Evaluation of a Joint Distractor to Facilitate Arthroscopy of the Canine Stifle

Objectives— To assess a novel technique for arthroscopic evaluation of the canine stifle avoiding the need for fat pad debridement.
Study Design— Prospective study.
Sample Population— Cadaveric canine stifles (n=10); Client-owned dogs (15).
Methods— In cadaveric stifles, the femoropatellar space was assessed before placement of a joint distractor and examination of the femorotibial joint. Time to complete evaluation of the femoropatellar space, to observe the cruciate ligaments, and to completion of examination of the femorotibial joint were recorded. Distractor-assisted arthroscopy was then performed in 15 consecutive clinical cases. Clinical information, time to complete joint evaluation, and ability to perform any additional arthroscopic surgery were recorded.
Results— Observation and palpation of intra-articular structures were possible in all cadaveric stifles. Mean time to evaluate the femoropatellar space was 3.2 minutes (range, 2–4 minutes); to observe the cruciate ligaments, 5.8 minutes (range, 3–8 minutes); and to completion of joint inspection, 9.1 minutes (range 6–13 minutes). In the clinical cases, observation of intra-articular structures was also possible in all stifles. Mean time to complete joint inspection was 21 minutes (range, 10–40 minutes). Partial meniscectomy was performed successfully in 5 stifles.
Conclusions— Use of a joint distractor allowed arthroscopic observation of all relevant structures. Partial meniscectomy was readily performed.
Clinical Relevance— Use of a joint distractor may simplify arthroscopic assessment of the canine stifle and avoid potential morbidity associated with fat pad debridement.     

In Vitro Biomechanical Evaluation and Comparison of FiberWire,FiberTape, OrthoFiber,and Nylon Leader Line for Potential Use During Extraarticular Stabilization Of Canine Cruciate Deficient Stifles

Objective— To compare biomechanical properties of 3 new generation polyethylene sutures (FiberTape [FT], FiberWire [FW], and OrthoFiber [OF]) with nylon leader line (NL) for use during extraarticular fixation of cranial cruciate deficient stifles. Study Design— In vitro biomechanical testing of suture loops under monotonic tensile and cyclical loading until failure. Sample Population— Constructs of FT, FW, OF, and NL. Methods— Twenty loops of each of 12 combinations of fixation and suture had monotonic tensile and cyclical loading. Two knotting techniques (square knot [SQ], slip knot [SL]) and a crimp clamp (CR) system were evaluated. Elongation, stiffness, and strength of constructs was tested. The main effects of group, loop material, and their interaction were evaluated. Results— Knotted FT, FW, and OF had less elongation than knotted NL under monotonic tensile and cyclical loading. Under monotonic tensile loading, knotted FT and OF were stiffer than knotted NL. CR FT, CR FW, and CR OF were stiffer than CR NL and CR FT, CR FW, and CR OF were stiffer than knotted FT, FW, and OF. FW and OF knotted loops were weaker than knotted NL. CR FT was stronger than CR NL. CR FT and CR OF were weaker than knotted FT and OF. Conclusions— Polyethylene sutures are stronger, stiffer and elongate less than nylon leader. Crimping suture alters the biomechanical properties of the loop. Clinical Relevance— FW, FT, and OF may perform better in reconstructive procedures, where increased strength and stiffness are considered to be beneficial.     

Blastomycotic osteomyelitis associated with severe lameness in a horse

A 12-year-old Quarter horse gelding was presented for evaluation of severe right forelimb lameness, 2 draining tracts over the lateral aspect of the right proximal antebrachium, and weight loss. A presumptive diagnosis of blastomycotic osteomyelitis was established based on radiographs and cytology of the exudate. This diagnosis was confirmed at necropsy.     

Epidural Idiopathic Sterile Pyogranulomatous Inflammation Causing Spinal Cord Compressive Injury in Five Miniature Dachshunds

Objective— To characterize the clinical signs, diagnostic and surgical findings, and outcome of dogs with idiopathic sterile pyogranulomatous inflammation (ISP) of epidural fat causing spinal cord compression.
Study Design— Retrospective study.
Animals— Dogs (n=5).
Methods— Dogs with epidural ISP (2002–2006) were identified retrospectively. Inclusion criteria were neurologic examination, myelography, and definitive diagnosis of ISP confirmed by surgery and histopathologic examination of epidural spinal cord compressive tissue.
Results— The most common clinical sign was paraparesis/paraplegia. No abnormalities were detected by laboratory testing or survey spine radiographs. On myelography, extradural spinal cord compressions were focal (dogs 1, 3, and 5) or multifocal (dogs 2 and 4). Surgical decompression of the spinal cord was completed by hemilaminectomy. Epidural fat collected surgically had pyogranulomatous inflammation of unknown cause and was histologically similar to subcutaneous ISP. All dogs had good long-term neurologic outcome (10–45 months follow-up). Some dogs had episodes of ISP at other sites before or after surgical treatment of epidural ISP, suggesting there may be a systemic form of ISP.
Conclusion— Epidural ISP may cause a spinal cord compressive lesion in Miniature Dachshunds, which can be treated by surgical decompression of the spinal cord with or without administration of adjunctive steroids.
Clinical Relevance— Epidural ISP should be considered as a possible cause of thoracolumbar myelopathy for Miniature Dachshunds.     

