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Simple Summary: Cranial cruciate ligament (CCL) disease often involves damage to the caudal horn of the medial meniscus, resulting in pain and the progression of osteoarthritis. Current treatments, primarily partial caudal meniscectomy, have shown disappointing long-term outcomes as osteoarthritis progresses. Consequently, restoring and preserving meniscal tissue is becoming increasingly important for maintaining the integrity and functionality of the meniscus whenever possible. Although meniscal suture techniques have been documented in canine cases, their clinical application remains limited. This study aims to assess the practicability of a minimally invasive double-needle technique (DNT) designed to facilitate meniscal sutures during arthroscopy with the use of joint distraction. The technique was applied in ten canine stifles undergoing arthroscopy for CCL disease with confirmed medial meniscal lesions of the caudal horn appropriate for suturing. The described DNT proved to be a viable method for suturing the caudal horn of the medial meniscus. It can be effectively applied in canine stifles, provided there is adequate visualization during the procedure. Current treatments for medial meniscus lesions in association with CCL ruptures have shown disappointing long-term outcomes. Meniscal suturing may improve the outcome, but their clinical application remains limited. This study aims to assess the practicability of a minimally invasive DNT to facilitate meniscal suturing in dogs. Ten stifles of eight client-owned dogs with arthroscopically confirmed CCL disease and medial meniscal tears in the abaxial third of the meniscus were included. The described suture technique was applied under joint distraction using the Titan joint distractor. Surgical stabilization of all stifles was then accomplished via an X-Porous TTA procedure. The DNT allowed for the precise placement of meniscal sutures. Minor intraoperative complications included reduced arthroscopic visibility (n = 2) and suture breakage during its passage through the meniscus (n = 3). No complications related to the meniscal sutures were noted throughout the six-month follow-up period. The described DNT proved to be a viable and effective method for suturing lesions of the caudal horn of the medial meniscus, provided there is adequate visualization during the procedure. Appropriate stifle stabilization postoperatively is mandatory for protecting the suture and avoiding concomitant meniscal lesions due to joint instability. [ABSTRACT FROM AUTHOR]

High‐field MRI of the equine stifle provides high‐resolution information about soft tissues that is useful in the diagnosis of stifle lameness. The aim of this prospective anatomic study was to describe the appearance, position, size, and shape of the equine femorotibial ligaments, meniscal ligaments, and menisci using 3 Tesla MRI under extended, extended‐loaded, and flexed conditions. Additionally, histologic examination of the collateral and cruciate ligaments (CLs) of a single stifle was performed to compare with MRI images. In extension, mild variations in MRI signal intensity were apparent in the CLs, and the cranial had two distinct longitudinal regions indicating two ligament bundles. Flexion had minor effects on CL signal intensity and altered the tibial angles of attachment. Histology indicated that both CLs were comprised of two fiber bundles. The collateral ligaments were the same low‐signal intensity. The medial collateral ligament had a smaller cross‐sectional area than the lateral, and flexion increased the length of the medial collateral ligament and the cross‐sectional area of the lateral. Low loads in extension did not affect the MRI appearance of stifle soft tissues. Flexion of the stifle impacted cruciate ligament insertion angles and the size and shape of collateral ligaments. This study provides support for the use of MRI to understand the anatomy and function of stifle ligaments. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Assess femorotibial features in foals with and without medial femoral condyle (MFC) subchondral radiolucencies (SR+ and SR-). METHODS: 3 independent, sequential radiographic studies were performed. Study 1 retrospectively measured femorotibial morphological parameters in repository radiographs (SR- and SR+). Study 2 qualitatively compared drawings of intercondylar notch shape in postmortem radiographs (SR-). Study 3 prospectively measured femorotibial parameters in 1-month-old foals (SR-). In studies 1 and 3, 13 morphologic parameters were measured. Limb directional asymmetry was assessed in 2 age groups (< 7 or ≥7 months). RESULTS: Study 1 (SR-group; n = 183 radiographs) showed increased femoral measurements with maturation, except the distal femoral intercondylar notch width (FINwal), which decreased. In contrast, in SR+ stifles (53 radiographs), 3 femoral parameters (MFC width [MFCwpf], MFC height, or FINwal) showed no changes. Tibial plateau width alone increased with maturation in both groups. Interobserver reliability was good to excellent. Study 2 (n = 53 radiographs) confirmed a distal FINw decrease in SR- foals. In study 1, left SR- stifles in greater than or equal to 7-monthold fillies had significantly larger femoral bicondylar width and FINw, while right SR+ stifles in fillies greater than or equal to 7 months had a significantly larger MFCw. In study 3 of 1-month-old foals (n = 94 SR- radiographs), the MFCw, femoral condyle bicondylar width, and lateral femoral condyle height were all greater on the left, whereas the intercondylar intereminence space width was larger on the right. CLINICAL RELEVANCE: In SR+ stifles, the distal femur exhibited divergent maturation, indicating a wider MFC in the right stifle in older foals. As SR lesions are more common on the right, this suggests a potential association with MFC morphology. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study evaluates the amplitude of the anatomical-mechanical angle (AMA-angle) using 4 measuring methods of the tibial distal anatomical axes (DAA) previously described, comparing the literature results to determine if there are significant differences in patients with cranial cruciate ligament (CrCL) rupture. ANIMALS: This study was comprised of 30 tibiae (29 dogs), including 1 bilateral case. METHODS: A retrospective study was selected for this research. DAA measurements were performed on all surgically confirmed cases of canine CrCL rupture at Hospital Veterinário de Especialidades Bruselas from 2019 to 2022. Four different published methods (identified by surname of the corresponding author of the original publication) were compared. Tibial measurements were made using Veterinary Preoperative Orthopedic Planning Pro software (https://vpoppro. com/) on mediolateral radiographic projections obtained from a digital database. RESULTS: The mean (range) in the DAA method conducted by Hulse obtained a AMA-angle of 5.4° (3.3 to 8.1°), 3.0° (0 to 5.8°) for Osmond et al, 3.2° (0.9 to 6°) for Miles, and 5.9° (2.4 to 8.8°) for Tudury. Differences among the means of the AMA-angle of the authors methods were found with a statistical difference (P < .05), except between Osmond and Miles. The mean AMA-angle with the Osmond method concurred with previous study results that determined the magnitude using the same measurement method of DAA in patients with CrCL rupture. CLINICAL RELEVANCE: The AMA-angle magnitude has been associated with higher sensitivity and specificity for predicting the development of CrCL rupture compared to other anatomical factors evaluated; therefore, future comparisons with different methods of measurement of the DAA between healthy and affected patients are recommended to determine whether any of them can increase the percentage value as a predictive factor for the occurrence of this condition. [ABSTRACT FROM AUTHOR]

ObjectiveDetermine whether dogs with well-functioning orthopedic metal implants can develop metal reactivity.SampleClient-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.ProceduresLymphocyte 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.ResultsSamples 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 relevanceMetal 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.

Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle. No hindlimb deformities were present on physical examination or radiographic evaluation. No stifle instability was present. Arthroscopy revealed severe (grade 5/5 modified Outerbridge score) cartilage erosion in the lateral compartment (femorotibial), marked degeneration of the lateral meniscus and early cranial cruciate ligament disease in both patients. Medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy (mcmtCBLO) was performed in both patients. The procedure aims to shift the pelvic limb's mechanical axis medially to reduce pressure in the lateral compartment while also reducing craniocaudal shear forces by lowering the tibial plateau angle. Eight weeks after surgery one patient's lameness had resolved while the other had improved significantly. Second-look arthroscopy performed at this time revealed fibrocartilage formation in the lateral compartment without progression of cruciate disease in both cases. At long-term follow-up (approximately 3 and 5 years), favourable outcomes (no or minimal lameness, mild or moderate osteoarthritis) were identified on the long-term owner survey, lameness examination and radiographs. mcmtCBLO reduced or eliminated short- and long-term lameness in these two cases afflicted by concurrent lateral compartment and early cranial cruciate ligament disease. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare palpation and ultrasound scores of effusion of the medial femorotibial and femoropatellar joints of horses. ANIMALS: 40 horses (80 stifles) were evaluated over a 12-week period. METHODS: Horses > 1 year of age without history of stifle disease were enrolled from September to December 2022. Palpation of right and left medial femorotibial and femoropatellar joint compartments was performed. Amount of effusion was scored by a board-certified large animal surgeon, a third-year large animal surgery resident, and an equine sports medicine intern. Effusion of right and left medial femorotibial and femoropatellar joints was quantified with ultrasound by a board-certified equine sports medicine and rehabilitation clinician. Amount of effusion on palpation and ultrasound was graded as none-mild (1), moderate (2), or severe (3). A 2-way intraclass correlation coefficient evaluated interrater reliability of palpation scores. The Spearman rank correlation determined association between palpation and ultrasound scores. RESULTS: Interrater reliability for palpation of effusion was poor between all observers for all joint compartments. No significant correlation was identified between palpation and ultrasound scores for any joint compartment for anyobserver. CLINICAL RELEVANCE: Clinicians often rely on palpation of joint effusion as an indication of stifle pathology. We found interrater reliability to be poor for palpation scores, indicating low agreement for palpation of joint effusion between clinicians within our group. No correlation was found between palpation and ultrasound scores for joint effusion, indicating that clinicians should not rely on palpation alone to quantify joint effusion of the medial femorotibial and femoropatellar joints. [ABSTRACT FROM AUTHOR]

Simple Summary: In patients suffering from cranial cruciate ligament disease, the patellar ligament is loaded aphysiologically, resulting in increased stress. To date, however, there have been no studies describing the establishment of anatomical or functional damage to this ligament after cranial cruciate ligament disease. This study aims to evaluate the appearance of the patellar ligament using ultrasound and elastosonography in dogs affected by disease of the cranial cruciate ligament but not yet treated in order to understand whether signs of thickening and a reduction in elasticity increase over time between the day of ligament disease onset and the day of diagnosis and therefore persist before being treated with the surgical procedure of tibial plateau leveling osteotomy or tibial tuberosity advancement. The results suggest that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and has a tendency to lose its elasticity. This study aims to evaluate the morpho-functional change in the patellar ligament in dogs with cranial cruciate ligament disease. We hypothesized that it may show increased thickening and stiffness with increasing days from onset to diagnosis instead of trauma. Understanding this aspect has implications for the choice of timing for treating patients suffering from cranial cruciate ligament disease, as well as the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau leveling osteotomy or tibial tuberosity advancement. Thirty-three dogs affected by unilateral cranial cruciate disease were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (1–15 days), Group 2 (16–60 days), and Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of the patellar ligament were performed without sedation for each dog. Upon ultrasonographic examination, all dogs showed modification in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder with increasing days after disease, although there were no significant differences between groups. Our results show that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity. [ABSTRACT FROM AUTHOR]

Current treatments for medial meniscus lesions in association with CCL ruptures have shown disappointing long-term outcomes. Meniscal suturing may improve the outcome, but their clinical application remains limited. This study aims to assess the practicability of a minimally invasive DNT to facilitate meniscal suturing in dogs. Ten stifles of eight client-owned dogs with arthroscopically confirmed CCL disease and medial meniscal tears in the abaxial third of the meniscus were included. The described suture technique was applied under joint distraction using the Titan joint distractor. Surgical stabilization of all stifles was then accomplished via an X-Porous TTA procedure. The DNT allowed for the precise placement of meniscal sutures. Minor intraoperative complications included reduced arthroscopic visibility (n = 2) and suture breakage during its passage through the meniscus (n = 3). No complications related to the meniscal sutures were noted throughout the six-month follow-up period. The described DNT proved to be a viable and effective method for suturing lesions of the caudal horn of the medial meniscus, provided there is adequate visualization during the procedure. Appropriate stifle stabilization postoperatively is mandatory for protecting the suture and avoiding concomitant meniscal lesions due to joint instability.

Case summary An 11-year-old female neutered domestic shorthair cat was referred for surgical management of a traumatic right stifle luxation. Orthopaedic examination of the affected stifle under general anaesthesia revealed joint effusion and craniocaudal and rotational instability. Cranial displacement of the tibia with respect to the femur and infrapatellar pad sign were identified on radiography. Intraoperatively, complete rupture of both cruciate ligaments and marked disruption of the mid and caudal poles of the medial and lateral menisci were observed. Both collateral ligaments appeared intact. The remnants of the injured cruciate ligaments were removed, and medial and lateral caudal hemimeniscectomies were performed. A tibial plateau levelling osteotomy (TPLO) was performed to address the craniocaudal stifle instability. Intraoperative assessment of the stifle revealed persistent instability with cranial tibial translation, internal and external rotation, and a positive caudal draw test. A lateral augmentation suture was employed to address the persistent cranial tibial translation and internal rotation. To successfully neutralise caudocranial and external rotational instability secondary to the caudal cruciate ligament deficiency, a medial augmentation suture was placed with the aid of three interference screws. Stifle stability was achieved. A modified Robert-Jones bandage was kept on for 24 h postoperatively. An excellent outcome was achieved, with successful limb function restoration. Relevance and novel information This case report represents the first documented instance of feline traumatic stifle luxation repair by combining a corrective tibial osteotomy and extra-articular augmentation. Notably, it introduces the novel technique of implementing a TPLO with medial and lateral augmentation sutures to address multidirectional stifle instability. [ABSTRACT FROM AUTHOR]

Case summary A domestic shorthair cat presented to the Animal Referral Hospital (Brisbane, Australia) after having the left pelvic limb incorrectly amputated. The cat was unable to ambulate on the remaining right pelvic limb due to a chronically subluxated stifle. A stifle arthrodesis was performed on the right pelvic limb to manage the injury. Follow-up radiographs performed 5 months postoperatively demonstrated stifle arthrodesis with no detectable complications. The owner reported that aside from some difficulties in toileting, the cat had a good quality of life and was capable of performing the majority of daily activities. Stifle arthrodesis in a feline pelvic limb amputee appears to be a viable treatment option. After a period of rehabilitation and adaptation, the cat in the case report has been able to lead a near-normal lifestyle. Relevance and novel information To the authors' knowledge, this is the first report of the outcome and complications associated with stifle arthrodesis in a feline pelvic limb amputee. This is also the first report of stifle arthrodesis in a cat using the bilateral plating technique. [ABSTRACT FROM AUTHOR]

Background: Subchondral lucencies (SCLs) in the distal aspect of the medial femoral condyle (MFC) of young Thoroughbred horses are a source of controversy on presale radiographs. There is limited scientific evidence regarding the risk of progression and impact on future racing performance. Objectives: To (1) identify the prevalence of MFC SCLs on sales repository radiographs in yearling and 2‐year‐old Thoroughbreds; (2) identify any association between grade of MFC SCL and future racing performance and (3) monitor changes in MFC SCL grades between yearling and 2‐year‐old sales. Study design: Prospective cohort study. Methods: Radiographs were obtained with consignor permission from a 2016 yearling sale and five 2017 2‐year‐old sales. Stifle radiographs were evaluated and MFC SCLs graded on a scale of 0–3. Axial MFC lucencies were recorded separately. Maximum MFC grades per horse were analysed for associations with racing performance outcomes, adjusted for sex, to the end of the horses' 4‐year‐old racing year. Analysis was via logistic, negative binomial or linear regression as appropriate, with the threshold for significance set at α = 0.05. Results: Radiographs from 2508 yearlings (5016 stifles) and 436 2‐year‐olds (872 stifles) were included in the study. MFC SCLs of grades 1–3 were observed in 242 (9.65%) yearlings and 49 (11.2%) 2‐year‐olds. Bilateral MFC SCLs of grades 1–3 were observed in 54 (2.2%) yearlings and 12 (2.8%) 2‐year‐olds. Grade 1 MFC SCLs in yearlings either remained unchanged (14/31), progressed to a grade 2 (6/31) or resolved (11/31) by the 2‐year‐old sale. Grade 2 MFC SCLs in yearlings remained unchanged (6/10), progressed to a grade 3 (2/10) or improved to a grade 1 (2/10). Yearlings with a grade 3 MFC SCL had a 78% probability of starting a race (95% confidence interval [CI] 58.2–89.6%), compared with an 84% probability of racing for grade 0 yearlings (95% CI 82.7–85.8%). Six of the seven yearlings with axial MFC lucencies raced. Main limitations: This study may underestimate the prevalence of severe lesions in the general yearling population of U.S. Thoroughbreds. However, the convenience sample used is representative of the population of interest at sales. The study design could not address exclusions prior to sale. Conclusions: Grade 1 MFC SCLs are the most common type seen in yearling and 2‐year‐old sales horses. The majority of yearling grade 1 MFC SCLs resolved or remained static by 2‐year‐old sales. It was also possible for grade 2 and 3 MFC SCLs to improve one grade between sales. Fewer sales yearlings with a grade 3 MFC SCL raced, but in those that did race there was no evidence of worse performance compared to unaffected peers. Axial MFC lucencies did not affect racing performance. [ABSTRACT FROM AUTHOR]

