🔍 Key Findings

• m-TTT yielded a low overall major complication rate (4.3%) and minor complication rate of 15%, consistent with or better than previous techniques.
• Patellar reluxation occurred in only 4.3% of stifles, with high-grade reluxation seen in just 0.6% of cases—lower than the 12.4–21% range reported for other techniques.
• Implant migration rate was 3.7%, lower than previously reported for smooth pin fixation (7.7–24.6%).
• Use of a tension band with single Steinmann and Kirschner wire reduced stress risers and fixation failure, supporting better stability.
• Tibial tuberosity fracture occurred in only 1.3% of cases, lower than the 1–6% seen in other reports.
• All long-term major complications (1.3%) were related to pin migration, but were easily resolved.
• Radiographic follow-up confirmed complete bone healing in all examined cases, even up to 9 years postoperatively.
• Owner satisfaction was 100%, and 95% rated quality of life as good to excellent based on CBPI surveys.

🔍 Key Findings

• Delayed union occurred in 13.9% of fractures; non-union in 4.6%; mal-union in 0.7%
• Major implant failure increased odds of delayed or non-union by 12.9×
• Surgical site infection increased risk 3.2×; bone grafting (any type) was also associated (OR 3.3)
• Comminuted fractures had 4.2× greater odds of delayed or non-union
• Older age increased risk, with odds increasing by 21% per year
• Radius and ulna fractures in toy breeds were not high risk, contrary to historical belief
• Most non-unions required revision surgery with rhBMP-2 or autograft to achieve union
• Ilium fractures showed 0% delayed/non-union — possibly due to robust muscle envelope

🔍 Key Findings

• Augmenting FEESA with two simple interrupted crotch sutures (TCS) or simple continuous crotch suture (SCCS) significantly increased initial leakage pressure (ILP) compared to no suture or a single suture (NCS, SICS).
• SCCS had the highest ILP (47.6 mm Hg), followed by TCS (37.8 mm Hg), SICS (33.0 mm Hg), and NCS (27.1 mm Hg).
• All crotch suture types increased maximal leakage pressure (MLP) compared to no crotch suture.
• Leakage from the crotch occurred most commonly in NCS (67%) and SICS (50%), but only 8% with TCS and 0% with SCCS.
• SCCS was the only technique where leakage never occurred at the crotch site.
• SCCS had the highest MLP (100.6 mm Hg), supporting its use in clinical settings with high-risk patients.
• Intraluminal pressures during leakage in NCS constructs were sometimes below normal physiologic pressures, emphasizing risk of leakage without crotch suture.
• The transverse staple line never leaked in any group, indicating the crotch is the primary weak point.

🔍 Key Findings

• TPLO mRUST scoring showed improved inter-rater reliability (ICC = 0.56) compared to subjective evaluation (Kappa = 0.33).
• Intra-rater reliability was similar for both methods (TPLO mRUST: 0.73, subjective: 0.72).
• TPLO mRUST scores ≥10/12 strongly correlated with radiographic union, as subjectively assessed (99% agreement).
• No significant difference in healing between first and second TPLO sides (P = .09), countering assumptions about load-bearing impact.
• Higher initial lameness scores and younger age were associated with higher TPLO mRUST scores, suggesting more robust healing in those groups.
• Postoperative complications were linked to lower TPLO mRUST scores, indicating impaired healing.
• Medial cortex was excluded from scoring due to plate obstruction, validating use of only 3 cortices for scoring.
• The TPLO mRUST system may standardize healing assessment, reducing subjective bias across specialties.

🔍 Key Findings Summary

• Study Design: Prospective case series of 52 scans from 44 dogs with CCL injury.
• Main Technique: 16-slice CTA; evaluated by 3 observers with varying experience; validated against surgical mini-medial arthrotomy findings.
• Diagnostic Metrics (Reading 2):
  • Sensitivity: 1.00 (Observers 1 & 2), 0.93 (Observer 3)
  • Specificity: 0.78–0.91
  • Positive Likelihood Ratio: Up to 10.71
  • Negative Likelihood Ratio: As low as 0.08
  • Accuracy: 90%+ for all in Reading 2
• Observer Effect: Significant improvement between first and second reading for less experienced observers (p < 0.05); learning curve evident.
• Meniscal lesions found:
  • 9/12 in suspected late meniscal injury cases
  • 19/40 in newly diagnosed CCL cases
  • Most common = bucket handle tears
• Conclusion: Multidetector CTA is a clinically useful, non-invasive tool for identifying medial meniscal lesions in dogs with CCL disease.

🔍 Key Findings Summary

• IMN provides relative stability, resists bending/torsion due to central axis alignment
• Larger diameter nails = exponentially greater stiffness (∝ D⁴)
• Trade-off: Larger interlocking holes weaken fatigue strength of the nail
• Reaming increases contact/stability but has pros/cons:
  • Improves outcomes in closed fractures
  • May reduce endosteal blood flow in thin-walled bones (e.g., cats)
• Design advances:
  • Angle-stable IMN reduce rotational slack
  • Expandable nails simplify insertion but may compromise removal or compressive load resistance
  • Precontoured nails match bone curvature but lack consistent clinical superiority
• Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)

🔍 Key Findings Summary

• Retrospective study of 33 fractures in 31 cats with Salter–Harris I or II distal femoral fractures
• Used 1 intramedullary Steinmann pin + 1 laterally placed antirotational pin
• 96.9% achieved full functional outcome at mid-term follow-up
• No implant migration or removal required
• Minor complications: 2 seromas; Major: 3 (patellar luxation [2], osteomyelitis [1])
• Growth plate remained open in 27.3% of cases at 6–8 weeks post-op

🔍 Key Findings

• Postoperative complications occurred in 20% of stifles, including 7.5% minor, 10.3% surgical, and 3.4% medical complications.
• The PROSPECT machine-learning model achieved high predictive accuracy: 92.3% for surgical complications, 91.9% for minor, and 94.3% for medical.
• Top predictive features included surgical technique, implant type, patient age, and surgeon identity.
• Surgeon-specific variables influenced predictions, indicating operator experience and technique matter.
• Engineered interaction features (e.g., breed × implant) were more predictive than raw clinical data alone.
• Rottweiler, intact male status, and higher bodyweight were associated with increased complication risk; Labradors had decreased risk.
• Model calibration was strong, especially for high and low probability predictions; midrange predictions were less reliable.
• The model supports individualized, probabilistic risk assessment, which could inform client counseling and tailored postoperative care.

PROSPECT = Predicting Risk Of Surgical compli­cations aftEr CCWO and TPLO