Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs

OBJECTIVE: To determine the effects of early postoperative rehabilitation on limb function in dogs after surgery for ruptured cranial cruciate ligament (RCCL). DESIGN: Prospective clinical study. ANIMALS: 51 client-owned dogs. PROCEDURE: Dogs weighing between 20 and 40 kg (44 to 88 lb) that had RCCL and medial meniscal injury were studied. After removal of the RCCL and complete medial meniscectomy, the stifle joint was stabilized by use of a lateral retinacular stabilization technique. Twenty-five dogs were included in a postoperative rehabilitation group, and 26 dogs were included in an exercise-restricted group. Limb function (peak vertical force [PVF] and vertical impulse [VI]) was determined before surgery and 6 months after surgery, using force platform gait analysis. RESULTS: Prior to surgery, mean PVF and VI in affected limbs were similar between groups. Six months after surgery, PVF and VI were significantly increased in dogs of both groups. However, PVF and VI in dogs in the rehabilitation group were significantly greater than those of dogs in the exercise-restricted group. At this time, differences in limb function (as measured by PVF and VI) between the repaired and normal limbs were not evident in dogs in the rehabilitation group. Conversely, limb function in the repaired limb of dogs in the exercise-restricted group was still significantly less than that of the normal limb. CONCLUSION AND CLINICAL RELEVANCE: Dogs that have surgery for RCCL and a torn medial meniscus benefit from postoperative rehabilitation; rehabilitation should be considered part of the postoperative management of these patients.     

The effect of tibial plateau angle on ground reaction forces 4-17 months after tibial plateau leveling osteotomy in Labrador Retrievers

OBJECTIVE: To assess the relationship between postoperative tibial plateau angle (TPA) and ground reaction forces (GRFs) in Labrador Retrievers at least 4-months after tibial plateau leveling osteotomy (TPLO) surgery. STUDY DESIGN: A retrospective longitudinal study. ANIMALS: Thirty-two Labrador Retrievers with unilateral cranial cruciate ligament disease that had TPLO and concurrent meniscal surgery. METHODS: TPA and GRFs were measured pre- and > or = 4 months postoperatively. Preoperative GRFs, preoperative TPA, duration of injury, postoperative TPA and degree of rotation were each compared with postoperative GRFs using correlation analysis. Dogs were also grouped by postoperative TPA and compared using 1-way analysis of variance (ANOVA). Postoperative function was compared with meniscal release/meniscectomy, patient age, sex, body weight and follow-up time using ANOVA. RESULTS: No significant relationship was found between preoperative GRFs, preoperative TPA, duration of injury, postoperative TPA, degree of rotation, or meniscal release/meniscectomy and postoperative function. Mean preoperative GRFs for all dogs were 28.8 +/- 9.5 for peak vertical force (PVF) and 9.3 +/- 3.1 for peak vertical impulse (VI). Mean postoperative GRFs for all dogs were 40.4 +/- 5.0 for PVF and 14.1 +/- 1.9 for VI. CONCLUSIONS: No statistically significant relationship was found between postoperative TPA and GRFs after TPLO > or = 4 months after surgery, where the postoperative angle was between 0 and 14 degrees. No significant relationship was found between the preoperative TPA and postoperative function. CLINICAL RELEVANCE: Limb function in Labrador Retrievers was not affected by postoperative TPA and re-operation for cases with a postoperative TPA between 0 and 14 degrees is not recommended.     

Tibial plateau angle in four common canine breeds with cranial cruciate ligament rupture, and its relationship to meniscal tears

OBJECTIVES: To compare tibial plateau angle (TPA) among Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs that had undergone tibial plateau leveling osteotomies (TPLO) for cranial cruciate ligament disease, and to determine if higher TPAs are associated with increased risk for concurrent meniscal injury. METHODS: This was a retrospective study including 275 client-owned dogs of one of the four aforementioned breeds that received TPLO radiographs between 1999 and 2005 prior to undergoing the TPLO procedure. The TPA measured by the original surgeon was compared among four breeds and analyzed with respect to presence or absence of meniscal injury diagnosed via arthroscopy or arthrotomy at the time of surgery. RESULTS: Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs had mean TPAs of 25.9 degrees , 26.2 degrees , 25.9 degrees , and 28.2 degrees , respectively. The TPA of German Shepherd Dogs was significantly higher than that of the other breeds of dogs examined. TPA higher than the mean for dogs in this study did not significantly increase the risk for concurrent meniscal injury. CLINICAL SIGNIFICANCE: German Shepherd Dogs with cranial cruciate ligament disease had a significantly higher TPA compared to the other breeds examined. Higher TPA did not increase the likelihood of meniscal tears in this study. However, several variables that were not assessed, including the degree of cranial cruciate ligament integrity at the time of surgery and the time between original CrCL deficiency and surgical assessment, could have affected this analysis.     