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Background and Aim: The association between bacterial DNA in stifle joints, including those with cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL), and osteoarthritis in dogs remains elusive. This study investigated the potential association between the detection of bacterial DNA and osteoarthritis in dogs using a broad-range polymerase chain reaction technique targeting the 16S ribosomal RNA gene. Materials and Methods: Synovial fluid (35 samples) and knee tissue samples (32 samples) were obtained from 35 dogs diagnosed with CCLR (n = 20; 11 males and nine females) or MPL (n = 15; five males and 10 females) who underwent a surgical operation between October 2014 and April 2015. Results: Dogs with CCLR had a higher average osteoarthritis score than those with MPL (2.0 ± 0.9 vs. 0.5 ± 0.9; p = 0.005). Bacterial DNA was detected in the stifle joints of 60.71% of dogs with MPL. Pelomonas spp. (25.00%), Halomonas spp. (17.86%), and 5 other species (17.86%) were the most frequently identified bacteria. Bacterial DNA was detected in 41.03% of dogs with CCLR. Pelomonas spp. (15.38%), Sphingomonas spp. (10.26%), Halomonas spp. (5.13%), and 4 other species (10.26%) were the most frequently identified bacteria. No significant difference was observed in the prevalence of bacterial DNA obtained from tissue samples (46.88%) or joint fluid samples (51.43%). The presence of bacterial DNA was not associated with the type of knee injury (MPL or CCLR; p = 1.000). There was a higher prevalence of bacterial DNA in samples from dogs with moderate-to-severe osteoarthritis (94.44%) than in those with minimal osteoarthritis (41.18%), and a significant association between the presence of bacterial DNA and moderate-to-severe osteoarthritis was identified (p < 0.01). Conclusion: Dogs with moderate-to-severe osteoarthritis were more likely to have bacterial DNA in their stifle joints than those with no or minimal osteoarthritis. These findings provide valuable insight into the potential role of bacterial DNA in joint tissue or joint fluid and the development of osteoarthritis in dogs.

Simple Summary: Persistent knee joint instability has been recognized as a potential postoperative consequence after Tibial Tuberosity Advancement (TTA) causing chronic lameness. A six-year-old male Labrador retriever (38 kg) with persistent lameness lasting six months after TTA Rapid surgery has been examined. During orthopedic examination, the lameness was subjectively graded 3/5 and the positive drawer and tibial compression tests were performed. Radiographical measurements were performed; the preoperative tibial plateau angle was 27° and the patella ligament angle relative to the tibial plateau was 102°. The decision was made to completely remove the TTA Rapid cage and all screws to have enough room to perform a TPLO and apply a 3.5 LCP plate. Long-term follow-up showed radiologically excellent healing with fusion of the gap and disappearance of the osteotomy line. Six months postoperatively, no lameness was detected at a walk and trot. The owner was completely satisfied and reported the dog being free of lameness even after long walks. The purpose of this case report is to describe the functional and clinical outcome of a tibial plateau leveling osteotomy (TPLO) in a dog with joint instability and persistent lameness following a Tibial Tuberosity Advancement surgery (TTA) Rapid. A six-year-old male Labrador retriever (38 kg) with a tibial plateau angle of 27° and a patella ligament to tibial plateau angle of 102° and persistent lameness lasting six months after TTA Rapid surgery has been examined. During orthopedic examination, the lameness was subjectively graded 3/5 and the positive drawer and tibial compression tests were performed. The TTA Rapid cage and all screws were completely removed from the tibia to have enough room to perform a TPLO radial cut. A lameness score evaluation, client satisfaction and radiographic follow-up were performed at 4 weeks, 8 weeks and 6 months postoperatively. Long-term follow-up showed radiologically excellent healing with fusion of the gap and disappearance of the osteotomy line. Six months postoperatively, no lameness was detected at a walk and trot. The owner was completely satisfied and reported the dog being free from lameness even after long walks. No complications related to the TPLO surgery occurred. [ABSTRACT FROM AUTHOR]

Background and Aim: The association between bacterial DNA in stifle joints, including those with cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL), and osteoarthritis in dogs remains elusive. This study investigated the potential association between the detection of bacterial DNA and osteoarthritis in dogs using a broad-range polymerase chain reaction technique targeting the 16S ribosomal RNA gene. Materials and Methods: Synovial fluid (35 samples) and knee tissue samples (32 samples) were obtained from 35 dogs diagnosed with CCLR (n = 20; 11 males and nine females) or MPL (n = 15; five males and 10 females) who underwent a surgical operation between October 2014 and April 2015. Results: Dogs with CCLR had a higher average osteoarthritis score than those with MPL (2.0 ± 0.9 vs. 0.5 ± 0.9; p = 0.005). Bacterial DNA was detected in the stifle joints of 60.71% of dogs with MPL. Pelomonas spp. (25.00%), Halomonas spp. (17.86%), and 5 other species (17.86%) were the most frequently identified bacteria. Bacterial DNA was detected in 41.03% of dogs with CCLR. Pelomonas spp. (15.38%), Sphingomonas spp. (10.26%), Halomonas spp. (5.13%), and 4 other species (10.26%) were the most frequently identified bacteria. No significant difference was observed in the prevalence of bacterial DNA obtained from tissue samples (46.88%) or joint fluid samples (51.43%). The presence of bacterial DNA was not associated with the type of knee injury (MPL or CCLR; p = 1.000). There was a higher prevalence of bacterial DNA in samples from dogs with moderate-to-severe osteoarthritis (94.44%) than in those with minimal osteoarthritis (41.18%), and a significant association between the presence of bacterial DNA and moderate-to-severe osteoarthritis was identified (p < 0.01). Conclusion: Dogs with moderate-to-severe osteoarthritis were more likely to have bacterial DNA in their stifle joints than those with no or minimal osteoarthritis. These findings provide valuable insight into the potential role of bacterial DNA in joint tissue or joint fluid and the development of osteoarthritis in dogs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the effect of arthroscopic partial meniscectomy in dogs with bucket handle meniscal tears and tibial plateau leveling osteotomy (TPLO), compared with dogs with cranial cruciate ligament rupture and no meniscal tear treated by TPLO alone. ANIMALS: 30 client-owned dogs with cranial cruciate rupture treated by either TPLO and arthroscopy alone if the meniscus was normal (normal meniscus [NM] group, n = 14) or by TPLO and an arthroscopic partial meniscectomy if a bucket handle tear was diagnosed (meniscal tear [MT] group, n = 16). METHODS: Medical records, lameness score, and symmetry gait analysis parameters were retrospectively collected from patient records preoperatively (PreO), then at 1, 3, and 6 months postoperatively (M1, M3, and M6, respectively). Osteoarthritic (OA) radiographic score was performed and compared at PreO and M6. RESULTS: PreO gait analysis parameters were lower in the MT group (P < 0.005). In the MT group, the lameness score significantly improved between PreO and M1, and there were no significant differences between groups at M6. OA score was significantly higher in the MT group at PreO and M6. However, postoperative progression of OA did not differ between the 2 groups (P = 0.16). CLINICAL RELEVANCE: Treatment for meniscal tear results in a significant improvement in lameness, with postoperative outcomes at 6 months comparable with dogs with intact menisci. Despite having significant osteoarthritic lesions at all time points, the progression of osteoarthritis is similar between dogs with meniscal tears and those with intact menisci. [ABSTRACT FROM AUTHOR]

