Quiz Question

In Sullivan 2025 et al., on TTT stabilization methods, what theoretical advantage does the spacer pin technique offer?

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Correct. Avoiding tuberosity pins may reduce risk of soft tissue irritation or fracture.
Incorrect. The correct answer is Avoids placing pins through tuberosity.
Avoiding tuberosity pins may reduce risk of soft tissue irritation or fracture.

🔍 Key Findings

  • Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
  • All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
  • Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
  • Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
  • No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
  • Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
  • Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
  • Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.

Sullivan

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

2025-3-VCOT-sullivan-4

Article Title: Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Lomas 2025 et al., on hybrid THR in cats, what was the most common indication for total hip replacement (THR) in this cohort?

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Correct. SCFE accounted for 13 out of 17 hips treated, making it the most common indication.
Incorrect. The correct answer is Slipped capital femoral epiphysis.
SCFE accounted for 13 out of 17 hips treated, making it the most common indication.

🔍 Key Findings

  • Hybrid THR in cats showed no major complications across 17 hips in 15 cats, including 2 bilateral cases.
  • Postoperative radiographs confirmed stable implant positioning with no loosening, migration, or dislocation in follow-up imaging.
  • Mean owner satisfaction was high, with a mean short-form feline musculoskeletal pain index (sf-FMPI) score of 2/36 at a mean follow-up of 438 days.
  • SCFE (slipped capital femoral epiphysis) was the most common indication, seen in 13/17 hips.
  • Partial tenotomy of rectus femoris origin resolved intraoperative medial patella luxation in 3 cases—no cats required surgical correction later.
  • A micro BFX cup allowed for increased acetabular offset, possibly reducing luxation risk even when using a +0 femoral head offset.
  • Hybrid THR was successfully used as a revision for failed CFX THR due to recurrent luxation—implants remained stable post-revision.
  • Use of oversized cups (12 mm) with shallow seating or medial breach still resulted in stable outcomes, suggesting good implant fixation even with reduced bone stock.

Lomas

Veterinary Surgery

6

2025

Medium‐term outcomes of hybrid total hip arthroplasty in cats: Cemented femoral stem and cementless acetabular cup in 17 hips (2020–2023)

2025-6-VS-lomas-1

Article Title: Medium‐term outcomes of hybrid total hip arthroplasty in cats: Cemented femoral stem and cementless acetabular cup in 17 hips (2020–2023)

Journal: Veterinary Surgery

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In Longo 2022 et al., on CT-guided osteotomies, what was the most common osteotomy location used in this study?

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Correct. Femoral diaphyseal osteotomies were most commonly performed (10/22).
Incorrect. The correct answer is Femoral diaphysis.
Femoral diaphyseal osteotomies were most commonly performed (10/22).

🔍 Key Findings

  • 3D CT volume rendering and CAL measurement successfully guided correction of femoral and tibial torsion in dogs with patellar luxation (PL).
  • Physiological patellar tracking was restored in 100% (22/22) of cases after detorsional osteotomy.
  • 94% of dogs (17/18) had either full or acceptable functional outcomes post-surgery.
  • CAL-based correction was accurate in 19/22 cases, confirming reliability of the measurement technique.
  • Complication rate was 45%, with major complications in 2/22 cases—both involved combined femoral and tibial osteotomies.
  • Combined femoral and tibial osteotomies in the same limb were linked to a higher risk of complications and poorer outcomes.
  • Diaphyseal osteotomies offered more implant space, but metaphyseal locations were associated with faster bone healing.
  • Use of a TPLO jig or goniometer was not essential—CAL-based bone marking was sufficient in most cases.

Longo

Veterinary Surgery

7

2022

Three‐dimensional volume rendering planning, surgical treatment, and clinical outcomes for femoral and tibial detorsional osteotomies in dogs

2022-7-VS-longo-4

Article Title: Three‐dimensional volume rendering planning, surgical treatment, and clinical outcomes for femoral and tibial detorsional osteotomies in dogs

Journal: Veterinary Surgery

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In Espinel Rupérez 2023 et al., on hip toggle stabilization, what was a major cause of technique deviation?

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Correct. This was a common deviation; though implant positions were ideal, 8 major deviations were noted—all in the femoral tunnel.
Incorrect. The correct answer is Femoral tunnel exit outside fovea capitis.
This was a common deviation; though implant positions were ideal, 8 major deviations were noted—all in the femoral tunnel.