Distribution of power across the hind limb joints in Labrador Retrievers and Greyhounds

OBJECTIVE: To quantify angular excursions; net joint moments; and powers across the stifle, tarsal, and metatarsophalangeal (MTP) joints in Labrador Retrievers and Greyhounds and investigate differences in joint mechanics between these 2 breeds of dogs. ANIMALS: 12 clinically normal dogs (6 Greyhounds and 6 Labrador Retrievers) with no history of hind limb lameness. PROCEDURE: Small retroreflective markers were applied to the skin over the pelvic limb joints, and a 4-camera kinematic system captured data at 200 Hz in tandem with force platform data while the dogs trotted on a runway. Breed-specific morphometric data were combined with kinematic and force data in an inverse-dynamics solution for stance-phase net joint moments and powers at the stifle, tarsal, and MTP joints. RESULTS: There were gross differences in kinematic patterns between Greyhounds and Labradors. At the stifle and tarsal joints, moment and power patterns were similar in shape, but amplitudes were larger for the Greyhounds. The MTP joint was a net absorber of energy, and this was greater in the Greyhounds. Greyhounds had a positive phase across the stifle, tarsal, and MTP joints at the end of stance for an active push-off, whereas for the Labrador Retrievers, the only positive phase was across the tarsus, and this was small, compared with values for the Greyhounds. CONCLUSIONS AND CLINICAL RELEVANCE: Gross differences in pelvic limb mechanics are evident between Greyhounds and Labrador Retrievers. Joint kinetics in specific dogs should be compared against breed-specific patterns.     

Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles)

OBJECTIVE: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. METHODS: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. RESULTS: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. CLINICAL SIGNIFICANCE: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.     

Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy

OBJECTIVE: To evaluate the biomechanical effects of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on joint stability in the cranial cruciate ligament (CCL)-deficient canine stifle before and after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Experimental study. ANIMALS: Thirty-one dogs. METHODS: In experiment 1, 16 pairs of normal hindlimbs randomly assigned to an intact or transected CCL group were studied to determine the magnitude of tibial translation after MMR and MCH under 20% body weight load using radiographic imaging of radio-opaque markers. In experiment 2, 15 pairs of CCL-deficient hindlimbs were randomly assigned to a TPLO or sham TPLO group. The remainder of the experiment was performed as described for experiment 1. The effect of CCL transection, MMR, MCH and TPLO were analyzed using 2-way repeated measures ANOVA; P<.05 was considered significant. RESULTS: We found a greater effect of MMR on tibial translation in transected CCL stifles than in intact stifles (P=.0016). We found no further effect of MCH after MMR (P>.05). We found a greater effect of MMR in sham TPLO than TPLO stifles (P=.0013) but no further effect of MCH after MMR (P>.05). CONCLUSIONS: By resisting tibial translation the medial meniscus might be at greater risk of tearing in CCL-deficient stifles. TPLO may spare the medial meniscus by neutralizing the tibial thrust and eliminating the wedge effect of the medial meniscus. CLINICAL RELEVANCE: MMR may not be indicated in the CCL-deficient stifle stabilized by TPLO.     