The knee joint capsules composed of a fibrous layer and a synovial layer. The knee meniscus consists of the superficial network, lamellar layer, tie fibre and circumferential bundles. However, the continuous structure of the knee joint capsule and meniscus has not been reported. Fetal and adult pigs were used to investigate the structural relationship between the stifle joint capsule and meniscus based on the gross anatomy and histological findings. In the gross anatomical examination, the joint capsule appeared to have separated attachments to the meniscus, except for the lower aspect of the popliteal hiatus. Histologically, the lower half of the popliteal hiatus was found to have separated attachments, with vessels running between the attachments of the joint capsules. The synovial layer of the joint capsule continued to the superficial network, and the fibrous layer of the joint capsule continued to the lamellar layer and tie fibres. There were two routes of arterial entry into the meniscus: intracapsular and intercapsular. It appeared that the presence of separated attachments of the joint capsule was necessary to allow the intercapsular route. This study clarified for the first time the routes of feeding vessels entering the meniscus and proposed to call this entry point the meniscus hilum. We consider that this detailed anatomical information is important for understanding the continuation between the joint capsule and the meniscus. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to evaluate the association between meniscal lesions and severity of osteoarthritis (OA) among dogs that underwent Tibial Plateau Leveling Osteotomy (TPLO) for stabilization of cranial cruciate ligament rupture (CrCLR) at the University of Tennessee in 2011–2017. Results There were a total of 252 meniscal tears. Factors associated with diagnosis of medial meniscal tears (MMT) in dogs were severe OA in comparison to no OA (3.8 OR, 2.0–8.0 95% CI, 0.001 p-value), sporting and mixed breed group compared to other breed (3.6 OR, 1.7–7.6 95% CI, 0.004 p-value; 3.2 OR, 1.6–6.6 95% CI, 0.019 p-value, respectively), increasing age (1.1 OR, 1.0-1.2 95% CI, 0.018 p-value), complete CrCLR compared to partial (3.3 OR, 2.1-5.0 95% CI,

A significant portion of equine lameness is localized to the stifle joint. Effective cartilage repair strategies are largely lacking, however, recent advances in surgical techniques, biomaterials, and cellular therapeutics have broadened the clinical strategies of cartilage repair. To date, no studies have been performed directly comparing neonatal and adult articular cartilage from the stifle across multiple sites. An understanding of the differences in properties between the therapeutic target cartilage (i.e., adult cartilage) as well as potential donor cartilage (i.e., neonatal cartilage) could aid in selection of optimal harvest sites within a donor joint as well as evaluation of the success of the grafted cells or tissues within the host. Given the dearth of characterization studies of the equine stifle joint, and in particular neonatal stifle cartilage, the goal of this study was to measure properties of both potential source tissue and host tissue. Articular cartilage of the distal femur and patella (P) was assessed in regards to two specific factors, age of the animal and specific site within the joint. Two age groups were considered: neonatal (

BACKGROUND:Skin marker-based three-dimensional kinematic gait analysis were commonly used to assess the functional performance and movement biomechanics of the pelvic limb in dogs. Unfortunately, soft tissue artefact would compromise the accuracy of the reproduced pelvic limb kinematics. Multibody kinematics optimization framework was often employed to compensate the soft tissue artefact for a more accurate description of human joint kinematics, but its performance on the determination of canine pelvic limb skeletal kinematics has never been evaluated. This study aimed to evaluate a multibody kinematics optimization framework used for the determination of canine pelvic limb kinematics during gait by comparing its results to those obtained using computed tomography model-based fluoroscopy analysis. RESULTS:Eight clinically normal dogs were enrolled in the study. Fluoroscopy videos of the stifle joint and skin marker trajectories were acquired when the dogs walked on a treadmill. The pelvic limb kinematics were reconstructed through marker-based multibody kinematics optimization and single-body optimization. The reference kinematics data were derived via a model-based fluoroscopy analysis. The use of multibody kinematics optimization yielded a significantly more accurate estimation of flexion/extension of the hip and stifle joints than the use of single-body optimization. The accuracy of the joint model parameters and the weightings to individual markers both influenced the soft tissue artefact compensation capability. CONCLUSIONS:Multibody kinematics optimization designated for soft tissue artefact compensation was established and evaluated for its performance on canine gait analysis, which provided a further step in more accurately describing sagittal plane kinematics of the hip and stifle joints.

This study aims to evaluate the morpho-functional change in the patellar ligament in dogs with cranial cruciate ligament disease. We hypothesized that it may show increased thickening and stiffness with increasing days from onset to diagnosis instead of trauma. Understanding this aspect has implications for the choice of timing for treating patients suffering from cranial cruciate ligament disease, as well as the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau leveling osteotomy or tibial tuberosity advancement. Thirty-three dogs affected by unilateral cranial cruciate disease were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (1–15 days), Group 2 (16–60 days), and Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of the patellar ligament were performed without sedation for each dog. Upon ultrasonographic examination, all dogs showed modification in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder with increasing days after disease, although there were no significant differences between groups. Our results show that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity.

The center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) technique was developed for cranial cruciate ligament (CrCL) rupture treatment, aiming to modify the mechanical-anatomical angle (AMA), which is described as a predictive risk factor for the disease and is recommended to be taken into consideration when one is choosing a surgical procedure for tibial plateau slope alteration. Identifying a tibial distal anatomical axis (DAA) is essential in CBLO surgical planning and measuring AMA amplitude. The aim of this study was: to evaluate two methods of cranial rotation of the proximal fragment using four different tibial distal anatomical axes for digital planning on the CBLO technique, comparing its effectiveness in achieving the desired tibial plateau angle (TPAd) and closing the AMA angle. Tibial measurements were made with the vPOP pro software using 30 mediolateral radiographs of canine stifles. The DAA described by four authors was used based on the amount of Rotation completed (Rc) for each. The rotation methods evaluated were: 1) commercial CBLO table (RT) and 2) overlapping the tip of the intercondylar eminence with the corresponding DAA line (RE). The TPAd to be obtained was fixed at 10°, and the final AMA to be achieved at 0°. The mean values and standard deviations of the final TPA and final AMA with the rotation method were TPA(RT)f(%TPAd), TPA(RE)f(%TPAd), AMA(RT)f(%AMAzero), AMA(RE)f(%AMAzero). The results of each author were Hulse 10.0 ± 0.3(46.6%), 9.9 ± 0.1(60%), 0.3 ± 0.3(33.3%), 0.3 ± 0.3(13.3%), Osmond 10.1 ± 0.2(75%), 10,1 ± 0.2(83.3%), 0.4 ± 0.4(33.3%), 0.4 ± 0.3(8,3%), Miles 10.0 ± 0.1(66.6%), 10.0 ± 0.1(75%), 0.2 ± 0.1(16.6%), 0.2 ± 0.1(8.3%), Tudury 9.6 ± 0.6(31.2%), 9.5 ± 0.2(31.2%), 1.0 ± 0.7(18.7%), 1.0 ± 0.6(12.5%), respectively. The initially described RT obtained a higher percentage of AMA at zero degrees. Therefore, the RE method is discarded for use as an alternative to CBLO planning.

