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Berger et al: The use of subchondral bone topography to approximate the center of rotation of the elbow joint in dogs
Veterinary Surgery 1, 2023

🔍 Key Findings

  • COR of elbows with FMCP was significantly more caudal compared to normal elbows, based on CT-derived geometry.
  • In normal elbows, 74% of medial and 93% of lateral axes exited cranial and distal to the epicondyles.
  • In FMCP elbows, 81% of medial and 70% of lateral axes exited caudal and distal to the epicondyles.
  • Different landmark combinations produced slightly different COR approximations, especially between humeral vs. radius/ulna-based axes.
  • The medial-lateral axis using trochlea and capitulum centers provided the most consistent COR approximation.
  • COR estimations based on diseased elbows may not match normal joint geometry, impacting implant alignment accuracy.
  • External epicondylar landmarks may be useful intraoperatively to estimate COR location, but variability limits precision.
  • Drill diameter size may buffer small COR differences, but impact in advanced disease or bilateral cases remains unclear.

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← Articles

Berger et al: The use of subchondral bone topography to approximate the center of rotation of the elbow joint in dogs
Veterinary Surgery 1, 2023

🔍 Key Findings

  • COR of elbows with FMCP was significantly more caudal compared to normal elbows, based on CT-derived geometry.
  • In normal elbows, 74% of medial and 93% of lateral axes exited cranial and distal to the epicondyles.
  • In FMCP elbows, 81% of medial and 70% of lateral axes exited caudal and distal to the epicondyles.
  • Different landmark combinations produced slightly different COR approximations, especially between humeral vs. radius/ulna-based axes.
  • The medial-lateral axis using trochlea and capitulum centers provided the most consistent COR approximation.
  • COR estimations based on diseased elbows may not match normal joint geometry, impacting implant alignment accuracy.
  • External epicondylar landmarks may be useful intraoperatively to estimate COR location, but variability limits precision.
  • Drill diameter size may buffer small COR differences, but impact in advanced disease or bilateral cases remains unclear.

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Multiple Choice Questions on this study

In Berger 2023 et al., on elbow COR estimation, what was the most common exit location of axes in *normal* elbows on the lateral cortex?

A. Proximal and caudal to the epicondyle
B. Cranial and distal to the epicondyle
C. Medial and cranial to the epicondyle
D. Lateral and proximal to the epicondyle
E. Central and distal to the epicondyle

Answer: Cranial and distal to the epicondyle

Explanation: In normal elbows, 93% of lateral exit points were cranial and distal to the lateral epicondyle.
In Berger 2023 et al., on elbow COR estimation, which axis provided the most consistent approximation of the elbow joint COR in dogs?

A. Radius-ulna axis
B. Medial/central axis
C. Lateral/central axis
D. Capitulum-centered axis
E. Medial-lateral axis

Answer: Medial-lateral axis

Explanation: The medial-lateral axis based on centers of trochlea and capitulum had the most consistent exit points.
In Berger 2023 et al., on elbow COR estimation, why may it be challenging to match COR in diseased elbows with the normal contralateral joint?

A. Because dogs tolerate large COR differences well
B. Because CT cannot detect COR differences
C. Because FMCP alters bone landmarks and geometry
D. Because drill angle cannot be controlled intraoperatively
E. Because epicondyles are symmetrical in all dogs

Answer: Because FMCP alters bone landmarks and geometry

Explanation: FMCP causes caudal displacement of COR and landmark changes, complicating surgical alignment.
In Berger 2023 et al., on elbow COR estimation, how might external epicondylar landmarks assist in elbow surgery?

A. They allow accurate diagnosis of FMCP
B. They eliminate need for imaging
C. They approximate COR for implant alignment
D. They improve cartilage visualization
E. They reduce FMCP progression

Answer: They approximate COR for implant alignment

Explanation: Epicondyles were used to relate exit points of COR axes, potentially aiding intraoperative tunnel guidance.
In Berger 2023 et al., on elbow COR estimation, how did the COR in FMCP elbows compare to normal elbows?

A. It was more cranial
B. It was more lateral
C. It was more distal
D. It was more caudal
E. It was more proximal

Answer: It was more caudal

Explanation: CT-based analysis showed that the COR in FMCP elbows shifted caudally compared to normal.

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