Multivariate analysis of morphometric characteristics to evaluate risk factors for cranial cruciate ligament deficiency in Labrador retrievers

Objectives: To determine the combination of conformation characteristics of the pelvic limbs of Labrador Retrievers that best discriminates between limb at risk to develop cranial cruciate ligament (CCL) disease and limbs at low risk using radiographs, computerized tomography (CT) images, and dual‐energy X‐ray absorptiometry (DEXA). Study Design: Cross‐sectional clinical study. Animals: Twelve clinically normal and 9 unilaterally CCL‐deficient Labrador Retrievers. Methods: The pelvic limbs of normal dogs were considered as non‐predisposed to CCL disease and the contralateral limbs of CCL‐deficient dogs as predisposed. Conformation variables, obtained from femur and tibial radiographs, pelvic limb CT images and DEXA studies, of predisposed pelvic limbs were compared with the conformation variables from pelvic limbs of the low‐risk group. An ROC curve analysis was used to assess the discriminating properties of conformation variables for several combinations. Results: We determined that a combination of tibial plateau angle (TPA) and femoral anteversion angle (FAA) measured on radiographs was optimal for discriminating predisposed and non‐predisposed limbs for CCL disease in Labrador Retrievers. Conclusions: Assessing predisposition to CCL disease with a combination of conformational measurements is better than using univariate parameters. In the future, TPA and FAA may be used to screen dogs suspected of being susceptible to CCL disease.     

Isoelectric focusing under dissociating conditions for analysis of muscle protein from clinically normal dogs and Labrador retrievers with hereditary myopathy

Protein profiles of whole homogenates of anconeus (slow twitch) and biceps femoris (fast twitch) muscles of clinically normal dogs and of Labrador Retrievers with hereditary myopathy (HM) were resolved on flat bed polyacrylamide isoelectric-focusing gels. Three methods of sample solubilization were performed. The solubilization buffer, with high concentrations of urea, precipitated the zwitterionic detergent, but use of the buffer containing 3% NP-40, 9.2M urea, and 0.1M arginine resulted in better resolution and stability of pH gradient. Gels of anconeus muscle from clinically normal dogs contained 2 protein bands specific to anconeus muscle, whereas gels of biceps femoris muscle from clinically normal dogs contained 3 protein bands amplified in biceps femoris muscle that were barely detectable in anconeus muscle. The staining intensity of protein bands in biceps femoris muscles from Labrador Retrievers with HM was decreased, relative to controls. The quantitative analysis of peak height ratios of biceps femoris muscle revealed significant (P less than 0.05) differences between profiles of clinically normal dogs and Labrador Retrievers with HM.     

Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog

OBJECTIVE: Comparison of 2 methods of surgical management of cranial cruciate ligament (CCL) injury in large-breed dogs using a radiographic osteoarthrosis (OA) scoring system. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n=66). METHODS: Radiographs were evaluated from dogs weighing >/=22.7 kg, with surgical management of CCL rupture using extracapsular repair (ECR) or tibial plateau leveling osteotomy (TPLO). Radiographs were taken immediately before surgery and >/=12 months later. An OA score was assigned to each set of radiographs taken at the preoperative and final examinations by evaluating 32 specific features of stifle OA. The difference between preoperative and final OA scores were subtracted and 2 final score categories of a change 5 were created. A logistic regression model was used to evaluate the effect of right versus left pelvic limb, age, preoperative weight, postoperative weight, days from surgery until final radiographic recheck, cranial cruciate status at surgery, medial meniscus status at surgery, and ECR versus TPLO. RESULTS: The ECR group had 27 stifles (22 dogs) and the TPLO group had 52 stifles (44 dogs). ECR dogs had a preoperative weight of 33.4+/-9.3 kg (range 22.7-54.1 kg) and a preoperative OA score of 13.0+/-8.4 (range 1-34) compared with TPLO dogs that had a preoperative weight of 38.9+/-9.1 kg (range 25-63.9 kg) and preoperative OA score of 15.9+/-8.4 (range 4-44). Postoperative weights for ECR and TPLO dogs were 33.6+/-9 kg (range 21.8-54.6 kg) and 39.4+/-10.1 kg (range 24-72 kg), respectively. Final OA scores were: ECR dogs, 26.3+/-10.8 (range, 10-54); TPLO dogs, 23.3+/-9.5 (range, 12-50). Dogs with a final change in OA score of >/=6 were 5.78 times more likely to have had ECR compared with those that had TPLO as stabilization procedure (odds ratio=5.78; Log-likelihood test P-value=.025). Other dependent variables were not significant. CONCLUSIONS: Based on logistic regression analysis, dogs with larger OA score differences were 5.78 times more likely to have had ECR than TPLO. CLINICAL RELEVANCE: Prospective, randomized surgical trials with pre-defined objective measures would be required to further evaluate the clinical importance of these preliminary findings which suggest that TPLO may help stabilize the cranial tibial thrust as originally proposed.     