Introduction: The purpose of this retrospective study is to report the management of multiligamentous stifle injury in 6 cats using an acrylic transarticular external skeletal fixator (ATEF) as a method for temporary immobilisation of the stifle joint to support ligament augmentation. Methods: Cats (n=6) presenting with catastrophic stifle instability treated with ligament repair or replacement were retrospectively reviewed from March 2018 to July 2021. Following stifle joint arthrotomy, reduction and ligament augmentation, the stifle was temporarily immobilised at a standing angle with a modified uniplanar ATEF applied laterally with 3-4 pins in the femur and tibia. Outcome was evaluated based on follow up rechecks, radiographs, telephone followup and use of the feline musculoskeletal pain index. Results: All cats returned to normal activity with full function of the affected limb. All cats had low scores on the feline musculoskeletal pain index at the time of follow up. No major complications requiring revision surgery were observed. Minor complications occurred in three out of six cases including pin loosening and fracture of the acrylic mould. Conclusions: The application of an ATEF for temporary immobilisation of the stifle appears to be a feasible and technically simple technique to use in the management of multi-ligamentous stifle injury in cats. [ABSTRACT FROM AUTHOR]

Allograft arthroplasty is a promising cartilage-resurfacing technique. A 14-year-old horse was diagnosed with a medial femoral condyle subchondral bone cyst. Allografts were harvested from a young donor animal and implanted to fill the cyst cavity. A visual assessment of the surgical site was possible during follow-up arthroscopy. In addition to a desirable gliding surface and a good adaptation of the grafts, fibrillation of the cranial ligament of the medial meniscus was noted and debrided. The recipient horse became sound four months after follow-up surgery with a high level of owner satisfaction. In conclusion allograft transplantation is a promising technique for treating subchondral bone cysts. [ABSTRACT FROM AUTHOR]

Striations are present on ultrasonography of the intermediate (middle) patellar ligament in the transverse plane, which can be confused with tears. Comparison to the contralateral limb is often performed to help differentiate anatomic variation from pathologic change. The purposes of this prospective, observational study were to describe the striation patterns in Warmbloods and Quarter Horses, determine if these patterns are bilaterally symmetrical, and compare striation characteristics between Warmbloods and Quarter Horses. The intermediate patellar ligaments of six Warmblood horses and six Quarter horses, free from clinical signs of hindlimb lameness and in full work, were examined ultrasonographically. Striation pattern, striation number, and the transverse‐sectional areas for intermediate patellar ligaments were compared between Warmbloods and Quarter horses. Striation patterns were also compared for the left and right limbs of each horse. A significant difference between breeds was identified at the mid‐portion of the intermediate patellar ligament when both left and right ligaments were included (P = 0.02) and when comparing the right intermediate patellar ligament (P = 0.02). There were no other significant breed differences, and a parallel pattern was the most common pattern type. Two‐thirds of the horses in this study had bilaterally symmetrical patterns within the distal aspect of their intermediate patellar ligaments, while one‐third of the population were asymmetric. These results show that comparison of the contralateral limb during ultrasonography to determine if changes within the distal aspect of the intermediate patellar ligament are normal striations versus tears may lead to misdiagnosis in one‐third of horses, regardless of breed. Other signs of pathology on ultrasonography should be used instead. [ABSTRACT FROM AUTHOR]

Summary: A 3‐year‐old Quarter Horse filly presented with an acute history of right hindlimb lameness. Examination of the right hind found moderate effusion in the medial femorotibial joint and a consistent grade 4/5 right hindlimb lameness. Ultrasonographic evaluation of the medial femorotibial joint revealed a disruption of the synovial membrane in the medial recess of the joint capsule. Arthroscopy of the medial femorotibial joint identified a tear in the joint capsule at the attachment to the medial collateral ligament. Treatment with autologous conditioned serum, rest and firocoxib resulted in improvement in overall lameness. Follow‐up examination revealed an improved lameness score; however, a synovial hernia was identified on sonographic evaluation of the joint. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the association between meniscal lesions and severity of osteoarthritis (OA) among dogs that underwent Tibial Plateau Leveling Osteotomy (TPLO) for stabilization of cranial cruciate ligament rupture (CrCLR) at the University of Tennessee in 2011–2017. Results: There were a total of 252 meniscal tears. Factors associated with diagnosis of medial meniscal tears (MMT) in dogs were severe OA in comparison to no OA (3.8 OR, 2.0–8.0 95% CI, 0.001 p-value), sporting and mixed breed group compared to other breed (3.6 OR, 1.7–7.6 95% CI, 0.004 p-value; 3.2 OR, 1.6–6.6 95% CI, 0.019 p-value, respectively), increasing age (1.1 OR, 1.0-1.2 95% CI, 0.018 p-value), complete CrCLR compared to partial (3.3 OR, 2.1-5.0 95% CI, < 0.001 p-value), and arthrotomy compared to arthroscopy (2.2 OR, 1.4–3.1 95% CI, 0.002 p-value). The factors that did not have significance in predicting MMT were weight, sex, lameness period, and side affected. [ABSTRACT FROM AUTHOR]

Simple Summary: Osteoarthritis is a common disease in dogs, most often affecting the stifle joint and causing damage to all joint structures. Detecting early stages of osteoarthritis is important for an effective treatment. Conventional magnetic resonance imaging (MRI) is the golden standard imaging technique for diagnosing pathologies of soft tissues in the stifle joint. However, it is limited to the visualization of macroscopic tissue pathology. In contrast, quantitative MRI offers a more sensitive method for diagnosing early pathological changes, as it enables the detection of microstructural processes. The menisci play an important role in joint health. They undergo structural changes in osteoarthritis, including alterations in water content and collagen structures, as well as deviations in proteoglycan content. Different studies have shown the potential of special MRI sequences to identify these changes, e.g., T2 relaxation time. In this study, canine menisci of elderly dogs without clinical evidence of hindlimb lameness were examined histologically and using MRI. Our results showed that clinically healthy elderly dogs exhibited slight histological, probably age-related, degenerative changes in the menisci, but did not reveal significant radiological evidence of chronic inflammatory and degenerative changes, including no significant changes in T2 relaxation time. Osteoarthritis is a chronic disease that often affects the canine stifle joint. Due to their biomechanical function, the menisci in the canine stifle play an important role in osteoarthritis. They compensate for the incongruence in the joint and distribute and minimize compressive loads, protecting the hyaline articular cartilage from damage. Meniscal degeneration favors the development and progression of stifle joint osteoarthritis. Qualitative magnetic resonance imaging (MRI) is the current golden standard for detecting meniscal changes, but it has limitations in detecting early signs of meniscal degeneration. A quantitative MRI offers new options for detecting early structural changes. T2 mapping can especially visualize structural changes such as altered collagen structures and water content, as well as deviations in proteoglycan content. This study evaluated T2 mapping and performed a histological scoring of menisci in elderly dogs that had no or only low radiographic osteoarthritis grades. A total of 16 stifles from 8 older dogs of different sex and breed underwent ex vivo magnet resonance imaging, including a T2 mapping pulse sequence with multiple echoes. A histological analysis of corresponding menisci was performed using a modified scoring system. The mean T2 relaxation time was 18.2 ms and the mean histological score was 4.25. Descriptive statistics did not reveal a correlation between T2 relaxation time and histological score. Ex vivo T2 mapping of canine menisci did not demonstrate histological changes, suggesting that early meniscal degeneration can be present in the absence of radiological signs of osteoarthritis, including no significant changes in T2 relaxation time. [ABSTRACT FROM AUTHOR]

IntroductionThe objective of this study was to investigate the effect of a novel screw type on stiffness and failure characteristics of a tibial plateau leveling osteotomy (TPLO) construct under cyclic loading conditions. The authors hypothesized that bone-screw-fasteners (BSF) would result in superior biomechanical stability compared with locking buttress screws (LBS).Materials and MethodsTwelve pairs of canine cadaveric pelvic limbs were included in this ex vivo biomechanical study. A TPLO was performed using a 3.5mm locking TPLO plate and stabilized using either LBS or BSF. Cyclic loading was performed for 30,000 cycles at 4Hz with a peak-load of 1000N (50N valley). The cyclic test was then continued by stepwise incremental increase of peak-load at a rate of 75N per 500 cycles until failure.ResultsCycles to failure for LBS (44,260 ± 5,770) and BSF (41,540 ± 7,686) were not significantly different (p = 0.36). Maximum force for LBS (3,134 ± 797N) and BSF (2,940 ± 831N) was not significantly different either (p = 0.58). Dynamic stiffness for LBS (1,778 ± 932 N/mm) and BSF (1,574 ± 677 N/mm) was not significantly different (p = 0.58).DiscussionStabilization of the TPLO with BSF provided similar biomechanical stability under cyclic axial loading conditions as the LBS. BSF may be an acceptable alternative to traditional locking screws for TPLO.

