Quiz Question

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 Butare-Smith 2022 et al., on cerclage knot biomechanics, which knot type demonstrated the highest resistance to cyclic loading before loosening?

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Correct. Double-loop cerclage resisted up to 500,000 cycles at high loads, outperforming other configurations.
Incorrect. The correct answer is Double-loop cerclage.
Double-loop cerclage resisted up to 500,000 cycles at high loads, outperforming other configurations.

🔍 Key Findings

  • Double-loop cerclage resisted the highest peak load (805 N) and maintained tension longer than twist (488 N) and single-loop (397 N) configurations.
  • Double-loop cerclage sustained 500,000 cycles at 60–80% of peak load in some cases without loosening, outperforming other types.
  • Twist knots loosened rapidly, often within 10 cycles even at low loads (100–390 N).
  • Single-loop knots performed better than twist, with partial resistance up to 100,000 cycles at 160 N, but showed wide variability.
  • All loosening occurred before wire breakage, indicating clinical failure would happen from slack, not fracture.
  • Double-loop cerclage had highest initial tension (323 N) compared to single-loop (124 N) and twist (69 N).
  • Fatigue limit was not identified for twist, since they all loosened early at even 20% of peak load.
  • Clinical recommendation: double-loop cerclage is best for resisting repeated subfailure loading, ideal for fissure prevention or fragment stabilization.

Butare-Smith

Veterinary Surgery

2

2022

Double-loop cerclage resists greater loads for more cycles than twist and single-loop cerclage

2022-2-VS-butare-smith-1

Article Title: Double-loop cerclage resists greater loads for more cycles than twist and single-loop cerclage

Journal: Veterinary Surgery

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In Fitzpatrick 2024 et al., on ESF for pelvic fractures in cats, what percentage of cases showed implant loosening on follow-up radiographs?

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Correct. Implant loosening was identified in 16/125 cases (13%) on radiographic follow-up.
Incorrect. The correct answer is 13%.
Implant loosening was identified in 16/125 cases (13%) on radiographic follow-up.

🔍 Key Findings

  • External skeletal fixation (ESF) was successfully applied to a variety of pelvic fracture types in cats, including sacroiliac luxations and ilial body fractures.
  • All fractures achieved radiographic union within 9 weeks, even in comminuted or complex configurations.
  • No intraoperative or long-term complications were reported during the study period.
  • Implant loosening was observed radiographically in 13% of cases, with 8% of pins found to be loose at frame removal.
  • ESF enabled indirect fracture reduction using components as handles, with a limited open approach minimizing soft tissue disruption.
  • No iatrogenic neurological deficits were observed, supporting safe pin placement near neurovascular structures, although some cats presented with pre-existing neurologic signs.
  • No cases required revision surgery, and all cats underwent stabilization solely with ESF as per study inclusion criteria.
  • Postoperative hospitalization ranged from 2 to 5 days, though no comparison to other fixation types was evaluated.

Fitzpatrick

Veterinary Surgery

7

2024

External skeletal fixation for the treatment of pelvic fractures in cats

2024-7-VS-fitzpatrick-2

Article Title: External skeletal fixation for the treatment of pelvic fractures in cats

Journal: Veterinary Surgery

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In McCarthy 2022 et al., on 3D drill guide accuracy, what was the advantage of 3D-GDT in terms of drill end point deviation?

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Correct. End point deviation was significantly reduced in all axes with 3D-GDT.
Incorrect. The correct answer is Lower deviation in craniocaudal, dorsoventral, and 3D linear distances.
End point deviation was significantly reduced in all axes with 3D-GDT.

🔍 Key Findings

  • 3D-printed drill guides (3D-GDT) significantly reduced craniocaudal and dorsoventral drilling angle deviation compared to free-hand drilling technique (FHDT), with statistical significance (p < .0001 and p = .01 respectively).
  • No sacral corridor breaches occurred with 3D-GDT, whereas FHDT resulted in 20% drill exit incidences (3/15 cases).
  • 3D-GDT had lower deviation from optimal drill trajectory at end points in all axes: craniocaudal (1.84 ± 1.6 mm vs. 4.18 ± 2.4 mm), dorsoventral (1.11 ± 1.0 mm vs. 2.4 ± 1.5 mm), and 3D linear (2.47 ± 1.4 mm vs. 5.35 ± 2.2 mm), all statistically significant.
  • Strong correlation (r = 0.77) between CT and 3D software measurements validated method reliability.
  • 3D guide trajectories showed consistent proximity to the optimal trajectory, especially at drill endpoints, indicating reduced variability in execution.
  • 3D-GDT was developed using open-source software and inexpensive materials, supporting future clinical application.
  • Major errors in FHDT occurred primarily at the drill endpoint, underscoring the challenge of maintaining optimal angulation during free-hand drilling.
  • The sacral corridor was recharacterized as pyramidal (not quadrilateral), with implications for safer implant placement.

McCarthy

Veterinary Surgery

1

2022

Accuracy of a drilling with a custom 3D printed guide or free‐hand technique in canine experimental sacroiliac luxations

2022-1-VS-mccarthy-3

Article Title: Accuracy of a drilling with a custom 3D printed guide or free‐hand technique in canine experimental sacroiliac luxations

Journal: Veterinary Surgery

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In Mullen 2023 et al., on microvascular perfusion, why was the green TA (4.8 mm) cartridge selected for stapled enterectomies?

