Quiz Question

In Walker 2022 et al., on TPLO mRUST scoring, what effect did bilateral cruciate ligament injury have on healing between staged TPLOs?

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Correct. P = .09 showed no significant difference in healing between first and second TPLO surgeries.
Incorrect. The correct answer is No difference in healing between sides.
P = .09 showed no significant difference in healing between first and second TPLO surgeries.

🔍 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.

Walker

Veterinary Surgery

8

2022

Evaluation of a modified radiographic union scale for tibial fractures scoring system in staged bilateral tibial plateau leveling osteotomy procedures and comparison of first and second side radiographic bone healing

2022-8-VS-walker-4

Article Title: Evaluation of a modified radiographic union scale for tibial fractures scoring system in staged bilateral tibial plateau leveling osteotomy procedures and comparison of first and second side radiographic bone healing

Journal: Veterinary Surgery

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In Foster 2026 et al., on right hepatic lobectomy, what was the reported median survival time (MST) for dogs diagnosed with hepatocellular carcinoma?

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Correct. The MST for dogs with HCC was 741 days.
Incorrect. The correct answer is 741 days.
The MST for dogs with HCC was 741 days.

🔍 Key Findings

  • Perioperative mortality rate was low (2.9%), with no intraoperative deaths reported.
  • Intraoperative complications occurred in 54.3% of dogs, most commonly hemorrhage and cardiovascular events.
  • 21% of dogs required blood transfusions, though transfusion was not associated with higher complication risk.
  • Advanced hemodynamic support (fluid + cardiovascular) was significantly associated with short-term complications (OR 17.3, p = .029) and shorter survival.
  • No surgical method (e.g., TA stapler, vessel sealing device, hilar resection) was associated with increased risk of complications.
  • Hepatocellular carcinoma (HCC) was the most common diagnosis (53%), with an MST of 741 days and 17.6% recurrence.
  • Surgical margins (complete vs incomplete) were not associated with overall survival time in dogs with HCC.
  • The use of preoperative CT and improved surgical instrumentation may have contributed to the lower observed mortality.

Foster

Veterinary Surgery

1

2026

Outcomes and prognostic variables associated with right divisional hepatic lobectomies in 70 dogs

2026-1-VS-foster-3

Article Title: Outcomes and prognostic variables associated with right divisional hepatic lobectomies in 70 dogs

Journal: Veterinary Surgery

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In Quitzan 2022 et al., on staple line configuration, which FEESA variation did *not* significantly increase ILP compared to 2V/2T?

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Correct. 3V/2T did not show a statistically significant increase in ILP vs. 2V/2T, unlike 2V/3T and 3V/3T.
Incorrect. The correct answer is 3V/2T.
3V/2T did not show a statistically significant increase in ILP vs. 2V/2T, unlike 2V/3T and 3V/3T.

🔍 Key Findings

  • All FEESA configurations leaked at lower pressures than intact segments, confirming reduced integrity vs. native tissue.
  • FEESA with 3-row transverse staples (3V/3T or 2V/3T) had significantly higher leak pressures than 2-row configurations.
  • 3V/3T configuration had the highest ILP (69.88 ± 21.23 mmHg) among all groups, significantly greater than 2V/2T and 3V/2T (P < .001).
  • Leakage consistently occurred at the transverse staple line (not vertical), regardless of configuration.
  • No significant difference in maximum intraluminal pressure (MIP) between FEESA groups.
  • All FEESA constructs withstood intraluminal pressures >25 mmHg, exceeding normal physiological jejunal pressure in dogs.
  • No leaks occurred from the vertical staple line, highlighting it as a more robust closure site.
  • Third staple row in transverse line may be a viable alternative to suture oversew, pending further clinical evaluation.

Quitzan

Veterinary Surgery

5

2022

Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study

2022-5-VS-quitzan-4

Article Title: Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study

Journal: Veterinary Surgery

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In Parker 2023 et al., on Locoregional analgesia in TPLO, which variable was significantly associated with increased preference for lumbosacral epidural (LE) over PNB?

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Correct. LE was more common in diplomates >10 years post-certification, while newer diplomates preferred PNB (p < .001).
Incorrect. The correct answer is Time from board-certification.
LE was more common in diplomates >10 years post-certification, while newer diplomates preferred PNB (p < .001).

🔍 Key Findings

  • Peripheral nerve block (PNB) was preferred by 79% of anesthesiologists; lumbosacral epidural (LE) by 21%; PI <1%.
  • Time since board-certification significantly influenced preference: PNB favored by newer diplomates, LE favored by more senior ones (p < .001).
  • Employment sector mattered: PNB was preferred more in private practice, LE more in academia (p = .003).
  • PNB perceived as more effective, with 78% reporting 81–100% effectiveness; compared to 55% for LE.
  • PNB associated with fewer adverse effects (75%) than LE (4%) and PI (21%).
  • PNB required less rescue analgesia intraoperatively (57%) and postoperatively (54%) than LE or PI.
  • LE preferred for bilateral TPLOs and in smaller dogs; PNB for larger dogs, due to motor function preservation.
  • Dexmedetomidine was the most common additive to PNB; bupivacaine-only was most used for PNB.

Parker

Veterinary Surgery

4

2023

Pelvic limb anesthesia and analgesia in dogs undergoing tibial plateau leveling osteotomy (TPLO): A survey of board-certified anesthesiologists

2023-4-VS-parker-2

Article Title: Pelvic limb anesthesia and analgesia in dogs undergoing tibial plateau leveling osteotomy (TPLO): A survey of board-certified anesthesiologists

Journal: Veterinary Surgery

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In Hawker 2024 et al., on checklist attitudes, which group was most often reported as noncompliant with SSC use?

