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OBJECTIVE To report the outcome of locally administered antibiotic-impregnated poloxamer 407 (P407) hydrogel in dogs diagnosed with orthopedic surgical site infections (SSIs) and to identify risk factors for treatment failure. ANIMALS 34 client-owned dogs diagnosed with an orthopedic surgical site infection treated with local antibiotic-impregnated P407 hydrogel. PROCEDURES Medical records were reviewed of dogs receiving antibiotic-impregnated P407 hydrogel for an active orthopedic SSI between March 2018 and December 2020. The rate of successful infection clearance was calculated. Risk factors for failed treatment were evaluated with statistical analyses. RESULTS 34 dogs met the inclusion criteria. Vancomycin-impregnated P407 hydrogel (20 mg/mL) was implanted in all dogs. The rate of infection clearance was 77%. Each unit increase in the number of surgeries performed at a site before gel implantation decrease the chance of successful infection clearance by 25% (P = .005; unit OR, 0.25; 95% CI, 0.08 to 0.81). Presence of multidrug or methicillin resistance increased risk for treatment failure by 7.69 times (P = .042; OR, 0.13; 95% CI, 0.01 to 1.14). No adverse events related to gel administration were seen. CLINICAL RELEVANCE Treatment outcomes were negatively impacted by the presence of multidrug or methicillin resistance and by an increased number of surgeries before gel implantation. Local administration of antibiotic-impregnated P407 hydrogel had a high success rate with no adverse effects in this population. Local antibiotic gel administration may improve treatment outcomes in dogs with complicated SSI.

OBJECTIVES To evaluate the effects of the chondrodystrophy-associated FGF4L2 retrogene on intervertebral disc (IVD) calcification and vertebral geometry. ANIMALS 22 Nova Scotia Duck Tolling Retrievers (NSDTR) with no FGF4L2 retrogene (n = 7, wild-type dogs), 1 retrogene copy (8, heterozygous dogs), or 2 retrogene copies (7, homozygous dogs). PROCEDURES Computed tomography (CT) scans of the vertebral column were analyzed using computer-aided design (CAD) software. IVD calcification, vertebral column length, and vertebral geometry of the third cervical (C3), 13th thoracic (T13), and first lumbar (L1) vertebrae were compared. RESULTS IVD calcification was not found in wild-type dogs. IVD calcification was more frequent in homozygous dogs than heterozygous (P = .008) or wild-type dogs (P < .001) and in heterozygous dogs compared to wild-type dogs (P < .001). Four IVDs were subclinically herniated in 3 dogs (2 homozygous, 1 heterozygous). Calcified IVD had a greater volume and surface area in heterozygous dogs than homozygous dogs. C3 vertebral canal height-to-width ratio was greater in homozygous dogs than heterozygous dogs (P = .044) and wild-type dogs (P = .010). CLINICAL RELEVANCE IVD calcification and vertebral geometry can be analyzed using CAD software. The presence of 1 or 2 FGF4L2 copies in the absence of the FGF4L1 retrogene has an additive effect on the number of calcified IVD and a minor effect on vertebral geometry in NSDTR dogs. Data support the use of FGF4L2 phenotyping to reduce clinical disease in segregating breeds and to monitor the introduction of wild-type alleles into fixed breed populations.

OBJECTIVE Determine whether dogs with well-functioning orthopedic metal implants can develop metal reactivity. SAMPLE Client-owned dogs that had tibial plateau leveling osteotomy (TPLO) or total hip replacement (THR) implants for 12 months or more and control dogs with no implants. PROCEDURES Lymphocyte transformation testing was performed by exposing peripheral blood lymphocytes to nickel (Ni), chromium (Cr), cobalt (Co), or a combination of these metals. Lymphocyte proliferation was assessed with flow cytometry. Lymphocyte stimulation indexes (SIs) were calculated. A SI > 2 was considered reactive. Median SIs of dogs in response to metal exposure were compared statistically. RESULTS Samples from 10 dogs with TPLO, 12 dogs with THR, and 7 control dogs were analyzed. Six dogs out of 22 with metal implants had a reactive SI to 1 or more metals, while 2 of 7 control dogs had a SI > 2 when exposed to nickel only. When all metals were considered, no differences in metal reactivity were found between TPLO, THR, and control groups. CLINICAL RELEVANCE Metal reactivity is present in dogs and can be identified using lymphocyte transformation testing. Reactivity to Ni is present in dogs with and without metal implants. Reactivity to Co and Cr occurs in some dogs with metal implants.

OBJECTIVE To evaluate the accuracy of six depth gauges used in three tibial plateau leveling osteotomy (TPLO) plate holes. STUDY DESIGN Ex vivo experimental study. ANIMALS AND SAMPLE POPULATION Cadaveric canine limbs (n = 10), one 25-mm-thick wood board, and one 33.8-mm-diameter polyvinyl chloride (PVC) pipe. METHODS A TPLO was performed on 10 canine cadaveric pelvic limbs. Three 3.5-mm plate holes were filled with screws. The remaining three plate holes: a compression hole, a combination compression-locking hole, and a stacked combination compression-locking hole were measured by three observers using six commercial depth gauges and using a micrometer as gold standard. The process was repeated on one wood board and one PVC pipe. RESULTS Bone measurements collected using two depth gauges with base diameter 5.5 mm (p ranging from < .001 to .038). Mean depth gauge measurements were smaller than micrometer measurements by 2.20 mm for the compression hole, 0.82 mm for the combination hole, and 3.57 mm for the stacked combination hole. Measurement differences among depth gauges were also present for wood board and PVC pipe measurements. Bone measurement variability between depth gauges was less for the combination and compression holes than for the stacked combination hole. CONCLUSION Depth gauges lacked accuracy. Measurements differed among gauges and measurement variability varied based on plate hole geometry. CLINICAL RELEVANCE Depth gauge measurement accuracy varies based on measuring devices and on 3.5-mm plate hole geometry.