IntroductionThe cranial cruciate ligament (CCL) is one of numerous structures which determine the path of the tibia relative to the femur when passively flexing/extending the stifle of the dog. The effect of cutting the CCL on passive motion with the hind limb in different orientations, is unknown. The aim of this study was to describe passive movement of the tibia relative to the femur in dogs, with the hind limb in three different orientations, and with CCL intact and cut.MethodsTen cadaveric hind limbs were obtained from dogs weighing between 20 kg and 25 kg and prepared for testing in a custom-built joint testing machine. Each hind limb was tested in three different orientations with data collected, using an electromagnetic tracking system, during 2 cycles of flexion/extension with the CCL intact and cut. Each cycle was initiated with the stifle in full extension (0°) and data was collected at 0°, 20°, 30°, 40°, 45°, and 55° of stifle flexion/extension.ResultsFlexion of the stifle resulted in caudal translation and internal rotation of the tibia relative to the femur, with cranial translation and external rotation occurring during extension along the identical path. Cutting the cranial cruciate ligament did not result in significant differences in translation or rotation when the stifle was orientated to approximated the standing position of a dog.DiscussionIsometric points at the origin and insertion of the CCL can potentially be identified in CCL deficient stifles using a technique based on passive motion of an intact stifle.

Category of research Treatment. Number and type of study designs reviewed Two relevant publications were found, both were retrospective case series. Strength of evidence Weak. Outcomes reported The success rate of horses returning to previous level of competition following arthroscopic debridement varies widely in the literature available, from 25–86%. While a study reports 64% return to soundness following rest, it is not clear which horses received strict box rest or paddock rest, the duration of the rest period, and whether non-steroidal anti-inflammatory drugs were also prescribed. It is also worth noting that all horses which undergo surgery will also undergo a period of box rest – which makes the two treatment options difficult to compare. Conclusion Newer techniques with better success rates are now available and should be considered in lieu of box rest or arthroscopic debridement. Across all treatments available, age remains an important factor with regards to return to soundness, with older horses having a poorer prognosis. Thorough examinations should therefore be performed to rule out concurrent conditions before deciding upon treatment options. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

The purpose of this case report is to describe the functional and clinical outcome of a tibial plateau leveling osteotomy (TPLO) in a dog with joint instability and persistent lameness following a Tibial Tuberosity Advancement surgery (TTA) Rapid. A six-year-old male Labrador retriever (38 kg) with a tibial plateau angle of 27° and a patella ligament to tibial plateau angle of 102° and persistent lameness lasting six months after TTA Rapid surgery has been examined. During orthopedic examination, the lameness was subjectively graded 3/5 and the positive drawer and tibial compression tests were performed. The TTA Rapid cage and all screws were completely removed from the tibia to have enough room to perform a TPLO radial cut. A lameness score evaluation, client satisfaction and radiographic follow-up were performed at 4 weeks, 8 weeks and 6 months postoperatively. Long-term follow-up showed radiologically excellent healing with fusion of the gap and disappearance of the osteotomy line. Six months postoperatively, no lameness was detected at a walk and trot. The owner was completely satisfied and reported the dog being free from lameness even after long walks. No complications related to the TPLO surgery occurred.

ObjectiveThe purpose of this study was to quantify three-dimensional (3D) stifle kinematics during walking in dogs with complete cranial cruciate ligament insufficiency (CCL-I) treated with a CORA-based leveling osteotomy (CBLO).Study designFour client-owned dogs with unilateral complete CCL-I were prospectively enrolled. Custom digital 3D models of the femora and tibiae were created from pre-and postoperative computed tomographic scans for each dog. Lateral view fluoroscopic images were collected during treadmill walking preoperatively and 6 months after CBLO. Results were generated using a 3D-to-2D image registration process. Pre-and postoperative stifle kinematics (craniocaudal translation, extension angle) were compared to that of the unaffected contralateral (control) stifle. Force plate gait analysis was performed, and symmetry indices (SI) were calculated for peak vertical force (PVF) and vertical impulse (VI).ResultsAfter CBLO, craniocaudal femorotibial motion was reduced by a median (range) of 43.0 (17.0–52.6) % over the complete gait cycle. Median (range) PVF SI was 0.49 (0.26–0.56) preoperatively and 0.92 (0.86–1.00) postoperatively, and VI SI was 0.44 (0.20–0.48) preoperatively and 0.92 (0.82–0.99) postoperatively.ConclusionCBLO mitigated but did not fully resolve abnormal craniocaudal translation; lameness was substantially improved at 6 months.

Simple Summary: Many orthopedic and neurological pathologic conditions can potentially lead to or be affected by joint instability. Standard magnetic resonance imaging, as a static technique that examine joints and body parts in functional rest, can underestimate or overlook key diagnostic findings. As a result, kinematic magnetic resonance imaging techniques were developed to evaluate joints and body parts under stress and load conditions or during movement. In human medicine, the real-time acquisition technique is one of the modalities for acquiring kinematic magnetic resonance imaging, and has gained popularity in recent years. This proof-of-concept study was designed to test the feasibility of real-time acquisition techniques in veterinary medicine for the first time. Based on the results of this preliminary cadaveric study, real-time kinematic magnetic resonance imaging may be a feasible and valuable procedure to be applied to the canine cervical spine and stifle joints. Moreover, given the ease of execution and the concise duration of acquisitions, it could be applied in a regular standard protocol MRI with little additional effort, risk, and cost. In this proof-of-concept study, a good visualization of the canine cervical spine and stifle joint was achieved, showing the potential of real-time acquisition techniques for clinical and research applications. Kinematic MRI (kMRI) is a novel human imaging technique that couples the excellent soft tissue contrast and multiplanar capabilities of traditional MRI with kinematic potential. The study's goals are: (1) testing the feasibility of spinal cord and joints real-time kMRI; and (2) evaluating the quality of these kinematic studies as a new diagnostic option in veterinary medicine. Standard and real-time kinematic MRI were performed on cervical spine, elbow, and stifle joints of seven cadavers. Studies were repeated after a surgical insult aimed to create a certain degree of joint instability. A total of 56 MRI were performed—7 cervical spinal tracts, 3 elbow joints, and 4 stifle joints were examined. The technique was feasible in all the three regions examined. The images were considered of excellent quality for the stifle joint, good to fair for the cervical spine, whereas two of three elbow studies were considered to have unacceptable image quality. Additionally, real-time kMRI provided good to excellent information about stifle instability. Therefore we consider kMRI a promising technique in veterinary medicine. Further studies and an in vivo setting are needed to increase the quality of the kMRI images, and to fully evaluate clinical usefulness. [ABSTRACT FROM AUTHOR]