🔍 Key Findings

  • Arthroscopic-assisted hip toggle stabilization (AA-HTS) was successfully completed in all 14 feline cadaver joints.
  • Femoral and acetabular tunnel creation was feasible in all cases, though femoral tunnel placement had a higher rate of deviations.
  • Intraoperative complications occurred in 5/14 joints, mostly related to femoral tunnel creation and toggle lodging.
  • Minor articular cartilage injury (<10% total cartilage area) occurred in 10/14 joints, but no injury to neurovascular or intrapelvic structures.
  • Thirteen surgical technique deviations (8 major, 5 minor) were identified in 7 joints, all involving the femoral tunnel.
  • Toggle passage through the femoral tunnel was the most challenging step, being mildly difficult in 6 joints.
  • Postoperative CT and gross dissection confirmed all toggles and buttons were in correct position, without damage to major surrounding structures.
  • No deviations, complications, or cartilage injuries occurred in the last 4 joints, suggesting a learning curve effect.

Espinel Rupérez

Veterinary Surgery

6

2023

Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study

2023-6-VS-espinel-5

Article Title: Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study

Journal: Veterinary Surgery

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In Kwok 2023 et al., on BFX lateral bolt THR in dogs,what was the most common intraoperative complication with the BFX lateral bolt stem?

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Correct. 10.3% of femurs developed medial calcar fissures during broaching.
Incorrect. The correct answer is Femoral fissure.
10.3% of femurs developed medial calcar fissures during broaching.

🔍 Key Findings

  • 97.4% of dogs returned to normal function after total hip replacement using the BFX lateral bolt.
  • Mean femoral stem subsidence was 1.22 mm, with most occurring in the first month and minimal thereafter.
  • Postoperative complication rate was 13.6%, with 9.2% major and 4.4% minor complications.
  • Femoral fractures (3.6%) and coxofemoral luxations (3.6%) were the most common major complications.
  • Increased age and higher stem size were risk factors for postoperative femoral fractures; CFI >2.0 was also associated.
  • Medial calcar fractures were avoided, and fractures occurred distal to stem ingrowth zone, simplifying repairs.
  • Three cases underwent prophylactic plating, all with excellent outcomes and no complications.
  • Explant rate was 2.6% (5/195), with most failures involving acetabular cup rather than femoral stem.

Kwok

Veterinary Surgery

1

2023

Clinical outcomes of canine total hip replacement utilizing a BFX lateral bolt femoral stem: 195 consecutive cases (2013–2019)

2023-1-VS-kwok-2

Article Title: Clinical outcomes of canine total hip replacement utilizing a BFX lateral bolt femoral stem: 195 consecutive cases (2013–2019)

Journal: Veterinary Surgery

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In Mazdarani 2025 et al., on simulated muscle loading, which model showed the lowest muscle force ratios (quadriceps:gastrocnemius)?

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Correct. Model 2 consistently showed lower ratios compared to others (p = .007).
Incorrect. The correct answer is Model 2 (rigid femoral fixation).
Model 2 consistently showed lower ratios compared to others (p = .007).

🔍 Key Findings

  • Simulated quadriceps and gastrocnemius forces increased proportionally with axial load in all three femoral fixation models.
  • Model 2 (rigid fixation) resulted in subphysiologic quadriceps forces and abnormally high gastrocnemius forces, reducing model fidelity.
  • Models 1 and 3 (with hip mobility) produced more physiologic quadriceps and force ratios, especially under 30–40% bodyweight loads.
  • Force ratios were significantly lower in rigid fixation (Model 2) compared to hip-mobile models (p = .007), suggesting model design affects simulated muscle coordination.
  • Joint angles (stifle and hock) remained within acceptable limits, though slight flexion occurred with increasing load.
  • Relative foot position differed by ~3.9 mm between models 2 and 3, with model 2 showing a more caudal position.
  • Model 3 preserved benefits of hip mobility while allowing radiographic documentation, making it a preferred setup for future studies.
  • The study suggests that models used in feline stifle stabilization research may underestimate physiologic forces, especially with rigid fixation designs.

Mazdarani

Veterinary Surgery

5

2025

Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

2025-5-VS-mazdarani-2

Article Title: Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

Journal: Veterinary Surgery

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In Husi 2023 et al., on TPLO vs TPLO-IB biomechanics, how did the TPLO-IB construct affect rotational stability compared to TPLO alone?

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Correct. TPLO-IB reduced internal tibial rotation to levels similar to intact stifles without inducing external overconstraint.
Incorrect. The correct answer is Restored rotational motion to pre-CCLD levels.
TPLO-IB reduced internal tibial rotation to levels similar to intact stifles without inducing external overconstraint.