This retrospective observational study aimed to characterize the severity and distribution of OA in the stifle joints of small and medium dogs with CCL injury and/or MPL. Radiographs of the stifle joints from 218 dogs from 10 small and medium breeds were included; 127 joints had CCL injury, 76 joints had MPL, and 73 joints had CCL injury and MPL. OA was graded at 33 sites within the joint. The mean ± SD OA score was 20.3 ± 9.9. For all joints, OA was more severe in heavier than lighter dogs (P = 0.003). Joints with MPL (14.9 ± 8.2) had lower OA scores than joints with CCL injury (22.2 ± 10.0, P = 0.003) or CCL injury and MPL (22.6 ± 9.4, P0.001). OA scores were higher in joints with MPL for older dogs (r = 0.408, P0.001) but did not change with age in joints with CCL injury. The pattern of OA did not differ among joints with CCL injury or MPL. The retrospective nature of the study limited findings to associations but did not allow conclusions regarding factors causing OA or enhancing its progression. We concluded that, in small- and medium-breed dogs, the patterns of stifle OA joint after CCL injury and MPL are similar. Radiographic OA after CCL injury is more severe than MPL. An increase in age leads to an increase in OA at the time of presentation at a referral hospital in stifle joints with MPL and without CCL injury.

Objectives This work sought to determine the prognosis for dogs for return to athletic function in canine agility competitions after digit amputation. Materials and Methods Data were collected using an Internet-based survey of owners of agility dogs with digit disorders that required amputation. Signalment and physical characteristics were compared between dogs with traumatic and nontraumatic disorders. Athletic performance before and after amputation was assessed subjectively by owner opinion and objectively for eight dogs using competition performance records. Results Problems leading to digit amputation in 46 dogs included acute or chronic traumatic lesions (30 dogs), infection (7 dogs), neoplasia (7 dogs), and cystic lesions (2 dogs). There were no differences in signalment or physical characteristics between dogs with traumatic and nontraumatic disorders. Of the 46 dogs, 39 (84.7%) had returned to agility at the time of the survey and 94.6% of the owners (37/39) were satisfied with performance after amputation. No dog failed to return to agility as a result of the digit disorder or amputation. There was no difference in mean competition speed before and after amputation. Clinical Significance Most agility dogs undergoing digit amputation perform satisfactorily after surgery, although modifications to performance criteria may be appropriate for some.

Author(s): Mariani, Christopher L; Zlotnick, Joshua A; Harrysson, Ola; Marcellin-Little, Denis J; Malinak, Kristen; Gavitt, Ashley; Guevar, Julien | Abstract: ObjectiveTo assess the accuracy of three-dimensionally (3-D) printed drill guides in constraining the trajectory of drill tracts for implants in canine thoracic vertebrae.Study designExperimental ex vivo study.Sample populationFive canine thoracic vertebral column specimens.MethodsGuides to constrain drill trajectories were designed on the basis of computed tomographic (CT) imaging of six thoracic vertebrae (T8-T13) and were 3-D printed. The guides were used to create drill tracts in these vertebrae by both an experienced and a novice surgeon, and CT imaging was repeated. The entry point and angulation of actual and planned drill tracts were compared for both surgeons. Unintended cortical violations were also assessed by using a modified Zdichavsky classification.ResultsFifty-eight drill tracts were created in 30 vertebrae. Mean entry point deviation was 1.4 mm (range, 0.4-3.4), and mean angular deviation was 5.1° (range, 1.5°-10.8°). There were no differences between surgeons in entry point deviation (P = .07) or angular deviation (P = .22). There were no unintended cortical bone violations, and all drill tracts were classified as modified Zdichavsky grade I.ConclusionThe 3-D printed guides used in the current study yielded drill tracts with small linear and angular errors from intended paths and 100% accuracy for placement within vertebral pedicles and bodies. This technique was conveniently used by both an experienced and a novice surgeon.Clinical significanceThis technique might be immediately applicable to clinical cases requiring thoracic vertebral stabilization and may allow safe and accurate implant placement for surgeons with varying experience levels.

