross-sectional area assessment provide useful outcome measures for clinical cases.
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Affiliation(s)
- Tari Kern
- Pawsitive Steps Rehabilitation and Sports Medicine, Rochester Hills, MI, United States
| | - Jane Manfredi
- Pathobiology and Diagnostic Investigation, Michigan State University College of Veterinary Medicine, East Lansing, MI, United States
| | - Julia Tomlinson
- Twin Cities Animal Rehabilitation and Sports Medicine Clinic, Burnsville, MN, United States
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Blake SP, Melfi VA, Tabor GF, Wills AP. Injury Risk Factors Associated with Training and Competition in Flyball Dogs. Top Companion Anim Med 2023; 53-54:100774. [PMID: 37040865 DOI: 10.1016/j.tcam.2023.100774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/07/2023] [Accepted: 03/22/2023] [Indexed: 04/13/2023]
Abstract
Flyball is a fast-paced, high-energy canine sport which has received negative press regarding the potential for injury, and possible welfare implications for canine competitors. Whilst frequency of injury within the sport has been investigated, evidence gaps remain regarding cause. The aim of this study was therefore to identify risk factors for injury within the sport, with a view to improving competitor safety. An online questionnaire was used to obtain data on dogs that had competed in flyball in the last five years but remained injury free, and a second questionnaire obtained data on dogs that had also competed within the last five years but sustained an injury. Data relating to conformation and performance was collected for 581 dogs, with the same data plus information relating to injury collected from an additional 75 injured dogs. Data were then compared using univariable, multivariable and multinomial logistic regression. Dogs completing a flyball course in less than four seconds had the highest level of injury risk (p=0.029), which reduced as time taken increased. There was an association between risk of injury and increasing age, with dogs over 10 years old most likely to be injured during their career in the sport (p=0.004). Furthermore, dogs using an angle of flyball box of between 45° and 55° had a greater risk of injury, while using an angle between 66° and 75° reduced the risk of injury by 67.2% (OR: 0.328). Use of carpal bandaging was significantly associated with carpal injuries (p=0.042). These findings identify new risk factors for injury within flyball which can be used to improve welfare and safety for competitors.
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Affiliation(s)
- Scott P Blake
- Hartpury University, Hartpury, Gloucester, GL19 3BE.
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Rosen S, Duerr FM, Elam LH. Prospective evaluation of complications associated with orthosis and prosthesis use in canine patients. Front Vet Sci 2022; 9:892662. [PMID: 35967994 PMCID: PMC9372342 DOI: 10.3389/fvets.2022.892662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe use of orthoses and prostheses is expanding in veterinary medicine. However, research evaluating the efficacy and complications of these devices in veterinary patients is limited. The primary objective of this study was to prospectively determine the complications and outcomes associated with custom orthosis and prosthesis use in the canine patient.Materials and MethodsThis was a prospective, clinical trial that followed patients for 12 months following device fitting. Owner-perceived complications, clinical metrology instruments, and objective gait analysis were used as outcome measures at various time points. The patients were grouped into the following four major categories: Patients with a carpal orthosis, patients with a stifle orthosis, patients with a tarsal orthosis, and patients with a prosthetic device.ResultsForty-three patients were included in the study. Thirty-nine out of 43 patients (91%) experienced at least one complication, with 7/7 (100%) prosthesis patients experiencing at least one complication. At least one skin complication was reported for the following patient groups during the first 3 months of use: 8/14 (58%) stifle orthoses, 9/10 (90%) carpal orthoses, 6/10 (60%) tarsal orthoses, and 4/7 (58%) prostheses. Patient non-acceptance of the device was identified in 2/15 (14%) stifle orthoses, 1/10 (10%) tarsal orthoses, and 4/7 (55%) prostheses. One out of 15 (7%) stifle orthoses, 4/10 (40%) carpal orthoses, 4/10 (40%) tarsal orthoses, and 1/7 (15%) prostheses experienced mechanical device problems necessitating repair. The majority of patients with carpal and stifle orthoses showed improvement on objective gait analysis in percent body weight distribution of the affected limb between baseline and the most recent follow-up without the device donned: 83% (n = 6) of patients with carpal orthoses, 100% (n = 11) of patients with stifle orthoses. None of the patients with tarsal orthoses showed a similar improvement (0%; n = 4).Discussion and conclusionThree major complications associated with canine orthosis and prosthesis use were identified in this study as follows: Skin complications (abrasions, loss of hair, and sores), mechanical device problems, and patient non-acceptance of the device. Owners should be notified of these potential complications prior to pursuing orthoses or prostheses as a potential treatment option. Although clinical improvement was noted in the majority of patients with stifle and carpal pathology, given the lack of a control group, it is unknown how much of this improvement can be attributed to the orthoses.