Noninvasive determination of body segment parameters of the hind limb in Labrador Retrievers with and without cranial cruciate ligament disease

OBJECTIVE: To determine mass, center of mass (COM), and moment of inertia (ie, body segment parameters [BSPs]) of hind limb segments by use of a noninvasive method based on computerized tomography (CT) in Labrador Retrievers with and without cranial cruciate ligament (CCL) disease and to provide regression equations to estimate BSPs of normal, CCL-deficient, and contralateral hind limbs. ANIMALS: 14 clinically normal and 10 CCL-deficient Labrador Retrievers. PROCEDURES: Bone, muscle, and fat areas were identified via CT. Mass, COM, and moment of inertia were determined on the basis of tissue densities in the thigh, crus, and foot segments. Regression models were developed to determine predictive equations to estimate BSP on the basis of simple morphometric measurements. RESULTS: The thigh and crus of CCL-deficient limbs weighed less than in contralateral segments. Thighs weighed less in CCL-deficient than in normal limbs. The thigh moment of inertia was less in CCL-deficient than in contralateral limbs. The crural COM was located more distally in normal limbs, compared with other limbs. Predictive equations to estimate BSP varied by parameter, body segment, and limb status. CONCLUSIONS AND CLINICAL RELEVANCE: BSPs of the thigh and crus varied with segment and status of the hind limb in Labrador Retrievers with or without CCL disease. Equations to estimate BSP on the basis of simple morphometric measurements were proposed, providing a basis for nonterminal studies of inverse dynamics of the hind limbs in Labrador Retrievers. This approach may offer new strategies to investigate the pathogenesis of nontraumatic joint diseases.     

Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001)

OBJECTIVE: To identify complications associated with tibial plateau leveling osteotomy (TPLO) for treatment of cranial cruciate ligament rupture in dogs and assess owner perceptions of outcome. DESIGN: Retrospective study. ANIMALS: 193 dogs that underwent unilateral or bilateral TPLO (253 TPLOs total) between November 1997 and March 2001. PROCEDURE: Complications associated with the surgical procedure were recorded. A questionnaire was sent to owners of all dogs to assess their perceptions of outcome. RESULTS: Complications were identified in 47 of the 193 (24.4%) dogs and in association with 52 of the 253 (20.6%) TPLOs. Dogs that underwent bilateral TPLOs during a single anesthetic episode had a higher complication rate than did dogs that underwent unilateral TPLO and dogs that underwent bilateral TPLOs during separate anesthetic episodes. Body weight, surgery time, whether a meniscal release or meniscectomy was performed, and extent of cruciate ligament damage were not associated with whether complications occurred. One hundred forty-one of 151 (93%) owners who responded to the questionnaire were satisfied with the outcome of the surgery. Assessments of outcome were not significantly different between owners of dogs that had complications and owners of dogs that did not. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that complications developed in approximately 25% of dogs undergoing TPLO for treatment of a cranial cruciate ligament injury but that most complications responded to appropriate treatment, and development of complications did not affect owner assessments of outcome. There was a higher incidence of complications when bilateral TPLOs were performed during a single anesthetic episode.     

The prevalence of medial coronoid process disease is high in lame large breed dogs and quantitative radiographic assessments contribute to the diagnosis

Medial coronoid process disease is a common leading cause of thoracic limb lameness in dogs. Computed tomography and arthroscopy are superior to radiography to diagnose medial coronoid process disease, however, radiography remains the most available diagnostic imaging modality in veterinary practice. Objectives of this retrospective observational study were to describe the prevalence of medial coronoid process disease in lame large breed dogs and apply a novel method for quantifying the radiographic changes associated with medial coronoid process and subtrochlear‐ulnar region in Labrador and Golden Retrievers with confirmed medial coronoid process disease. Purebred Labrador and Golden Retrievers (n = 143, 206 elbows) without and with confirmed medial coronoid process disease were included. The prevalence of medial coronoid process disease in lame large breed dogs was calculated. Mediolateral and craniocaudal radiographs of elbows were analyzed to assess the medial coronoid process length and morphology, and subtrochlear‐ulnar width. Mean grayscale value was calculated for radial and subtrochlear‐ulnar zones. The prevalence of medial coronoid process disease was 20.8%. Labrador and Golden Retrievers were the most affected purebred dogs (29.6%). Elbows with confirmed medial coronoid process disease had short (P < 0.0001) and deformed (～95%) medial coronoid process, with associated medial coronoid process osteophytosis (7.5%). Subtrochlear‐ulnar sclerosis was evidenced in ～96% of diseased elbows, with a significant increase (P < 0.0001) in subtrochlear‐ulnar width and standardized grayscale value. Radial grayscale value did not differ between groups. Periarticular osteophytosis was identified in 51.4% of elbows with medial coronoid process disease. Medial coronoid process length and morphology, and subtrochlear‐ulnar width and standardized grayscale value varied significantly in dogs with confirmed medial coronoid process disease compared to controls. Findings indicated that medial coronoid process disease has a high prevalence in lame large breed dogs and that quantitative radiographic assessments can contribute to the diagnosis.     