Simple Summary: This study provides initial information on the effect of platelet rich plasma in some of the most important pro-inflammatory cytokines identified in osteoarthritic stifle joint in dogs. The use of platelet rich plasma is getting more popular in the veterinary field but its effect in those cytokines is not known. Evaluation of effect of Leukoreduced Platelet Rich Plasma (LrPRP) on TNF-α and IL-6 (pro-inflammatory cytokines) in joint fluid in dogs with cranial cruciate ligament rupture (CCLR). Eight client-owned dogs with CCLR were assigned to treatment (2 mL LrPRP) or control (2 mL saline) injection groups. Day of evaluation (day 0) and day of surgery (day 10–14), joint fluid was collected and joint injected. Joint fluid was also collected on day of suture removal (day 20–28). TNF-α and IL-6 concentrations of joint fluid were measured using a bead-based antibody assay. Concentrations at the later time points were expressed as a ratio to the initial level within each stifle. LrPRP had a mean concentration of platelets 1.7 times higher that of whole blood on day of evaluation and 1.4 times higher on day of the surgery. Leukocytes were reduced by 99.7%. On day of surgery, TNF-α ratios in the joint fluid from dogs injected with LrPRP were significantly different that TNF-α ratios of control group. On the day of suture removal ratios of IL-6 and TNF-α were lower in LrPRP treatment group compared with control group; however, differences were not significant. LrPRP modulate ratios of pro-inflammatory cytokine TNF-α in dogs with CCLR. [ABSTRACT FROM AUTHOR]

Considering the prevalence of cranial cruciate ligament disease (CCLD) and concurrent medial patellar luxation (MPL) among dogs, and the concomitant bone deviations routinely identified, the aim of this study is to evaluate the efficacy of the combination between distal femoral osteotomy (DFO) and modified tibial plateau levelling osteotomy (mTPLO) for the treatment of MPL with distal femoral varus, tibial torsion, and CCLD. Dogs with concurrent MPL and CCLD that underwent DFO and mTPLO procedures were included. Subjective clinical evaluations of gait and pre-operative and immediate post-operative radiographic examinations were performed. Surgical data were documented. The anatomical lateral distal femoral angle (aLDFA), femoral varus angle, mechanical medial proximal tibial angle, and tibial plateau angle (TPA) were compared between the pre- and post-operative periods. A total of 12 dogs were included in this study. Closing-wedge DFO and mTPLO procedures were performed on 14 limbs. The mean pre-operative and post-operative aLDFA values were 104.8 ± 3.9° and 95.4 ± 2.4°, respectively. TPA values were 26.2 ± 3.7° pre-operatively and 6.3 ± 3.2° post-operatively. Bone healing was observed in 7.1 %, 71.3 %, and 85.5 % of patients at the first, second, and third follow-up, respectively. Lameness was resolved in 28.5 %, 78.5 %, and 100 % at 30, 60, and 90 days, respectively. No major peri- or post-operative complications were reported. The combination of mTPLO and DFO aligns the stifle extensor mechanism, promoting dynamic stabilization. It can be considered for the treatment of concurrent MPL and CCLD in dogs, performed as a single procedure, and is associated with favorable short-term outcomes., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Patellar ligament (PL) injuries are increasingly being reported in horses, but few studies have described the normal PL ultrasonographic appearance in horses. The aims of this prospective observational study were to describe the ultrasonographic appearance of the PLs and infrapatellar fat pad in a population of horses in training and to relate the ultrasonographic findings to objectively measured movement asymmetry. B-mode and color Doppler ultrasonographic examination of the PLs and infrapatellar fat pad in both hind limbs and objective gait analyses were performed on the 116 riding and trotting horses included in the study. The association between ultrasonographic findings, horse age, and movement asymmetry during the trot was then investigated. Distinct or diffuse hypoechoic regions were commonly found in the intermediate PL (24/116; 20.7%), especially in the caudal aspect of the mid-third of the ligament. The infrapatellar fat pad had a hypoechoic striated appearance in all horses except one, in which it was hyperechoic. No association was found between ultrasonographic findings in the PLs and infrapatellar fat pad and lameness. It is important to recognize that there is biological variation in PL appearance, which may or may not be associated with pain in this area, therefore emphasizing the use of local analgesia to determine the location of the lameness., (© 2024 The Author(s). Veterinary Radiology & Ultrasound published by Wiley Periodicals LLC on behalf of American College of Veterinary Radiology.)

Simple Summary: Tibial tuberosity advancement is a method of surgical treatment of cranial cruciate ligament rupture in animals.. In previous reports, the biomechanical effectiveness of tibial tuberosity advancement surgeries was evaluated by axial pressure on the tibial tuberosity to test the strength and resistance of the fixation or by pulling on the tuberosity. To our knowledge, there are no reports that examined the strength that is needed to pull out an implant from the tibia after tibial advancement. This study is the first report that focuses on pulling out the TTA implant, which corresponds to the biointegrity and ingrowth of the TTA cage with the tibia. Background: Modifications of tibial tuberosity advancement are well accepted for cranial cruciate rupture repair. We compared the loads that were needed to pull the TTA CF cage out in the two groups. The first group consisted of five sheep in which osteotomy and TTA CF cage fixation were performed as assumed preoperatively. The second group consisted of five sheep in which intraoperative or postoperative discrepancies from preoperative planning were found. This is also the first report describing biomechanical testing after tibial tuberosity advancement with cranial implant fixation (TTA CF) surgical procedures. Results: A total of 10 ovine proximal tibiae were tested biomechanically by tearing out TTA CF implants from the bone. The mean maximal loaded forces to pull out the cage in Group 1, in which fixation of the implant was performed as assumed preoperatively, was 878 ± 61 N, and in Group 2, in which discrepancies from preoperative planning were found, was 330 ± 55 N. The mean implant displacement under maximal load to failure was 2.6 mm and 2.2 mm in Groups 1 and 2, respectively. There was a significant difference between Group 1 and Group 2 in the maximal loads-to-failure; however, the difference in the displacement at maximal loaded forces to pull out the cage was not significant between the groups. Conclusions: The mean maximal loaded forces to pull out the cage was significantly lower in Group 2, where discrepancies from preoperative planning were found (878 ± 61 N vs. 330 ± 55 N). The lower forces that were needed to extract the TTA CF implant from the tibia can lead to the conclusion that biointegration of the implant is also weaker. Correct positioning of the osteotomy line and TTA CF implant is essential for good biointegrity and thus for limiting complications in the form of tibial tuberosity avulsion fracture or tibial shaft fracture. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome. Methods: The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners. Results: Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5–204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome. Conclusions and relevance: Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate. [ABSTRACT FROM AUTHOR]

ObjectiveThe purpose of this study was to develop and test a quantitative stifle function score (SFS) in dogs with unilateral cranial cruciate ligament disease by combining clinical measures and functional tests. The objective of this study was to compare the proposed SFS to a symmetry index (SI) calculated from objective ground reaction forces (GRFs). We hypothesized that the SFS would have a strong correlation with SI.MethodsDogs with surgically and nonsurgically treated unilateral cranial cruciate ligament rupture and dogs with no known musculoskeletal problems were included in the study. Each dog was scored using the SFS and trotted across a force platform to obtain GRFs and calculate the SI, based on vertical GRFs. Fourteen items were included in the SFS: limb use at a walk, limb use at a trot, lameness at a walk, lameness at a trot, stair climbing, sit-to-stand, dancing, pain response, stifle effusion, thigh circumference/muscle atrophy, stifle extension, stifle flexion, and cranial drawer/tibial thrust, with each item scored based on previously determined criteria. A perfect SFS would receive a score of 100.ResultsTwenty-seven dogs were included in the study: twenty-one with unilateral cranial cruciate ligament disease and six control dogs. The mean SFS was 71.5 out of 100. To further characterize the association between SFS and SI the degree of gait asymmetry using SI was classified as 25% difference between the pelvic limbs for all dogs. The mean SFS for each of the five categories were 97.8, 85.2, 65.4, 63, and 56.4, respectively. Correlation of SI and SFS was −0.863 (p < 0.0001). All of the individuals evaluated tests in the score were significantly correlated with SI except for pain response and stifle flexion. The SFS is in strong agreement with the SI, as confirmed by Bland–Altman analysis.ConclusionThe SFS had a significant correlation and agreement with the SI calculated from GRFs. This SFS may be a useful, simple, and inexpensive tool to use in a clinical environment to monitor progression during the rehabilitation and recovery process following unilateral cranial cruciate ligament rupture.