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Renner C, Medl N. Multi‐ligamentous injury of the carpus with dislocation of the ulnar styloid in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Carina Renner
- AniCura Kleintierklinik Babenhausen GmbH Babenhausen Germany
| | - Nikola Medl
- AniCura Kleintierklinik Babenhausen GmbH Babenhausen Germany
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Beierer LH. Canine Carpal Injuries: From Fractures to Hyperextension Injuries. Vet Clin North Am Small Anim Pract 2021; 51:285-303. [PMID: 33451806 DOI: 10.1016/j.cvsm.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The canine and feline carpus is a complex arrangement of bones, ligaments, and joint spaces that functions as a ginglymus joint to provide carpal flexion and extension. Given the demanding biomechanical demands on the carpus during weight bearing, a variety of region-specific pathology, often secondary to trauma, are reported. This review details carpal anatomy, biomechanical understandings, and current evidence surrounding carpal pathology and its management. Partial carpal arthrodesis and pancarpal arthrodesis outcomes are reviewed in detail.
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Affiliation(s)
- Lucas Henry Beierer
- Queensland Veterinary Specialists, 263 Appleby Road, Stafford Heights, Queensland 4053, Australia.
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Young AN, Amsellem P, Muirhead TL, Pack L, Matthews AR. Ulnar ostectomy decreases the stability of canine cadaver carpi as assessed with stress radiography. Vet Radiol Ultrasound 2018; 60:19-27. [PMID: 30239050 DOI: 10.1111/vru.12684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/18/2018] [Accepted: 07/17/2018] [Indexed: 12/01/2022] Open
Abstract
Distal ulnar ostectomy may be performed palliatively in patients with distal ulnar osteosarcoma. Concurrent arthrodesis of the carpus has been proposed to counteract joint instability following transection of carpal ligaments associated with removal of the distal ulna. The objective of this prospective one group pretest, posttest study was to assess stability of the carpus following distal ulnar ostectomy using pre- and postoperative stress radiographic views in a group of canine cadaver limbs. Seven thoracic limbs from six canine cadavers weighing more than 20 kg were obtained. Lateral and dorsopalmar, extended lateral, medial stress, and lateral stress radiographs were made before and after distal ulnar ostectomy. Presurgical canine cadaver carpal angle measurements were as follows (mean ± standard deviation): extension 205.9° ± 5.4; medial stress 25.1° ± 5.7; and lateral stress 13.3° ± 5.2°. Cadaver limb joint angles exceeded those previously reported in live dogs. A significant increase in carpal angle was noted following ulnar ostectomy. The mean increases in carpal angle were as follows: (mean ± standard deviation (95% confidence interval)): extension 6.2° ± 4.9 (2.6-9.8) (P = 0.007); medial stress 3.2° ± 3.0 (1.0-5.5) (P = 0.015); lateral stress 6.2° ± 5.2 (2.4-10.1) (P = 0.010). Findings from this cadaver study support the use of supplementary stabilization for clinical patients undergoing distal ulnar ostectomy. Future studies are needed in clinical patients to evaluate changes in limb positioning and gait associated with distal ulnar ostectomy.
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Affiliation(s)
- Aisha N Young
- Diagnostic Imaging, Faculty of Veterinary and Agricultural Sciences, Werribee Campus, University of Melbourne, Werribee, 3030, Australia
| | - Pierre Amsellem
- Companion Animal Department, Atlantic Veterinary College, Charlottetown, Canada
| | - Tammy L Muirhead
- Companion Animal Department, Atlantic Veterinary College, Charlottetown, Canada
| | - LeeAnn Pack
- Companion Animal Department, Atlantic Veterinary College, Charlottetown, Canada
| | - Andrea R Matthews
- Antech Imaging Services, St. John's, Newfoundland and Labrador, Canada
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Bertocci GE, Brown NP, Mich PM. Why Owners Choose an Orthosis Over Stifle Surgery for Canine Cranial Cruciate Ligament Deficiency. Top Companion Anim Med 2018. [PMID: 29525232 DOI: 10.1053/j.tcam.2017.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to describe the patient population of dogs with cranial cruciate ligament (CrCL) deficiency that were prescribed a stifle orthosis. A total of 215 client-owned dogs with previously diagnosed CrCL deficiency were prescribed a stifle orthosis at a veterinary pain management and mobility clinic. Patient intake data collected included dog signalment, chief medical complaint, home environment and activity description, medical and surgical history, and diagnosing veterinarian. An orthopedic examination was conducted to assess pelvic limb function and determine pelvic limb morphologic measures. Spayed females (57.2%) were most common in our sample. Median age, body weight, and body condition score were 9.00 ± 3.23 years, 32.98 ± 13.37kg, and 6.00 ± 1.04, respectively. Most common breeds prescribed stifle orthoses included Labrador Retriever, Golden Retriever, and German Shepherd. Right and left limbs were equally affected, and 19.5% of dogs previously had stifle stabilization surgery. Primary reasons for seeking a stifle orthosis consultation were surgical concerns, advanced age, and surgery cost. Most common chief complaints included altered gait, decreased weight bearing, and pain following activity. Reduced stifle extension, increased cranial drawer score, and decreased 3-leg stance time characterized the CrCL-deficient stifle. Stifle orthosis represents an alternative approach to surgical stabilization and management of CrCL deficiency. CrCL-deficient dogs prescribed stifle orthoses were generally large breeds of advanced age with above ideal body condition score. Owners commonly sought a stifle orthosis for CrCL deficiency due to reservations regarding surgical management.