Effect of carprofen on hemostatic variables in dogs

OBJECTIVE: To evaluate the effect of carprofen on hemostatic variables in clinically normal dogs. ANIMALS: 12 clinically normal Labrador Retrievers. PROCEDURE: 10 dogs (6 females, 4 males) received carprofen (2.2 mg/kg of body weight, PO, q 12 h) for 5 days. Two dogs (untreated control group; 1 female, 1 male) did not receive carprofen. Hemostatic variables (platelet count, activated partial thromboplastin time, prothrombin time, fibrinogen, platelet aggregation, and bleeding time) were assessed for all dogs prior to treatment, on day 5 of treatment, and 2 and 7 days after discontinuation of the drug (days 7 and 12). Serum biochemical variables and Hct were assessed prior to treatment and on days 5 and 12. RESULTS: In dogs receiving carprofen, platelet aggregation was significantly decreased, and onset of aggregation was significantly delayed on days 5, 7, and 12, compared with pretreatment values. Activated partial thromboplastin time was significantly increased on days 5, 7, and 12 over pretreatment values in treated dogs, but values remained within reference ranges. Significant differences were not detected in buccal mucosal bleeding time, other serum biochemical and hemostatic variables, or Hct, compared with pretreatment values and the internal control group. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of carprofen for 5 days causes minor but not clinically important alterations in hemostatic and serum biochemical variables in clinically normal Labrador Retrievers. Carprofen is commonly used to treat osteoarthritis and chronic pain in dogs, but prior to this study, its effect on platelet aggregation and hemostatic variables was unknown.     

Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament

OBJECTIVE: To compare tibial plateau angle (TPA) between Greyhounds without damage to the cranial cruciate ligaments and Labrador Retrievers with and without damage to the cranial cruciate ligaments. DESIGN: Clinical study. ANIMALS: 87 client-owned dogs and 15 research colony Greyhounds. PROCEDURE: Standing position, horizontal-beam radiography was performed on Greyhounds and unaffected Labrador Retrievers to determine standing TPA. Lateral radiography of the stifle joint was performed on all dogs to determine traditional TPA. Age and body weight were recorded for unaffected and affected Labrador Retrievers. RESULTS: Greyhounds had mean standing TPA of 1.56 degrees and mean traditional TPA of 22.50 degrees. Unaffected Labrador Retrievers had mean standing TPA of 3.52 degrees and traditional TPA of 27.97 degrees. Affected Labrador Retrievers had mean traditional TPA of 25.55 degrees. No significant difference was found in mean standing TPA between Greyhounds and unaffected Labrador Retrievers. Standing TPAs in Greyhounds and unaffected Labrador Retrievers were not significantly different from a plane drawn parallel to the ground. Significant differences in traditional TPAs were detected among all 3 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Greyhounds had mean traditional TPA of 22.50 degrees; similar angles should be considered normal for dogs. Although affected Labrador Retrievers had mean traditional TPA that was significantly greater than that of Greyhounds, the steepest TPA was found in unaffected Labrador Retrievers. Because Greyhounds and unaffected Labrador Retrievers had similar standing TPAs, we conclude that although TPA may be associated with damage to the cruciate ligaments, many dogs with a steep TPA do not develop cruciate ligament disease.     

