Quiz Question

In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, which screw location was most commonly associated with TCTFs?

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Correct. 50% of TCTFs occurred at middle screws in the distal part of the TPLO plate.
Incorrect. The correct answer is Middle screws distal to osteotomy.
50% of TCTFs occurred at middle screws in the distal part of the TPLO plate.

🔍 Key Findings

  • 42% of dogs (33/78) treated with Arthrex 3.5 mm STS during TPLO developed radiographic TCTF
  • TCTFs occurred exclusively distal to the osteotomy
  • 14% of screws (36/250) distal to the osteotomy were associated with TCTFs
  • 6% of dogs with TCTFs developed major complications (e.g., complete tibial fracture requiring surgical revision)
  • Angulation of cortical STS screws, especially in the distal plate holes, was a key contributor to complications
  • Locking screws were also involved, but cortical screws angled improperly were overrepresented in serious outcomes
  • Revision recommendations included preemptive fixation for large TCTFs or angulated screw placements
  • Use of non-self-tapping screws (NSTS) previously showed a <1% TCTF rate, supporting higher risk with STS

Gollnick

Veterinary Surgery

6

2024

Tibial fracture associated with use of Arthrex self‐tapping screws during tibial plateau leveling osteotomy in dogs and development of transcortical tibial fracture

2024-6-VS-gollnick-2

Article Title: Tibial fracture associated with use of Arthrex self‐tapping screws during tibial plateau leveling osteotomy in dogs and development of transcortical tibial fracture

Journal: Veterinary Surgery

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In Huels 2025 et al., on second-generation screw cup THA, what was the observed rate of late aseptic loosening?

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Correct. No cases of late aseptic loosening were observed during a median 17.5-month follow-up.
Incorrect. The correct answer is None of the hips.
No cases of late aseptic loosening were observed during a median 17.5-month follow-up.

🔍 Key Findings

  • Total complication rate was 16.7%, with 5/30 hips experiencing major complications, mostly related to the femoral component.
  • Cup-associated complications were rare (3.3%), with only one case of acetabular cup luxation attributed to surgical technique rather than implant failure.
  • No cases of late aseptic loosening were observed during a median follow-up of 17.5 months.
  • Implant stability was attributed to the SCSL's porous, trabecular titanium surface, enhancing osseointegration.
  • Three femoral stem fractures occurred in a single dog, leading to implant removal; material testing was not performed.
  • Most complications were femoral in origin (6/7), not acetabular, suggesting improved performance of the SCSL.
  • Explantation rate was 13% (4/30), but some removals were due to owner preference against revision.
  • Subjective functional outcome was full recovery in 26/30 hips, including one with successful revision of stem subsidence.

Huels

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup

2025-2-VCOT-huels-1

Article Title: Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Deprey 2022 et al., on gap fracture implants, which construct demonstrated higher torque to failure during torsional testing?

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Correct. The NAS-ILN resisted significantly more torque before failure than the LCP construct in torsional testing.
Incorrect. The correct answer is NAS-ILN construct.
The NAS-ILN resisted significantly more torque before failure than the LCP construct in torsional testing.

🔍 Key Findings

  • NAS-ILN had significantly greater stiffness in both axial compression and 4-point bending compared to LCP constructs.
  • Ultimate load to failure was significantly higher for NAS-ILN in compression (804 N vs 328 N) and bending (25.7 Nm vs 16.3 Nm).
  • Torsional stiffness and angular deformation were similar, but NAS-ILN resisted higher torque to failure than LCP (22.5 Nm vs 19.1 Nm).
  • No slack was observed with the NAS-ILN construct, unlike older nail designs.
  • Failure modes differed: LCPs failed via plate bending; NAS-ILNs failed at the implant or bone near screw holes.
  • Titanium alloy and curved design of NAS-ILN provides better anatomic fit and more uniform stress distribution.
  • A third, perpendicular locking hole in NAS-ILN may enhance torsional stability but was not utilized in this study.
  • The curved, angle-stable design of NAS-ILN is a novel advancement in veterinary orthopedics.

Deprey

Veterinary Surgery

8

2022

Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

2022-8-VS-deprey-3

Article Title: Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

Journal: Veterinary Surgery

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In Dalton 2023 et al., In Minimally invasive acetabular fracture repair in dogs, what was the primary purpose of using mirrored 3D-printed hemipelves in this study?

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Correct. 3D-printed models enabled accurate plate contouring before surgery, minimizing intraoperative bending.
Incorrect. The correct answer is To allow precontouring of fixation plates.
3D-printed models enabled accurate plate contouring before surgery, minimizing intraoperative bending.

🔍 Key Findings

  • Feasibility study in 5 canine cadavers plus 1 clinical case (Chihuahua, 5.5 kg).
  • Technique used two small approaches (caudal and craniolateral) connected with an epiperiosteal tunnel.
  • Plates were precontoured on mirrored 3D-printed hemipelves to improve fit and reduce intraoperative bending.
  • Cadaver outcomes: fracture gap <2 mm, step defect <1 mm, pelvic angulation <5°.
  • Sciatic nerve injury was minimal: 1/5 cadavers had a mild indentation; others had no gross injury.
  • Median total surgical time: ~46 minutes in cadavers; incisions ~5 cm.
  • Clinical Chihuahua case: weight-bearing within 24 hrs, radiographic union at 3 months; one screw fractured but no adverse effect.
  • Authors conclude: MIAF with 3D printing is feasible and accurate, but requires further evaluation before routine use.