🔍 Key Findings

  • TPLO alone failed to neutralize rotational instability under tibial pivot compression (TPT), despite a negative TCT.
  • TPLO combined with lateral augmentation (TPLO-IB) restored both craniocaudal and rotational stability to near-intact levels.
  • Cranial tibial translation was 6× greater after TPLO vs intact stifles when tested with TPT (p < .001).
  • No significant difference in cranial tibial translation or internal rotation between intact stifles and TPLO-IB group during TCT, eTPT, or iTPT.
  • TPLO-IB did not overconstrain the stifle, avoiding excessive external rotation.
  • External tibial rotation (eTPT) was more sensitive than TCT in detecting persistent instability after TPLO.
  • Excellent intraobserver reliability for both eTPT and iTPT (ICC > 0.9).
  • Study supports intraoperative use of TPT to identify cases needing additional rotational stabilization.

Husi

Veterinary Surgery

5

2023

Comparative kinetic and kinematic evaluation of TPLO and TPLO combined with extra-articular lateral augmentation: A biomechanical study

2023-5-VS-husi-3

Article Title: Comparative kinetic and kinematic evaluation of TPLO and TPLO combined with extra-articular lateral augmentation: A biomechanical study

Journal: Veterinary Surgery

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In Nagahiro 2023 et al., on quadriceps-femoral mismatch, what was the reference value for normal QML/FL derived from healthy beagles?

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Correct. The reference QML/FL was 0.87–1.00 based on healthy beagle data. Values below 0.87 were considered abnormal.
Incorrect. The correct answer is 0.87–1.00.
The reference QML/FL was 0.87–1.00 based on healthy beagle data. Values below 0.87 were considered abnormal.

🔍 Key Findings

  • Quadriceps muscle length/femoral length ratio (QML/FL) was significantly lower in dogs with grade IV MPL than grades I–III (p ≤ .002).
  • Shortened QML was associated with increased femoral torsion angle (FTA) and increased aLDFA, indicating correlation with femoral deformity.
  • QML/FL increased with age, possibly due to muscular development or reduced deformity in older dogs (p = .004).
  • Grade IV MPL dogs had QML/FL < 0.87, the lower normal limit based on healthy beagles, suggesting clinically significant muscle shortening.
  • PLL/PL ratio (used to diagnose patella alta) was not associated with QML/FL or MPL severity in small breeds.
  • QML/FL can help preoperatively identify candidates for femoral shortening ostectomy, improving femoropatellar alignment.
  • Multivariate regression model confirmed QML/FL is independently influenced by age, FTA, and aLDFA (R² = 0.45).
  • CT-based 3D measurements enabled objective, noninvasive quantification of femoral and muscle alignment parameters.

Nagahiro

Veterinary Surgery

4

2023

Evaluation of the quadriceps muscle length to femoral length ratio in small breed dogs with medial patellar luxation

2023-4-VS-nagahiro-5

Article Title: Evaluation of the quadriceps muscle length to femoral length ratio in small breed dogs with medial patellar luxation

Journal: Veterinary Surgery

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In Kwok 2023 et al., on BFX lateral bolt THR in dogs,what was the reported mean subsidence of the femoral stem at 1 month?

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Correct. Mean subsidence was 1.22 ± 0.16 mm at 1 month.
Incorrect. The correct answer is 1.22 mm.
Mean subsidence was 1.22 ± 0.16 mm at 1 month.

🔍 Key Findings

  • 97.4% of dogs returned to normal function after total hip replacement using the BFX lateral bolt.
  • Mean femoral stem subsidence was 1.22 mm, with most occurring in the first month and minimal thereafter.
  • Postoperative complication rate was 13.6%, with 9.2% major and 4.4% minor complications.
  • Femoral fractures (3.6%) and coxofemoral luxations (3.6%) were the most common major complications.
  • Increased age and higher stem size were risk factors for postoperative femoral fractures; CFI >2.0 was also associated.
  • Medial calcar fractures were avoided, and fractures occurred distal to stem ingrowth zone, simplifying repairs.
  • Three cases underwent prophylactic plating, all with excellent outcomes and no complications.
  • Explant rate was 2.6% (5/195), with most failures involving acetabular cup rather than femoral stem.

Kwok

Veterinary Surgery

1

2023

Clinical outcomes of canine total hip replacement utilizing a BFX lateral bolt femoral stem: 195 consecutive cases (2013–2019)

2023-1-VS-kwok-4

Article Title: Clinical outcomes of canine total hip replacement utilizing a BFX lateral bolt femoral stem: 195 consecutive cases (2013–2019)

Journal: Veterinary Surgery

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In Sullivan 2025 et al., on TTT stabilization methods, which stabilization method showed significantly different failure force or stiffness?

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Correct. All methods showed comparable failure force and stiffness.
Incorrect. The correct answer is No significant differences were found.
All methods showed comparable failure force and stiffness.

🔍 Key Findings

  • Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
  • All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
  • Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
  • Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
  • No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
  • Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
  • Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
  • Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.

Sullivan

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

2025-3-VCOT-sullivan-1

Article Title: Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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Quiz Results

Topic: Femoral Fixation
70%

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