Measurement of femoral angles in four dog breeds

Objective— To develop a standard method of measurement for femoral angles and report values for normal Labrador Retrievers, Golden Retrievers, German Shepherds, and Rottweilers.
Study Design— Retrospective evaluation of canine pelvis and femoral radiographs.
Sample Population— Radiographs of Labrador Retrievers, Golden Retrievers, German Shepherds, and Rottweilers (n=100 for each breed).
Methods— Anatomic lateral distal and proximal femoral angle, mechanical lateral distal and proximal femoral angle, and femoral angle of inclination were measured from radiographs.
Results— For the 4 breeds (Labrador Retrievers, Golden Retrievers, German Shepherds, and Rottweilers, respectively) anatomic lateral distal femoral angles were 97°, 97°, 94°, and 98°; mechanical lateral distal femoral angles were 100°, 100°, 97°, and 100°; anatomic lateral proximal femoral angles were 103°, 98°, 101°, and 96°; mechanical lateral proximal femoral angles were 100°, 95°, 97°, and 93°; and inclination angles were 134°, 134°, 132°, and 137°. Labrador Retrievers, Golden Retrievers, and Rottweilers had significantly higher values for both anatomic and mechanical lateral distal femoral angle than German Shepherds. Anatomic and mechanical lateral proximal angles were greatest for Labrador Retrievers and lowest for Rottweilers.
Conclusion— Anatomic and mechanical femoral joint angles vary between breeds of dogs.
Clinical Relevance— Values for femoral joint angles may be clinically useful for angular limb deformity diagnosis, treatment, and assessment.     

Cranial cruciate ligament rupture in the dog—a retrospective study comparing surgical techniques

SUMMARY Three surgical techniques, grouped as intra-articular techniques, extra-capsular techniques and fibular head transposition, were used for repair of the cranial cruciate ligament (CCL)-deficient stifle in 113 dogs over a 4 year 4 month period. The clinical outcome of the techniques were compared using information provided by the owners and physical examination. Regardless of surgical technique, 85.7 to 91.0% of dogs showed clinical improvement after surgery. However, less than 50% of dogs became clinically sound on the operated leg and 9.0 to 14.3% of dogs remained persistently lame on the operated leg. No statistical association was found between result after surgery and age, body weight, sex, duration of injury before surgery, association with injury, tibial plateau angle, degree of radiographic osteoarthritis before surgery or the presence of concurrent medial meniscal injury. On physical examination, extra-capsular techniques appeared superior to the fibular head transposition in terms of joint stability and limb function. Concurrent medial meniscal injury necessitating meniscectomy existed in 48.0% of cases. Twenty-two percent of dogs ruptured their contralateral CCL at an average of 14 months after the first.     

Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease

OBJECTIVE: To assess functional outcome in dogs with cranial cruciate ligament (CrCL) disease after tibial tuberosity advancement (TTA) using force plate gait analysis, and to evaluate parameters potentially influencing outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Consecutive clinical patients (n = 37) with CrCL-deficient stifles (n = 40). METHODS: The stifle joints were examined arthroscopically prior to TTA. Meniscal release was not performed if the medial meniscus was intact. Open medial arthrotomy and partial meniscectomy were performed in the presence of meniscal tears. Vertical ground reaction forces were measured preoperatively and at follow-up examinations four to 16 months postoperatively (mean: 5.9 months). The ground reaction forces of a group of 65 healthy dogs were used for the comparison. The potential effects of clinical parameters on functional outcome were evaluated statistically. RESULTS: Complete CrCL rupture was identified in 28 joints, and partial CrCL rupture in 12 joints. The medial meniscus was damaged in 21 stifles. Vertical ground reaction forces were significantly higher at follow-up (P < 0.01), but remained significantly lower than those of control dogs (P < 0.01). Complications were identified in 25% of joints, and the dogs with complications had significantly lower peak vertical forces at follow-up than the dogs without complications (P = 0.04). Other clinical parameters did not influence outcome. CONCLUSIONS: Tibial tuberosity advancement significantly improved limb function in dogs with CrCL disease, but did not result in complete return to function. Complications adversely affected functional outcome. CLINICAL SIGNIFICANCE: A return to a function of approximately 90% of normal can be expected in dogs with CrCL disease undergoing TTA.     