Dalton

Veterinary Surgery

7

2023

Minimally invasive repair of acetabular fractures in dogs: Ex vivo feasibility study and case report

2023-7-VS-dalton-1

Article Title: Minimally invasive repair of acetabular fractures in dogs: Ex vivo feasibility study and case report

Journal: Veterinary Surgery

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In Rodiño Tilve 2022 et al., on feline THR outcomes, which implant feature was associated with all luxation complications?

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Correct. All luxations occurred in implants using femoral neck +0 mm, though not all such implants luxated.
Incorrect. The correct answer is Femoral neck extension +0 mm.
All luxations occurred in implants using femoral neck +0 mm, though not all such implants luxated.

🔍 Key Findings

From “Long-term follow up of 44 cats undergoing total hip replacement” by Rodiño Tilve et al.

  • Slipped capital femoral epiphysis (SCFE) was the most common surgical indication (61%, 34/56 hips), primarily affecting young neutered male cats.
  • All THRs used cemented micro/nano BioMedtrix implants; most common femoral stem was size #3, and most common acetabular cup was 12 mm.
  • Postoperative complication rate was 19.6% (11/56) with 9 major complications (luxation most common), and no intraoperative complications reported.
  • All luxations occurred in hips implanted with femoral neck +0 mm length implants.
  • Second luxations were more common when revision used same implant size; use of larger implants reduced reluxation rates.
  • FMPI-sf score improved significantly from median 2.111 pre-op to 0.111 post-op (P < .001), indicating reduced pain and improved function.
  • Very high owner satisfaction: 91% (30/33) reported outcome as "very good."
  • No significant associations found between complications and variables like weight, sex, implant size, or surgical indication.

Rodiño Tilve

Veterinary Surgery

5

2022

Long‐term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010–2020)

2022-5-VS-rodino-3

Article Title: Long‐term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010–2020)

Journal: Veterinary Surgery

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In Wilson 2025 et al., on acetabular measurement accuracy, what was the main drawback of femoral head circle methods?

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Correct. FHC-based methods underestimated cup size by 2.4–3.6 mm.
Incorrect. The correct answer is Underestimated cup size.
FHC-based methods underestimated cup size by 2.4–3.6 mm.

🔍 Key Findings

Study population: 73 hips from 60 dogs undergoing cementless THR.
Methods evaluated:

  • ACVD/ACOLL (acetabular circle on VD or OLL view)
  • ALVD/ALOLL (acetabular line)
  • FHCVD/FHCOLL/FHCCCHB (femoral head circle)
Findings:
  • Intraobserver repeatability and interobserver consistency were excellent for ACVD and ACOLL.
  • FHC methods consistently underestimated actual cup size by 2.4–3.6 mm.
  • AC and AL methods had low bias (±0.5 mm) and better predictive value.
  • OA severity negatively affected the accuracy of all measurements (p < .05).
  • Highest predictive accuracy was ~49% using ACVD with rounding down protocol.

Wilson

Veterinary Surgery

1

2025

Evaluation of three acetabular measurement methods for total hip replacement in dogs

2025-1-VS-wilson-2

Article Title: Evaluation of three acetabular measurement methods for total hip replacement in dogs

Journal: Veterinary Surgery

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In Raleigh 2022 et al., on pericardiectomy complications, which surgical tool was most frequently associated with the onset of ventricular fibrillation?

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Correct. In 15 of 16 dogs, electrosurgical devices were used, and VF coincided with their use in 8.
Incorrect. The correct answer is Bipolar electrosurgical device.
In 15 of 16 dogs, electrosurgical devices were used, and VF coincided with their use in 8.

🔍 Key Findings

  • Ventricular fibrillation (VF) occurred in 3% of pericardiectomy cases across reporting institutions.
  • 14 of 16 dogs (88%) that developed intraoperative VF died, indicating high mortality.
  • Electrosurgical devices were used in 15/16 dogs; VF onset coincided with their use in 8 dogs, suggesting a potential but unproven association.
  • Preoperative arrhythmias were seen in 7 dogs (e.g., VPCs, VT, bradycardia), possibly serving as early warning signs.
  • Thoracoscopic approach was used in 75% of cases; however, conversion to open surgery was required in 9/13 thoracoscopic procedures after VF onset.
  • Defibrillation was attempted in 13 dogs, but only 3 converted to sinus rhythm, and only 2 survived postoperatively.
  • VF may result from stray current or cardiac manipulation; bipolar energy devices were implicated despite lower theoretical risk.
  • Preventative strategies include judicious electrosurgery use, close ECG monitoring, rapid CPR preparedness, and preop cardiac risk assessment.