Objective To report the clinical characteristics, surgical management, and medium-term outcomes of total hip replacement (THR) performed in dogs with previous contralateral pelvic limb amputation. Animals Thirteen client-owned dogs. Study design Multi-institutional retrospective clinical study. Methods Data recorded from medical records included signalment, indication for amputation and THR, and surgical complications. Implant positioning and complications were assessed on radiographs. Clinical outcomes were evaluated during follow-up examinations by one of the authors and through a mobility- and lifestyle-based questionnaire completed by owners. Results All 13 dogs had satisfactory clinical results at follow-up a median of 3 months (range, 2-36) after THR. No postoperative luxation was recorded. Four dogs had minor complications that did not require additional treatment. The only major complication was one failure of osseointegration of a cementless acetabular cup, and it was successfully revised. Conclusion Total hip replacement resulted in satisfactory clinical results and acceptable morbidity in this population. Clinical significance Total hip replacement should be considered in dogs with severe coxofemoral joint disease and contralateral pelvic limb amputation.

Objective This study aimed to report the adverse drug events and treatment outcome of systemic linezolid therapy to manage multi-drug resistant orthopaedic surgical site infection in dogs. Materials and Methods Retrospective case review of four dogs that received linezolid to treat surgical site infections after orthopaedic surgery. Reevaluations consisted of a clinical examination or a telephone interview. Results Serum drug concentrations varied. All dogs showed a temporary resolution of clinical signs of surgical site infection. Two dogs that received linezolid at the previously reported dose developed drug-associated side effects. The side effects were anorexia, nausea, vomiting and regenerative anaemia. All side effects resolved after the discontinuation of linezolid. Surgical site infection recurred in two dogs 52 and 177 days after discontinuing linezolid respectively. Clinical significance Adverse drug events occurred in dogs receiving oral linezolid at the dosage of 10 to 20 mg/kg. Oral linezolid therapy failed to resolve deep orthopaedic surgical site infections in two out of four dogs. As a tertiary antimicrobial, linezolid should only be used in carefully selected cases while monitoring for drug-associated side effects.

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This study in dogs explored the feasibility of using cartilage fragments removed and discarded during routine palliative surgery for osteochondritis dissecans (OCD) as a source of primary chondrocytes for scaffold-free cartilage tissue-engineering. Primary chondrocytes were obtained from three OCD donors and one age-matched healthy articular cartilage (HAC) donor. After monolayer expansion of primary cells, a three-dimensional spherical suspension culture was implemented. Following this stage, cells were seeded at a high density into custom-made agarose molds that allowed for size and shape-specific constructs to be generated via a method of cellular self-assembling in a scaffold-free environment. Fifty-eight neocartilage constructs were tissue-engineered using this methodology. Neocartilage constructs and native cartilage from shoulder joint were subjected to histological, mechanical, and biochemical testing. OCD and HAC chondrocytes-sourced constructs had uniformly flat morphology and histology consistent with cartilage tissue. Constructs sourced from OCD chondrocytes were 1.5-times (32%) stiffer in compression and 1.3 times (23%) stronger in tension than constructs sourced from HAC chondrocytes and only 8.7-times (81%) less stiff in tension than native tissue. Constructs from both cell sources consistently had lower collagen content than native tissue (22.9%/dry weight [DW] for OCD and 4.1%/DW for HAC vs. 51.1%/DW native tissue). To improve the collagen content and mechanical properties of neocartilage, biological and mechanical stimuli, and thyroid hormone (tri-iodothyronine) were applied to the chondrocytes during the self-assembling stage in two separate studies. A 2.6-fold (62%) increase in compressive stiffness was detected with supplementation of biological stimuli alone and 5-fold (81%) increase with combined biological and mechanical stimuli at 20% strain. Application of thyroid hormone improved collagen content (1.7-times, 33%), tensile strength (1.8-times, 43%), and stiffness (1.3-times, 21%) of constructs, relative to untreated controls. Collectively, these data suggest that OCD chondrocytes can serve as a reliable cell source for cartilage tissue-engineering and that canine chondrocytes respond favorably to biological and mechanical stimuli that have been shown effective in chondrocytes from other animal species, including humans.

OBJECTIVE To evaluate accuracy of articular surfaces determined by use of 2 perpendicular CT orientations, micro-CT, and laser scanning. SAMPLE 23 cat cadavers. PROCEDURES Images of antebrachia were obtained by use of CT (voxel size, 0.6 mm) in longitudinal orientation (CTLO images) and transverse orientation (CTTO images) and by use of micro-CT (voxel size, 0.024 mm) in a longitudinal orientation. Images were reconstructed. Craniocaudal and mediolateral length, radius of curvature, and deviation of the articular surface of the distal portion of the radius of 3-D renderings for CTLO, CTTO, and micro-CT images were compared with results of 3-D renderings acquired with a laser scanner (resolution, 0.025 mm). RESULTS Measurement of CTLO and CTTO images overestimated craniocaudal and mediolateral length of the articular surface by 4% to 10%. Measurement of micro-CT images underestimated craniocaudal and mediolateral length by 1%. Measurement of CTLO and CTTO images underestimated mediolateral radius of curvature by 15% and overestimated craniocaudal radius of curvature by > 100%; use of micro-CT images underestimated them by 3% and 5%, respectively. Mean ± SD surface deviation was 0.26 ± 0.09 mm for CTLO images, 0.30 ± 0.28 mm for CTTO images, and 0.04 ± 0.02 mm for micro-CT images. CONCLUSIONS AND CLINICAL RELEVANCE Articular surface models derived from CT images had dimensional errors that approximately matched the voxel size. Thus, CT cannot be used to plan conforming arthroplasties in small joints and could lack precision when used to plan the correction of a limb deformity or repair of a fracture.