Quantification of measurement of femoral head coverage and Norberg angle within and among four breeds of dogs

OBJECTIVE: To report values for percentage coverage of the femoral head (PC) and Norberg angle (NA) in 4 common breeds of dogs and to determine values for each that distinguish between normal and dysplastic hip status on the basis of Orthopedic Foundation for Animals (OFA) hip evaluation. ANIMALS: 1,841 dogs 24 to 48 months of age that were Labrador Retrievers (455), Golden Retrievers (423), Rottweilers (545), or German Shepherd Dogs (418). PROCEDURE: Retrospective analysis of NA and PC measured from standard OFA ventrodorsal pelvic radiographs from 4 breeds of dog. RESULTS: Norberg angle ranged from 67.4 to 124.4 degrees for Labrador Retrievers, 59.7 to 128.6 degrees for Rottweilers, 70.2 to 119.4 degrees for Golden Retrievers, and 55.3 to 121.3 degrees for German Shepherd Dogs. The PC ranged from 6.5 to 79.9% for Labrador Retrievers, 5.7 to 79.5% for Rottweilers, 8.3 to 79.3% for Golden Retrievers, and 5.4 to 83.7% for German Shepherd Dogs. On the basis of logistic regression modeling for determining normal versus abnormal hip status for all 4 breeds, cutoff points for NA were <105 degrees and PC were <50%. CONCLUSIONS AND CLINICAL RELEVANCE: Results of our study indicate that cutoff points of NA of 105 degrees and PC of 50% do not differentiate normal versus dysplastic hip status. Each of the 4 breeds had different values for NA and PC that distinguished normal from dysplastic hip status.     

Radiographic measurement of the proximal and distal mechanical joint angles in the canine tibia

Objective— To describe a method for radiographic measurement of proximal and distal mechanical joint angles of the canine tibia. Normal ranges were established for a population of dogs, and specifically, Labrador retrievers, with cranial cruciate ligament rupture.
Study Design— Retrospective study.
Sample Population— Tibiae (n=105) of dogs evaluated for cranial cruciate ligament rupture; 70 tibiae were from Labrador retrievers, 35 tibiae were from other breeds.
Methods— Anatomic landmarks were established and craniocaudal radiographs were used to measure the mechanical medial proximal (mMPTA) and distal (mMDTA) tibial angles in the frontal plane.
Results— Means (±SD) for all tibiae were mMPTA, 93.30±1.78°, and mMDTA, 95.99±2.70°. For Labrador retrievers, means were mMPTA, 93.38±1.81°, and mMDTA 96.34±2.51°. No significant differences were detected between Labrador Retrievers and non-Labrador retrievers with respect to mMPTA (power=0.5) or mMDTA (power=0.342). Labrador Retrievers were significantly younger than non-Labradors ( P =.003).
Conclusion— A method for measurement of the mechanical joint angles of the canine tibia in the frontal plane was established and reference ranges for a population of dogs and Labrador Retrievers with cranial cruciate ligament rupture are reported.
Clinical Relevance— The established method of measurement and references ranges can be used to aid in diagnosis, determining indications, and surgical planning for angular limb deformities of the tibia, especially when affected bilaterally. The methodology and reference values may also be used for postoperative critique.     

Pre- and postoperative force plate analysis of dogs with experimentally transected cranial cruciate ligaments treated using tibial plateau leveling osteotomy

Objective— Quantitative and objective assessment of hindlimb kinetics after cranial cruciate ligament (CrCL) transection and subsequent stifle stabilization using the tibial plateau leveling osteotomy (TPLO) in normal dogs.
Study Design— In vivo experimental biomechanical evaluation.
Animals— Six healthy adult foxhounds.
Methods— Dogs were screened by orthopedic and radiographic examination before study entry. Force plate analysis of gait was measured before extirpation of the right CrCL and TPLO and again at 8 and 18 weeks after surgery.
Results— There was a significant decrease in peak vertical forces (PVFs) and vertical impulse (VI) of the treated hindlimb at 8 weeks when compared with preoperative and 18-week measurements. When compared with preoperative values, there was no significant difference in 18 week PVF and VI in dogs that had TPLO.
Conclusion— TPLO can restore kinetic measures of limb function at 18-weeks after surgery when compared with preoperative values after experimental transection of the CrCL in dogs.
Clinical Relevance— TPLO induces lameness that returns to near normal at 18 weeks. The severity and duration of lameness was similar to that reported for other experimental models of stifle instability repaired by different techniques.