Raleigh

Veterinary Surgery

4

2022

The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs

2022-4-VS-raleigh-3

Article Title: The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs

Journal: Veterinary Surgery

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In Scott 2023 et al., on thoracoscopic-assisted lung lobectomy, which **surgical device** was associated with **shorter median surgery time**?

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Correct. Median surgery time was shorter for procedures using linear staplers (57.5 min) compared to endoscopic staplers (80 min).
Incorrect. The correct answer is Linear stapler (DST series).
Median surgery time was shorter for procedures using linear staplers (57.5 min) compared to endoscopic staplers (80 min).

🔍 Key Findings

  • TA lung lobectomy was feasible in dogs ≥3 kg, including those with lesions up to 10 cm.
  • 12 intraoperative complications (40%) occurred, with 6 dogs (20%) converted to open thoracotomy, mainly due to adhesions or inability to isolate lobes.
  • Postoperative complications occurred in 8 dogs (27%), most were mild (63%), and only 1 death (3%) was reported.
  • Median hospitalization was 47 hours; 29/30 dogs were discharged successfully.
  • One-lung ventilation (OLV) was attempted in 7 dogs but successfully maintained in only 4.
  • Linear staplers had shorter surgery times (median 57.5 min) than endoscopic staplers (80 min).
  • Histopathology confirmed neoplasia in 77% of cases, most commonly papillary and bronchioalveolar carcinoma.
  • TA lobectomy allows MIS in smaller dogs or with large lesions, avoiding need for full thoracotomy or complex anesthesia/stapling.

Scott

Veterinary Surgery

1

2023

Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs

2023-1-VS-scott-3

Article Title: Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs

Journal: Veterinary Surgery

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In Lee 2022 et al., on TPLO accuracy, what feature of the 3D-printed guide directly aided in more accurate jig pin placement?

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Correct. The 3D-printed guide included a pinhole aligned perpendicular to the long axis to ensure correct jig pin placement.
Incorrect. The correct answer is A pinhole positioned perpendicular to the tibial axis.
The 3D-printed guide included a pinhole aligned perpendicular to the long axis to ensure correct jig pin placement.

🔍 Key Findings

  • 3D-printed TPLO guides significantly reduced osteotomy inclination angle in both bone models and cadaver limbs compared to jig alone (P < .001).
  • Torsional deformities were lower when the 3D-printed guide was used in bone models (P < .001), but not significantly different in cadavers.
  • Angular deformities were significantly reduced in cadavers using 3D-printed guides (P < .001).
  • Proximal jig pin angulation was more accurate with the guide in cadavers (P < .001); not significant in bone models.
  • Medial cortex damage was substantially reduced in bone models when the 3D-printed guide was used (P < .001).
  • Postoperative tibial plateau angle (TPA) did not differ significantly between groups, suggesting that clinical alignment can still be achieved without the guide.
  • Clinical significance of improved metrics is uncertain, but improved precision may reduce surgical complications.
  • 3D guide design allowed direct placement of jig and bone plate, potentially improving workflow and safety.

Lee

Veterinary Surgery

6

2022

Evaluation of a customized 3D‐printed saw guide for tibial plateau leveling osteotomy: An ex vivo study

2022-6-VS-lee-5

Article Title: Evaluation of a customized 3D‐printed saw guide for tibial plateau leveling osteotomy: An ex vivo study

Journal: Veterinary Surgery

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In Jeon 2025 et al., on distal femoral shortening, what was the **median femoral shortening ratio** required to achieve prosthesis reduction?

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Correct. The median femoral shortening length ratio was 13.8% (range: 10.7–15.3%) to enable prosthesis reduction.
Incorrect. The correct answer is 13.8%.
The median femoral shortening length ratio was 13.8% (range: 10.7–15.3%) to enable prosthesis reduction.

🔍 Key Findings

  • Distal femoral shortening osteotomy (DFSO) enabled prosthesis reduction in all 4 dogs with irreducible luxoid hips undergoing total hip replacement.
  • Median femoral shortening ratio was 13.8% (range: 10.7–15.3%) based on intraoperative tension needed for prosthesis reduction.
  • Bone union was achieved in all cases post-DFSO, indicating good healing potential.
  • Two major complications occurred: one prosthetic luxation and one aseptic stem loosening requiring explantation.
  • One intraoperative fracture of the greater trochanter occurred during trial reduction before DFSO.
  • DFSO did not result in neurovascular injury, even in cases with significant femoral head displacement (>4 cm).
  • Radiographic planning with FHD index and intraoperative assessment were crucial for determining DFSO necessity.
  • DFSO avoids complications linked to subtrochanteric osteotomy by preserving proximal femoral anatomy and allowing secure distal fixation.

Jeon

Veterinary Surgery

6

2025

Distal femoral shortening osteotomy for managing irreducible hips during total hip replacement in four dogs with severe luxoid hips

2025-6-VS-jeon-2

Article Title: Distal femoral shortening osteotomy for managing irreducible hips during total hip replacement in four dogs with severe luxoid hips

Journal: Veterinary Surgery

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Quiz Results

Topic: Implant Selection & Configuration
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