OBJECTIVE To describe methods to measure the 3-D orientation of the proximal, diaphyseal, and distal segments of the canine radius by use of computer-aided design software (CADS) and to compare the repeatability and reliability of measurements derived by those methods. SAMPLE 31 canine radii with biapical deformities and 24 clinically normal (control) canine radii. PROCEDURES Select CT scans of radii were imported into a CADS program. Cartesian coordinate systems for the humerus and proximal, diaphyseal, and distal radial segments were developed. The orientation of each radial segment in the frontal, sagittal, and transverse planes was measured in triplicate by 3 methods. The repeatability and reliability of those measurements were calculated and compared among the 3 measurement methods. RESULTS The mean ± SD within-subject repeatability of radial angular measurements for all 3 methods was 1.40 ± 0.67° in the frontal plane, 3.17 ± 2.21° in the sagittal plane, and 3.01 ± 1.11° in the transverse plane for control radii and 2.56 ± 1.95° in the frontal plane, 3.59 ± 2.39° in the sagittal plane, and 3.47 ± 1.19° in the transverse plane for abnormal radii. Mean ± SD bias between radial measurement methods was 1.88 ± 2.07° in the frontal plane, 6.44 ± 6.80° in the sagittal plane, and 2.27 ± 2.81° in the transverse plane. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that use of CADS to assess the 3-D orientation of the proximal, diaphyseal, and distal segments of normal and abnormal canine radii yielded highly repeatable and reliable measurements.

OBJECTIVE To determine the influence of interlocking screw threads on the biomechanical properties of repaired canine humeral condylar fractures. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION Thirty-six humeral condyles. METHODS Simulated fractures of the lateral aspect of the humeral condyle were stabilized by a 3.5 mm interlocking thread screw (ITS) or 3.5 mm buttress thread screw placed in lag (BTS-L) or positional fashion (BTS-P) and axially loaded at a walk, trot, 2-mm displacement, and failure cycles. Compact flute drill bits (CFBs) were used for ITS constructs and standard flute drill bits (SFB) for BTS constructs. The effects of bit type on drilling parameters and screw type on screw insertion properties and fragment stability were assessed. RESULTS CFB produced a 6°C greater temperature increase (p = .042) and required 20 N higher torque (p = .003) than SFB. Insertional torque was greater for ITS than BTS-P (p = .001) and BTS-L (p = .001). Condylar fragment rotation at failure was lower in ITS (lsmean ± SE, 8.3° ± 1.9°) than BTS-L constructs (14.5° ± 2.3°, p = .011). ITS resisted greater loads (1503 ± 105 N) than BTS-P (1189 ± 99 N, p = .038) but not BTS-L (1249 ± 123 N, p = .121) constructs. CONCLUSION Biomechanical performance of constructs was improved with ITS rather than BTS fixation. CLINICAL SIGNIFICANCE ITS can be considered for stabilization of humeral condylar fractures in adult dogs.

Background This study aimed to define the rate of progression of radiographic osteoarthritis (OA) of the canine hip joint and to describe factors affecting this progression. Methods Dogs that underwent unilateral total hip replacement (THR) were reviewed for the evaluation of radiographic appearance of the non-operated hip joint over time. Standard extended ventrodorsal hip radiographs were taken preoperatively and postoperatively. All images were anonymized, randomized and scored using three different methods. The mean daily change between evaluations was calculated in each individual dog, and the effect of sex, age, body weight, open/closed status of the proximal femoral physis, preoperative severity of OA, time after surgery and their interactions, were investigated as potential influencing factors. Results After reviewing the medical records, 163 dogs (468 images) met the inclusion criteria. Consistent across the three scoring systems, radiographic progression of OA was greater in younger (open physis) and spayed female dogs. A subset of seven patients (4.3%) had a faster progression of OA and was considered outliers. No dog was rated as outlier by all three scoring systems. Conclusion The rate of progression of radiographically assessed coxofemoral OA varies greatly, but is faster in younger, spayed female dogs. Unusually fast progression occasionally occurs.

Author(s): Hersh-Boyle, Rebecca A; Chou, Po-Yen; Kapatkin, Amy S; Spriet, Mathieu; Filliquist, Barbro; Garcia, Tanya C; Marcellin-Little, Denis J | Abstract: ObjectiveTo evaluate the diagnostic value of still images of needle arthroscopy (SNAR), still images of traditional arthroscopy (STAR), and computed tomography (CT) to diagnose medial coronoid process (MCP) pathology.Study designProspective clinical trial.AnimalsDogs (nn=n17) presented for evaluation of elbow dysplasia.MethodsFor each case, two SNAR and STAR images of the MCP were reviewed independently and in random order by three board-certified surgeons. Computed tomographic images were reviewed by one board-certified radiologist. Reviewers were blinded to surgical and clinical findings. Surgical findings from real-time TAR with palpation were used as the gold standard. Receiver operating characteristic (ROC) curves and concordance statistics tests for the diagnostic accuracy of MCP fissure, MCP fragment, medial compartment condition, and cartilage score were calculated.ResultsImages of 27 elbows joints were reviewed. For MCP fissure detection, areas under the ROC curves for CT (0.84), STAR (0.73), and SNAR (0.57) did not differ. For the detection of MCP fragment, STAR had a larger area under the ROC curve (0.93) compared with SNAR (0.74, Pn=n.015) and CT (0.54, P l .001). Still images of TAR and SNAR had comparable concordance for cartilage score (0.80 and 0.77, respectively) and medial compartment pathology (0.80 and 0.73, respectively).ConclusionStill images of NAR, STAR, and CT had similar diagnostic value to identify MCP fissures. Still images of TAR was superior to SNAR and CT to identify MCP fragments.Clinical significanceThe diagnostic accuracy of SNAR varied on the basis of the coronoid lesion being evaluated.