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Affiliation(s)
- Gina E Bertocci
- Department of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, KY.
| | - Nathan P Brown
- Department of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, KY
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Torres BT, Fu YC, Sandberg GS, Budsberg SC. Pelvic limb kinematics in the dog with and without a stifle orthosis. Vet Surg 2017; 46:642-652. [PMID: 28198549 DOI: 10.1111/vsu.12634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/30/2016] [Accepted: 11/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report a method of evaluating 3-dimensional joint motion in dogs with a stifle orthosis. STUDY DESIGN Experimental. ANIMALS Six healthy dogs. METHODS Three-dimensional pelvic limb joint motion was recorded with and without a stifle orthosis. Kinematic data were collected from dogs at a walk and trot for the hip, stifle, and tarsus prior to, and after application of, a stifle orthosis. Data were also obtained for the orthosis alone. Comparisons were made between the braced and unbraced limb, and between the braced limb and the orthosis alone. Complete waveforms, kinematic, and temporospatial variables were compared. RESULTS Gait waveforms differed between braced and unbraced limbs for all joints and planes of motion (P < .05), as well as between the braced stifles and the orthosis alone at both a walk and trot. However, joint ROM was inconsistently altered. The effect of bracing on stifle ROM was limited to a reduced extension at the end of stance. Adjacent joint ROM was affected by the stifle orthosis. Temporospatial variables were predominantly affected while walking. CONCLUSIONS The restrictive motion of the stifle orthosis is not fully translated to the underlying joint, based on the limited differences between the motion of braced and unbraced stifles. This effect varies with plane of motion and phase of the gait cycle, with most changes in stifle motion being detected during the stance phase. The stifle orthosis had an equal or greater effect on the motion of adjacent joints, especially the tarsus.
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Affiliation(s)
- Bryan T Torres
- The Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Yang-Chieh Fu
- The Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, Mississippi
| | - Gabriella S Sandberg
- The Department of Small Animal Medicine and Surgery, University of Georgia, College of Veterinary Medicine, Athens, Georgia
| | - Steven C Budsberg
- The Department of Small Animal Medicine and Surgery, University of Georgia, College of Veterinary Medicine, Athens, Georgia
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Bertocci GE, Brown NP, Mich PM. Biomechanics of an orthosis-managed cranial cruciate ligament-deficient canine stifle joint predicted by use of a computer model. Am J Vet Res 2017; 78:27-35. [PMID: 28029280 DOI: 10.2460/ajvr.78.1.27] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of an orthosis on biomechanics of a cranial cruciate ligament (CrCL)-deficient canine stifle joint by use of a 3-D quasistatic rigid-body pelvic limb computer model simulating the stance phase of gait and to investigate influences of orthosis hinge stiffness (durometer). SAMPLE A previously developed computer simulation model for a healthy 33-kg 5-year-old neutered Golden Retriever. PROCEDURES A custom stifle joint orthosis was implemented in the CrCL-deficient pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation in the orthosis-stabilized stifle joint (baseline scenario; high-durometer hinge]) were determined and compared with values for CrCL-intact and CrCL-deficient stifle joints. Sensitivity analysis was conducted to evaluate the influence of orthosis hinge stiffness on model outcome measures. RESULTS The orthosis decreased loads placed on the caudal cruciate and lateral collateral ligaments and increased load placed on the medial collateral ligament, compared with loads for the CrCL-intact stifle joint. Ligament loads were decreased in the orthosis-managed CrCL-deficient stifle joint, compared with loads for the CrCL-deficient stifle joint. Relative tibial translation and rotation decreased but were not eliminated after orthosis management. Increased orthosis hinge stiffness reduced tibial translation and rotation, whereas decreased hinge stiffness increased internal tibial rotation, compared with values for the baseline scenario. CONCLUSIONS AND CLINICAL RELEVANCE Stifle joint biomechanics were improved following orthosis implementation, compared with biomechanics of the CrCL-deficient stifle joint. Orthosis hinge stiffness influenced stifle joint biomechanics. An orthosis may be a viable option to stabilize a CrCL-deficient canine stifle joint.
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Hart JL, May KD, Kieves NR, Mich PM, Goh CSS, Palmer RH, Duerr FM. Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs. J Am Vet Med Assoc 2016; 249:391-8. [DOI: 10.2460/javma.249.4.391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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