Arthroscopic Subchondral Bone Plate Microfracture Technique Augments Healing of Large Chondral Defects in the Radial Carpal Bone and Medial Femoral Condyle of Horses

OBJECTIVE: To evaluate the effect of arthroscopic subchondral bone microfracture on healing of large chondral defects in horses. STUDY DESIGN: Short- (4 months) and long-term (12 months) in vivo experimental chondral defect model. ANIMALS: 10 horses, aged 2 to 5 years. METHODS: Each horse had a 1 cm2 full-thickness chondral defect created in both radial carpal bones and both medial femoral condyles. One carpus and one femoral condyle of each horse had the subchondral bone plate under the defect perforated using an orthopedic awl. All horses were exercised, five horses were evaluated after 4 months and five horses after 12 months. Gross, histologic, and histomorphometric examination of defect sites and repair tissues was performed, as was collagen typing of the repair tissue. RESULTS: On gross observation a greater volume of repair tissue filled treated defects (74%) compared with control defects (45%). Histomorphometry confirmed more repair tissue filling treated defects, but no difference in the relative amounts of different tissue types was observed. There was an increased percentage of type II collagen in treated defects compared with control defects and evidence of earlier bone remodeling as documented by changes in porosity. CONCLUSIONS: In full-thickness chondral defects in exercised horses, treatment with subchondral bone microfracture increased the tissue volume in the defects and the percentage of type II collagen in the tissue filling the defects when compared to nontreated defects. CLINICAL RELEVANCE: No negative effects of the microfracture technique were observed and some of the beneficial effects are the basis for recommending its use in patients cases with exposed subchondral bone.     

Radiographic aspects of exercise-induced pulmonary hemorrhage in racing horses

Abnormal pulmonary radiopacities were identified in 13 racing horses in which a diagnosis of exercise-induced pulmonary hemorrhage (EIPH) had been confirmed. The lesions were in the caudal lung lobe in all horses; seven were on the right and three on the left, and the laterality for three could not be determined. In ten horses the opacities, which were large and peripherally located, obliterated the thoracophrenic angle. They merged with the silhouette of the diaphragm and had a circular or ovoid surface directed toward the hilum. The intensity of opacification of the consolidated areas varied, and they often were not sharply marginated. Dorsal displacement of the pulmonary arteries was noted in the region of the radiopacity in seven horses. Varying volumes of pleural effusion were observed in nine horses. Serial radiographic examinations were performed in seven horses. The pulmonary radiopacities cleared within ten days in two horses. In the remaining five horses, gradual resolution, characterized by a reduction in lesion size with improved margination, occurred during several months. The central region of the radiopaque lesion commonly had a patchy appearance, suggesting cavitation. Normal pulmonary vascular and interstitial markings were evident following complete resolution of these lesions. The cause of these abnormal pulmonary opacities has not been determined. Pathologic-radiologic correlations will be required to improve understanding of the pathophysiology of EIPH in the racing horse.     

Dorsal Laminectomy in the Horse II. Evaluation in the Normal Horse

Subtotal dorsal cervical laminectomy was performed on nine normal horses to evaluate positioning, refine the surgical technique, and assess the immediate and long-term effects of this procedure in the horse. Funkquist type B laminectomies were performed at various levels from C3-C4 to C6-C7. Absorbable gelatin sponge or autogenous nuchal fat was placed over the exposed dura mater. Surgery times varied from 2 to 3 hours, and all horses recovered without complication. Rapid primary intention wound healing occurred, with two horses showing neck pain. All remained neurologically normal. The horses were euthanized 6 weeks, 3 months, or 6 months postoperatively. Myelograms performed just prior to euthanasia demonstrated normal or expanded dye column widths. Necropsy revealed that all surgical sites had healed well. The laminectomy membrane was soft and pliable and could be easily separated from the underlying dura mater when fat was used as interpositional material. When gelatin sponge was used, the laminectomy membrane was firmly bonded to the dura. Spinal cords at the level of laminectomy appeared normal and moved freely within the vertebral canal. Histological evaluation of the laminectomy sites and associated spinal cord revealed no abnormalities attributable to the surgery. It was concluded that dorsal cervical laminectomy can be performed in horses without untoward sequelae. The procedure may be useful for the treatment of equine cervical compressive myelopathies.