18F-Sodium Fluoride (18F-NaF) positron emission tomography (PET) provides high resolution functional information about bone activity and can be fused with CT images to improve three-dimensional localization and characterization of lesions. This prospective, observational study assessed 18F-NaF PET-CT for imaging of canine elbows, compared PET with CT findings, and assessed correlation with lameness. Twelve patients with elbow pain were included. Cases included primarily young, large breed dogs. A three-level clinical lameness score was assigned to each forelimb. All dogs had bilateral elbow joints imaged with CT and PET under general anesthesia, approximately 1.5 h after intravenous injection of 3 MBq/kg of 18F-NaF. Imaging findings were independently reviewed by two radiologists using a three-level scoring scheme over nine anatomical regions in the elbow. PET imaging identified areas of bone activity where minimal change was identified on CT. PET imaging also demonstrated absence of uptake in areas where modeling was present on CT. A stronger correlation was observed between clinical grades and PET scores (r2 = 0.38, P = .001) than between clinical grades and CT scores (r2 = 0.17, P = .048). The total PET scores were significantly different for each clinical grade (P = .013) but total CT scores did not differ (P = .139). This exploratory study suggests that PET improves the ability to detect lesions and to determine the clinical significance of CT findings in dogs with elbow pain.

Metal additive manufacturing (AM) technologies, commonly referred to as 3D printing, provide a good prospect for medical applications because complex geometries and customized parts can be fabricated to meet individual patient needs. Orthopedic implants are a group of medical parts with high relevance for AM. This paper discusses relevant AM technologies, several orthopedic applications, materials and material properties, mechanical surface finishing techniques, and measurement techniques from the literature. Today, most metal 3D printed implants are manufactured through metal powder bed fusion technology which includes direct metal laser sintering (DMLS), selective laser melting (SLM), and electron beam melting (EBM). Common materials include titanium alloys, cobalt chromium (CoCr) and stainless steel, chosen because of their biocompatibility and mechanical properties. Surface finishing is most often required for 3D printed implants due to the relatively poor surface quality to meet the desired surface texture for the application. Typically, postprocessing is done mechanically, including manual and automated grinding, sandblasting, polishing, or chemically, including electrochemical polishing. This review also covers an overview of surface quality characterization of AM metal implants which includes surface texture and topography. The surface parameters used to characterize the surface of the implants: surface roughness (Ra), differences between the peak and valley (Rz), waviness, and micro-finish.

Background Little is known about the weight distribution to the remaining limbs for amputee dogs that undergo orthopedic surgery. The objective of the paper was to describe stance and weight distribution after tibial plateau leveling osteotomy (TPLO) in forelimb and in hind limb amputees (AmpTPLO) and to compare them to four-legged TPLO patients (4LTPLO) and amputees without TPLO (Amp). Weight bearing distribution at a stance was compared between groups. Joint angles of forelimb and hind limb joints in a sagittal plane, hind limb orientation in a frontal plane, and pelvic orientation in a transverse plane (pelvic tilt) were measured and compared between groups. Results Joint angles, hind limb abduction, and pelvic tilt of AmpTPLO and Amp did not differ statistically. Mean weight bearing in the operated hind limb was higher for AmpTPLO than 4LTPLO. Mean weight bearing for thoracic limbs of AmpTPLO and 4LTPLO did not differ statistically. Weight bearing of the hind limb of AmpTPLO and Amp did not differ statistically. Conclusions The position of the center of mass and posture of AmpTPLO and Amp does not differ. The weight distribution and posture of Amp is not impacted negatively by TPLO.

This report describes a clinical case of a press fit biological fixation femoral implant neck fracture (fatigue failure) and its revisions in a dog. A total hip arthroplasty revision was performed. The stem was replaced with a bigger one through a V-shape osteotomy of the proximal–lateral aspect of the femur. Stabilization was accomplished using a locking plate and two over-the-plate cerclage wires. Subsidence of the femoral stem occurred following revision and was revised with a second revision in which a collared stem was used. Two revision surgeries were necessary to have a stable functional prosthesis with successful bone integration at 7 months postoperative revaluation. Major errors encountered in this case were placement of an undersized stem and an inadequate femoral canal stability/press-fit. Fracture of a BFX femoral stem neck has not been previously reported.