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Correct. The green TA cartridge matched canine small intestinal thickness (approx. 2.5 mm), supporting its appropriate use.
Incorrect. The correct answer is It matches canine intestinal thickness more closely.
The green TA cartridge matched canine small intestinal thickness (approx. 2.5 mm), supporting its appropriate use.

🔍 Key Findings

  • Microvascular density at the site of foreign body obstruction was significantly lower in obstructed dogs compared to healthy controls.
  • PBR (perfused boundary region) was paradoxically lower in obstructed dogs, indicating that PBR may not reliably correlate with tissue viability in this context.
  • No significant difference in microvascular perfusion between subjectively viable vs nonviable intestines, suggesting subjective assessment is unreliable.
  • No difference in perfusion parameters between handsewn and stapled enterectomies, indicating both techniques preserve vascular health equally.
  • Stapled enterectomy using green TA staples is safe and did not impair intestinal perfusion at the anastomosis site.
  • SDF videomicroscopy is feasible intraoperatively and can differentiate healthy from diseased intestine in dogs.
  • Surgeons' subjective evaluations led to potentially unnecessary enterectomies, as microvascular parameters did not differ.
  • No cases of dehiscence or mortality, suggesting both surgical approaches are effective when applied properly.

Mullen

Veterinary Surgery

4

2023

A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health

2023-4-VS-mullen-5

Article Title: A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health

Journal: Veterinary Surgery

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In Rodiño Tilve 2022 et al., on feline THR outcomes, what femoral implant size was most commonly used?

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Correct. Implant size #3 was used in 46 of 56 THRs, making it the most common.
Incorrect. The correct answer is #3.
Implant size #3 was used in 46 of 56 THRs, making it the most common.

🔍 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-2

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 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 Scortea 2025 et al., on sacroiliac fixation accuracy, which statement regarding sacral bone purchase is correct?

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Correct. >60% sacral bone purchase was achieved in 92.9% of 3D-DGT screws versus 64.3% with MIO.
Incorrect. The correct answer is 3D-DGT achieved >60% purchase more consistently than MIO.
>60% sacral bone purchase was achieved in 92.9% of 3D-DGT screws versus 64.3% with MIO.

🔍 Key Findings

  • 3D-printed drill guide technique (3D-DGT) resulted in fewer suboptimal screw placements than minimally invasive osteosynthesis (MIO) (7.14% vs 42.85%), though not statistically significant.
  • Entry point translation (EPT) in the dorsoventral direction was significantly lower with 3D-DGT compared with MIO (p = .009).
  • Maximum angular screw deviation (MASD) did not differ significantly between 3D-DGT and MIO in dorsal or transverse planes.
  • Ventral cortical breach was the most common error with both techniques, more frequent with MIO.
  • Achievement of >60% sacral bone purchase was more consistent with 3D-DGT (92.9%) than with MIO (64.3%).
  • Modified Gras grade distribution was similar between techniques, with most screws graded as secure (“a” or “b”).
  • 3D-DGT required substantially longer preoperative planning time than MIO (median 34 vs 8.5 minutes).
  • Both techniques demonstrated overall acceptable accuracy, emphasizing the importance of CT-based planning and assessment.

Scortea

Veterinary and Comparative Orthopaedics and Traumatology

6

2025

Comparative analysis of 3D-printed drill guides and minimally invasive osteosynthesis in feline sacroiliac luxation: A cadaveric study

2025-6-VCOT-scortea-4

Article Title: Comparative analysis of 3D-printed drill guides and minimally invasive osteosynthesis in feline sacroiliac luxation: A cadaveric study

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Trefny 2025 et al., on locking plate biomechanics, which configuration showed higher construct stiffness in compression bending?

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Correct. Short working length had significantly higher stiffness than long in compression bending.
Incorrect. The correct answer is Short working length.
Short working length had significantly higher stiffness than long in compression bending.

🔍 Key Findings

  • Short working length constructs had significantly higher stiffness and lower strain than long constructs in compression bending (p = 0.0172).
  • In tension bending, short constructs also had higher precontact stiffness and lower strain, but this reversed after transcortical contact (~150 N).
  • Transcortical contact increased stiffness only in long constructs, producing a bilinear load-displacement curve.
  • Postcontact stiffness was higher in long constructs, but this may not reflect clinical benefit due to risks of high interfragmentary strain.
  • Short working length reduced strain at multiple ROIs under both loading conditions, including over fracture gap (Tables 1–3).
  • Increased working length promoted stress concentration and deformation, especially in compression bending.
  • In vitro benefits of long constructs (via contact stability) may not translate to healing, as repetitive loading could increase plate strain and bone resorption.
  • Plate strain was effectively mapped using 3D digital image correlation, confirming regional strain differences between configurations.

Trefny

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Effect of Plate Screw Configuration on Construct Stiffness and Plate Strain in a Synthetic Short Fragment Small Gap Fracture Model Stabilized with a 12-Hole 3.5-mm Locking Compression Plate

2025-3-VCOT-trefny-1

Article Title: Effect of Plate Screw Configuration on Construct Stiffness and Plate Strain in a Synthetic Short Fragment Small Gap Fracture Model Stabilized with a 12-Hole 3.5-mm Locking Compression Plate

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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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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Quiz Results

Topic: Implant Selection & Configuration
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