The agouti (Dasyprocta prymnolopha, Wagler 1831) is a wild rodent of great zootechnical potential, a fact that enables anatomical and morphological studies to support management actions with this animal. In this perspective, this study aimed to describe the anatomy and histology of the agouti stifle joint. Four adult agoutis were used, two females and two males. The animals were submitted to dissection and identification of the structures of the stifle joint. For light microscopy study, samples of the patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments were used. Agouti has a highly congruent patellofemoral joint; elongated patella; medial and lateral fabellae at the proximal insertion of the gastrocnemius muscle; medial and lateral meniscus with lunula; in addition to the presence of the following ligament structures: patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments, meniscofemoral ligament, caudal meniscal ligament of the medial meniscus, and medial and lateral cranial ligaments. The patellar ligament presents bundles of parallel collagen fibers with a straight path and coated fibroblasts; collateral and cruciate ligaments had loose and dense connective tissue, coated fibroblasts and collagen bundle undulations, the latter most expressive in the caudal cruciate ligament. Thus, except for the shape and angulation of the stifle, which allows specific movements, the agouti stifle has structures analogous to that of other rodents and domestic animals. [ABSTRACT FROM AUTHOR]

Abstract Background Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively. Results The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected. Conclusions Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.

ABSTRACT The effects of two vibration platform (VP) exercise protocols on stifle and rectal temperatures were evaluated. Eleven animals participated in two exercise protocols, different in duration in each exercise. Exercise protocol 1 (EP1) took 30 seconds and EP2, 60 seconds, with different vibratory levels in both cases (L1 = acceleration ≅ 1g, L4 = acceleration ≅ 2.5g, and L7 = acceleration ≅ 5g). The animals were evaluated before and 1 minute after the exercise, using infrared thermography to obtain stifle temperatures. The rectal temperature (RT) was also checked at each moment. The dogs had higher stifle temperatures in EP1 at all vibratory levels compared to the time before the exercise; EP2 resulted in higher temperature only at maximum vibration intensity (L7). Increase in TR was observed only in EP2. The results suggested that the short duration protocol (EP1) increased the muscular and peripheral vascular activities of the joint, regardless of the vibration intensity. The long duration protocol (EP2) with maximum vibration intensity increased the RT, demonstrating activity beyond the stifle muscle group. It is concluded that exercises on the VP can be used as complementary therapy for low-impact muscle activity in dogs and may be adequate for efficient energy consumption.

Kurt P Venator,* Christopher W Frye,* Lauri-Jo Gamble, Joseph J Wakshlag Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY 14853, USA*These authors contributed equally to this workCorrespondence: Joseph J WakshlagCornell University College of Veterinary Medicine, Vet. Med. Center C2-008, Ithaca, NY 14853, USATel +1 607 351 6545Email dr.joesh@gmail.comPurpose: The use of platelet-rich plasma (PRP) to treat canine osteoarthritis has gained support within the scientific community. PRP effects on pain control for degenerative joint disease induced by naturally occurring cranial cruciate ligament instability are limited, particularly in a cohort of dogs with chronic instability and osteoarthritis (> 12 months), representing a commonly encountered clinical population that often defaults to medical management. The goal of this study was to assess the effects of a single intra-articular PRP injection into an effected stifle in this cohort, to assess response to treatment, quantitative kinetic data as it relates to percent body weight for peak vertical force (PVF) and vertical impulse (VI) were collected, and symmetry indices related to PVF were determined.Methods: Twelve dogs with unilateral or bilateral osteoarthritis with ruptured, non-stabilized cranial cruciate ligaments over 12 months duration were identified. Unilateral injections of 2.5 mL of a PRP preparation into the most severely affected stifle based on kinetic analysis was performed. Repeat pressure-sensitive walkway analysis was conducted monthly for 3 months. Peak vertical force (PVF) and vertical impulse (VI) were normalized to body weight and identified in all four limbs. Previously published symmetry indices regarding PVF were calculated, comparing the treated limb with the contralateral limb, ipsilateral forelimb, and contralateral forelimb.Results: After treatment, hind limb symmetry index (SI) regarding PVF showed improved symmetry, suggesting more weight placement at all-time points after injection of the most affected limb (p < 0.01). Further, PVF asymmetry indices assessing contralateral fore (CFL) and hind limb (CHL) as well as ipsilateral forelimb (IFL) revealing a significant decrease from baseline for CHL at week 4 (p = 0.02), but not weeks 8 and 12. The CFL showed decreased differences in symmetry from baseline at each time point (p = 0.03). There were no statistically significant changes in PVF or VI over time in treated dogs.Conclusion: A single injection of PRP improved kinetics for minimally 4 weeks with some data suggesting an effect for up to 12 weeks. Therefore, PRP might be a viable therapeutic option for instability and inflammation associated with chronic osteoarthritis due to cranial cruciate ligament disease in the non-surgical patient.Keywords: platelet, stifle, canine, osteoarthritis and cruciate

Osteoarthritis is a chronic disease that often affects the canine stifle joint. Due to their biomechanical function, the menisci in the canine stifle play an important role in osteoarthritis. They compensate for the incongruence in the joint and distribute and minimize compressive loads, protecting the hyaline articular cartilage from damage. Meniscal degeneration favors the development and progression of stifle joint osteoarthritis. Qualitative magnetic resonance imaging (MRI) is the current golden standard for detecting meniscal changes, but it has limitations in detecting early signs of meniscal degeneration. A quantitative MRI offers new options for detecting early structural changes. T2 mapping can especially visualize structural changes such as altered collagen structures and water content, as well as deviations in proteoglycan content. This study evaluated T2 mapping and performed a histological scoring of menisci in elderly dogs that had no or only low radiographic osteoarthritis grades. A total of 16 stifles from 8 older dogs of different sex and breed underwent ex vivo magnet resonance imaging, including a T2 mapping pulse sequence with multiple echoes. A histological analysis of corresponding menisci was performed using a modified scoring system. The mean T2 relaxation time was 18.2 ms and the mean histological score was 4.25. Descriptive statistics did not reveal a correlation between T2 relaxation time and histological score. Ex vivo T2 mapping of canine menisci did not demonstrate histological changes, suggesting that early meniscal degeneration can be present in the absence of radiological signs of osteoarthritis, including no significant changes in T2 relaxation time.

Goniometry is an essential skill used in veterinary rehabilitation settings to monitor orthopedic conditions. Our objectives were to create a normal canine stifle goniometry model and to compare students' confidence and accuracy in performing goniometry with exposure to either the model or traditional teaching methods. We hypothesized that students would demonstrate goniometry skills more confidently and accurately after using a simulation model than those given traditional materials. A flexible model of a canine stifle was made. Twenty-eight veterinary students (8 clinical, 20 pre-clinical) prepared with either instructional material from a textbook ( n = 15) or access to the stifle model ( n = 13), and then assessed when performing goniometry (live dog). Students completed pre- and post-surveys where they indicated their confidence and anxieties. Statistical analyses included thematic analysis, descriptive statistics, and Chi-square analyses (significant at p ≤ .05). There was no difference in goniometry assessment or anatomy palpation scores between the model and reading groups. Clinical students ( n = 8) achieved higher scores in goniometry assessment ( p = .01) and anatomy palpation ( p = .04). Students were more confident when identifying their anatomical landmarks after using prep materials as compared to before using the prep materials ( p = .03), but only averaged identification of 3 out of 5 landmarks. Half could not correctly read the goniometer. In general, learning with models was preferred by all. There was no difference in learning between the model and textbook, so either can be used based on student preference. Further goniometer instructions should be provided. Anatomy of live dogs should be assessed more frequently pre-clinically.