Two FGF4 retrogenes (FGF4L1 on chromosome 18 and FGF4L2 on chromosome 12) have been identified to cause dwarfism across many dog breeds. Some breeds are nearly homozygous for both retrogenes (e.g., Dachshunds) and others are homozygous for just one (e.g., Beagles and Scottish Terriers). Since most breeds do not segregate both of these retrogenes, it is challenging to evaluate their individual effects on long bone length and body size. We identified two dog breeds selected for hunting ability, the Alpine Dachsbracke and the Schweizer Niederlaufhund, that segregate both of these retrogenes. Using individual measurements of height at the shoulder, back length, head width, thorax depth and width, and thoracic limb measurements, we evaluated the combined effects of FGF4 retrogenes within these breeds. We applied multivariable linear regression analysis to determine the effects of retrogene copy numbers on the measurements. Copy numbers of both retrogenes had significant effects reducing height at the shoulders and antebrachial length, with FGF4L1 having a much greater effect than FGF4L2. FGF4L1 alone influenced the degree of carpal valgus and FGF4L2 alone increased head width. Neither retrogene had an effect on thorax width or depth. Selectively breeding dogs with FGF4L1 and without FGF4L2 would likely lead to a reduction in the FGF4L2-related risk of intervertebral disc herniation while maintaining the reduction in leg length resulting from FGF4L1.

OBJECTIVES: To evaluate the accuracy of detection of temperature differences among skin sites of lay individuals and manual physical therapists. METHODS: Forty-four manual physical therapists and 44 lay individuals were recruited. Subjects palpated two temperature-controlled surfaces that ranged in temperature between 30 and 35 °C and varied randomly by 1, 2, 3, 4, or 5 °C for 10 s. The subjects were then asked to identify the warmer pad. RESULTS: Accuracy increased with larger temperature differences. Accuracy of detection of 1 and 3 °C temperature differences was higher in manual physical therapists than lay individuals. DISCUSSION: Palpation can be used to accurately detecting temperature differences between sites and is more accurately performed by an experienced practitioner. LEVEL OF EVIDENCE: 3b

Objectives To evaluate the influence of radiographic malpositioning on canine sacroiliac and lumbosacral inclination angles. Methods Using canine cadavers, lateral pelvic radiographs were acquired with the radiographic beam in a neutral position and then rotated 5, 10 and 15° to mimic rotational malpositioning. The focal point of the beam was then focused over the abdomen and again over mid-diaphysis of the femur to mimic an abdominal or femoral radiographic study. Results Five degrees of rotational malpositioning did not influence measurements of sacroiliac or lumbosacral inclination, but malpositioning by more than 5° led to a significant decrease in both sacroiliac and lumbosacral angles. Moving the focal point to the femur significantly decreased the measured lumbosacral angle. Abdominally centred radiographs had no effect on lumbosacral and sacroiliac angle measurements. Clinical Significance When evaluating canine lumbosacral and sacroiliac angles radiographically, pelvic rotation of more than 5° should be avoided as should the use of lateral radiographs centred over the femur.

OBJECTIVE To identify potential risk factors for digit injuries in dogs training and competing in agility events. DESIGN Internet-based, retrospective, cross-sectional survey. ANIMALS 1,081 dogs training or competing in agility events. PROCEDURES Data were collected for eligible animals via retrospective surveys distributed electronically to handlers of dogs participating in agility-related activities. Variables evaluated included demographic (handlers) and signalment (dogs) information, physical characteristics of dogs, and injury characteristics. A separate survey of dogs competing in similar agility-related activities but without digit injuries was also administered. Multivariable logistic regression was used to develop a model for assessment of risk factors. RESULTS Data were collected from 207 agility dogs with digit injuries and 874 agility dogs without digit injuries. Factors associated with significantly increased odds of injury included Border Collie breed (OR, 2.3; 95% confidence interval [CI], 1.5 to 3.3), long nails (OR, 2.4; 95% CI, 1.3 to 4.5), absence of front dewclaws (OR, 1.9; 95% CI, 1.3 to 2.6), and greater weight-to-height ratio (OR, 1.5; 95% CI, 1.1 to 2.0). Odds of injury decreased with increasing age of the dog (OR, 0.8; 95% CI, 0.76 to 0.86). CONCLUSIONS AND CLINICAL RELEVANCE Results should be cautiously interpreted because of potential respondent and recall bias and lack of review of medical records. Nevertheless, results suggested that retaining healthy dewclaws, maintaining lean body mass, and trimming nails short for training and competition may decrease the likelihood of digit injuries. Research to investigate training practices, obstacle construction specifcations, and surface considerations for dogs competing in agility activities is indicated.

Objective To evaluate lateral fabellotibial suture (LFTS) and TightRope CCL (TR) extra-articular stabilization biomechanics in the cranial cruciate ligament (CrCL)-deficient canine stifle joint during the stance phase of gait. Study design Computer simulations. Animals Healthy 33-kg Golden Retriever. Methods LFTS and TR were implemented in a previously developed 3-D quasi-static rigid body CrCL-deficient canine pelvic limb computer model simulating the stance phase of gait. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared across the CrCL-intact, CrCL-deficient, and extra-articular stabilized stifle joints. Results Compared to the CrCL-intact stifle, peak caudal cruciate and lateral collateral ligament (LCL) loads were increased in the LFTS-managed stifle, peak caudal cruciate and LCL loads were decreased in the TR-managed stifle, and peak medial collateral and patellar ligament (PL) loads were similar for both techniques. Compared to the CrCL-deficient stifle, peak caudal cruciate, lateral collateral, and medial collateral ligament loads decreased, and peak PL load was similar in the LFTS- and TR-managed stifle joints. Peak relative tibial translation decreased, and peak relative tibial rotation changed from internal rotation to external rotation in the LFTS- and TR-managed stifle joints compared to the CrCL-deficient stifle. Conclusion Our computer model predicted controlled tibial translation, decreased cruciate and collateral ligament loads, and a change in femorotibial rotation from internal to external with LFTS and TR stifle management as compared to the CrCL-deficient stifle. This study demonstrates how computer modeling can be used to evaluate biomechanics of stifle stabilization surgical techniques.

Chondrodystrophy results in predictable and progressive biochemical and structural changes to the intervertebral disc, resulting in early onset degeneration and dystrophic mineralization of the disc. Accelerated degeneration and mineralization of the intervertebral disc are common in multiple dog breeds and can result in compromised function, herniation, pain, and a variety of neurological sequelae. A mutation responsible for chondrodystrophy in dogs has been identified as an aberrant fibroblast growth factor 4 ( FGF4) retrogene insertion on chromosome 12 (CFA12) and is associated with short stature of the Nova Scotia Duck Tolling Retriever. Segregation of the CFA12 FGF4 retrogene in this dog breed provides an opportunity to examine the effect of retrogene presence on radiographic and histologic appearance of chondrodystrophic disc degeneration within a single breed. Here we found that in the intervertebral discs isolated from 2 dogs with the CFA12 FGF4 genotype, the nucleus pulposus was largely replaced by cartilaginous tissue, and physaliferous notochordal cells were rarely if ever identified. These findings are in contrast to the normal histologic findings in 2 breed-matched dogs lacking the mutation. The findings are consistent with premature chondroid degeneration of the intervertebral disc and suggest that the presence of the CFA12 FGF4 retrogene is sufficient to cause the chondrodystrophic phenotype.

Objectives: Osseointegrated prostheses are increasingly used for amputees, however, the lengthy rehabilitation time of these prostheses remains a challenge to their implementation. The aim of this study was to investigate the ability of locally applied vibration or low-intensity pulsed ultrasound (LIPUS) to accelerate osseointegration and increase peri-implant bone volume. Methods: A 4-week and 8-week rodent study were conducted in a femoral intramedullary implant model (control, vibration, LIPUS, and combined treatment) to determine effects on healing. Osseointegration was evaluated quantitatively through mechanical, µCT and histological evaluations. Results: Maximum pushout load at 4 weeks increased with LIPUS relative to control (37.7%, P=0.002). Histologically, LIPUS and vibration separately increased peri-implant bone formation after 4 weeks relative to control. Vibration resulted in greater peri-implant bone after 8 weeks than all other groups (25.7%, P

The motion of wing joints is a critical factor for successful flight in avian patients, but little information is available about goniometry in birds. Elbow and carpus joints in flexed and extended positions from 10 orthopedically normal wings of 6 adult wild barred owls (

The objective of this work was to understand glucose oxidase (GOx) immobilization on mesoporous carbon (MC) and the electrochemical performance of a bio-anode fabricated from GOx-immobilized MC. GOx, MC, and NaCl concentrations significantly influenced GOx immobilization. The GOx enzyme adsorption on MC increased by 2.3 times when the total solute concentration was increased from 20.5 to 164 mg mL-1. With the addition of NaCl (1.2 M), enzyme adsorption increased by 1.3 times compared to the control group. The bio-anode fabricated by GOx-immobilized MC displayed direct and surface-controlled redox reactions with an electron transfer coefficient (α) of 0.57 in 0.1 M phosphate buffer saline (PBS) solution (pH 7.0) with 10 mM glucose. GOx immobilization improved electron transfer between the electrolyte and the electrode surface with ΔEp shifting to 255 mV, compared to non-immobilized free enzymes on MC (ΔEp = 263 mV). The bio-electrode made by GOx-immobilized MC showed a current density of 227.37 μA cm-2.

OBJECTIVE To investigate in vitro carboplatin release from 6 carrier media. SAMPLE 6 carboplatin-containing carrier media. PROCEDURES An in vitro release study was performed with 6 commercially available carrier media: a hemostatic gelatin sponge, a poloxamer copolymer gel, and 2 sizes (3 and 4.8 mm in diameter) of beads molded from each of 2 commercial calcium sulfate products. All carrier media contained 10 mg of carboplatin. Carrier media specimens were placed in 37°C PBS solution for 96 hours. Carboplatin concentrations in PBS solution were measured by use of high-performance liquid chromatography at 15 time points to calculate the amount and proportion of carboplatin released from each specimen. RESULTS Peak release of carboplatin from the poloxamer copolymer gel and hemostatic gelatin sponge were achieved after 4 and 20 hours, respectively. Maximum release did not differ significantly between the poloxamer copolymer gel and hemostatic gelatin sponge, but both released significantly more carboplatin within 96 hours than did both of the commercial calcium sulfate products. The poloxamer copolymer gel released 99% of the carboplatin, and the hemostatic gelatin sponge released 68.5% of the carboplatin. Peak release of carboplatin from the calcium sulfate beads was not reached within 96 hours. CONCLUSIONS AND CLINICAL RELEVANCE In this study, carboplatin release from the hemostatic gelatin sponge was incomplete. The poloxamer copolymer gel and hemostatic gelatin sponge released carboplatin rapidly in vitro, whereas calcium sulfate beads did not.

Summary Objective: To assess the geometry of canine humeri as seen on radiographs in chondrodystrophic dogs (CD) and brachycephalic dogs (BD) compared to non-chondrodystrophic dogs (NCD). Methods: Mediolateral (ML) and craniocaudal (CC) radiographs of skeletally mature humeri were used (CD [n = 5], BD [n = 9], NCD [n = 48]) to evaluate general dimensions (length, width, canal flare, cortical thickness), curvature (shaft, humeral head, and glenoid), and angulation (humeral head and condyle). Measurements from CD, BD, and NCD were compared. Results: Mean humeral length was shorter in CD (108 mm) compared to BD (184 mm, p = 0.001) and NCD (183 mm, p Clinical significance: Bone proportions and curvature in CD differ from BD and NCD. Differences are minor and unlikely to have clinical significance.

Objective: This study assessed femur properties in 80 adult female rats exposed to a range of whole body vibration amplitudes at 45 Hz over five weeks. Our hypothesis was that an optimal amplitude for whole body vibration would be apparent and would result in increased bone strength. Methods: Animals were treated in five amplitude groups (0 g, 0.15 g, 0.3 g, 0.6 g, and 1.2 g peak), for 15 minutes per day, five days per week, for five weeks. Femur strength was assessed via: (1) three-point bending of the shaft, (2) cantilever bending of the neck, and (3) indentation of distal cancellous bone. Femoral bone mineral density, plasma prostaglandin E2 (PGE2) concentrations, cartilage thickness, and histopathologic properties were measured. Results: Vibration doubled (P=0.039) cancellous bone stiffness in the 0.6 g and 1.2 g groups and induced a 74% increase in PGE2 concentrations (P=0.007). However, femoral densitometry and strength of the neck and shaft were unchanged and the cancellous bone indentation strength did not differ statistically (P=0.084). Cartilage thickness of vibrated groups at the medial condyle did not increase significantly (P=0.142) and the histopathologic grade did not change. There was no definitive optimal vibration amplitude. Conclusion: The benefits of vibration therapy over five weeks were confined to cancellous bone.

OBJECTIVE To evaluate the 3-D geometry of canine pelves and to characterize the long-term effects of juvenile pubic symphysiodesis (JPS) on pelvic geometry by comparing the pelvic configuration between littermates that did and did not undergo the procedure. ANIMALS 24 Labrador Retriever, Golden Retriever, or Labrador Retriever–Golden Retriever crossbred service dogs from 13 litters. PROCEDURES At 16 weeks old, puppies with a hip joint distraction index ≥ 0.5 were randomly assigned to undergo thermal JPS (n = 9), mechanical JPS (7), or a sham (control) surgical procedure (8). Ten years later, each dog underwent a CT scan of the pelvic region. Modeling software was used to create 3-D reconstructions from the CT scans, and various pelvic measurements were made and compared among the 3 treatments. RESULTS Compared with the control treatment, thermal and mechanical JPS increased the hemipelvis acetabular angle by 4°, the acetabular angle of lateral opening by 5°, and the orientation of the medial acetabular wall in a transverse plane by 6°, which indicated that JPS increased dorsal femoral head coverage by the acetabulum. Both JPS procedures decreased the pelvic canal area by approximately 20% and acetabular inclination by 6° but did not alter acetabular retroversion. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that thermal and mechanical JPS were equally effective in altering the 3-D pelvic geometry of dogs. These findings may help guide future studies of alternatives for optimizing canine pelvic anatomy to minimize the risk of hip dysplasia and associated osteoarthritis.

Osseointegrated implants transfer loads from native bone to a synthetic joint and can also function transdermally to provide a stable connection between the skeleton and the prostheses, eliminating many problems associated with socket prostheses. Additive manufacturing provides a cost-effective means to create patient-specific implants and allows for customized textures for integration with bone and other tissues. Our objective was to compare the osseointegration strength of two primary additive manufacturing methods of producing textured implants: electron beam melting (EBM) (mean Ra = 23 μm) and direct metal laser sintering (DMLS) (mean Ra = 10 μm). Due to spatial resolution, DMLS can produce surfaces with a roughness comparable to EBM. Two cohorts of Sprague-Dawley rats received bilateral, titanium implants in their distal femurs and were followed for 4 weeks. The first-cohort animals received EBM implants transcortically in one femur and a DMLS implant in the contralateral femur. The second cohort received DMLS implants (either fine textured or coarse textured to mimic EBM) in the intramedullary canal of each femur. Osseointegration was evaluated through mechanical testing and micro-computed tomography (bone volume fraction [BV/TV] and bone-implant contact [BIC]). The fixation strength of coarse textured implants provided superior interlocking relative to fine textured implants without affecting BV/TV or BIC in both cohorts. Coarse EBM implants in a transcortical model demonstrated an 85% increase in removal torque relative to the fine DMLS textured implants. The thrust load in the intramedullary model saw a 35% increase from fine to coarse DMLS implants.