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Correct. Surgeons were most commonly identified as noncompliant users.
Incorrect. The correct answer is Surgeons.
Surgeons were most commonly identified as noncompliant users.

🔍 Key Findings

  • 67.9% of respondents reported using SSCs, with most indicating frequent use (64% used in every surgery).
  • 78.7% agreed SSCs reduce complications, and 89.6% believed SSCs improve communication.
  • Respondents not using SSCs were more likely to view them as a waste of time (p < .001).
  • Forgetfulness (39.6%) and time constraints (36.5%) were leading reasons for checklist noncompletion.
  • Only 23.3% had SSC training during surgical residency, with newer diplomates more likely to have had exposure (p < .001).
  • Key strategies to improve uptake included: staff feedback modifications (67.9%), formal designation of initiator (48.6%), and training (52.2%).
  • Surgeons and OR staff were most commonly identified as noncompliant team members.
  • SSC use was more frequent in small animal practices, and mandating SSCs by management was favored but not always effective alone.

Hawker

Veterinary Surgery

5

2024

Attitudes towards surgical safety checklists among American College of Veterinary Surgeons diplomates

2024-5-VS-hawker-4

Article Title: Attitudes towards surgical safety checklists among American College of Veterinary Surgeons diplomates

Journal: Veterinary Surgery

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In Dobberstein 2024 et al., on liver biopsy forceps, what was concluded about diagnostic suitability of 3 mm samples?

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Correct. The 3 mm samples were sufficient for histopathology, but diagnostic accuracy remains unknown.
Incorrect. The correct answer is Adequate but lower diagnostic accuracy.
The 3 mm samples were sufficient for histopathology, but diagnostic accuracy remains unknown.

🔍 Key Findings Summary

  • Subjects: 12 healthy colony cats, 68 total liver samples collected via laparoscopy
  • Biopsy instruments: 3 mm vs 5 mm Storz Blakesley cup forceps
  • Techniques: Twist (T), Pull (P), Twist + Pull (TP)
  • Results:
    • 5 mm forceps yielded significantly more hepatic lobules (mean 12.4 vs 4.9), portal triads (29.6 vs 19.0), weight, and histologic area (p < .01)
    • T and P techniques yielded more portal triads and lobules than TP (p = .003 and p = .015)
    • TP technique resulted in greater tissue crush vs T (p = .01)
    • Good diagnostic agreement between 3 mm and 5 mm samples only with TP (κ = 0.75)
    • All samples were of sufficient diagnostic quality, despite size or technique
  • Clinical implication: Both 3 mm and 5 mm forceps are viable; further studies are needed to confirm diagnostic accuracy of 3 mm samples

Dobberstein

Veterinary Surgery

2

2024

Comparison of the diagnostic yield of 3 and 5 mm laparoscopic liver biopsy forceps in cats

2024-2-VS-dobberstein-5

Article Title: Comparison of the diagnostic yield of 3 and 5 mm laparoscopic liver biopsy forceps in cats

Journal: Veterinary Surgery

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In Scharpf 2024 et al., what was the effect of autologous conditioned plasma (ACP) compared to placebo on postoperative outcome?

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Correct. No differences in vertical, braking, or propulsive force or symmetry indices were observed between ACP and placebo groups throughout the study:contentReference[oaicite:2]{index=2}
Incorrect. The correct answer is ACP had no statistically significant effect at any time point.
No differences in vertical, braking, or propulsive force or symmetry indices were observed between ACP and placebo groups throughout the study:contentReference[oaicite:2]{index=2}

🔍 Key Findings Summary

  • Subtotal coronoidectomy improved vertical and propulsive forces, but braking forces remained subnormal at 26 weeks.
  • No significant benefit was seen from ACP vs placebo at any timepoint across all force parameters or lameness scores.
  • Force plate analysis was more sensitive than visual lameness scoring.
  • Braking force (%FY+) was best at detecting persistent lameness, and SI < 0.9 persisted in most dogs at 26 weeks.
  • Outcome less favorable than historically reported — challenges status of subtotal coronoidectomy as “gold standard” for MCD.

Scharpf

Veterinary and Comparative Orthopedics and Traumatology

2

2024

Assessment of Arthroscopic Subtotal Coronoidectomy in Treating Medial Coronoid Disease and Effect of Concurrent Autologous Conditioned Plasma in Dogs Using Force Plate Analysis

2024-2-VCOT-scharpf-2

Article Title: Assessment of Arthroscopic Subtotal Coronoidectomy in Treating Medial Coronoid Disease and Effect of Concurrent Autologous Conditioned Plasma in Dogs Using Force Plate Analysis

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Ritson 2025 et al., on feline hilar lobectomy sealants, what **pressure level** was used as the endpoint for leak testing?

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Correct. The endpoint was a supraphysiologic pressure of 40 cm H₂O to stress test device seal.
Incorrect. The correct answer is 40 cm H₂O.
The endpoint was a supraphysiologic pressure of 40 cm H₂O to stress test device seal.

🔍 Key Findings

  • No leakage occurred using pretied ligature loops (PLL) or double-shank (DS) titanium clips up to 40 cm H₂O airway pressure.
  • 1/10 stapled lobes leaked at supraphysiologic pressure (40 cm H₂O), but this was not statistically significant (p = .33).
  • All techniques sealed effectively under physiologic and supraphysiologic pressures in cadaveric feline lungs.
  • PLL and DS clips required less working space than staplers, making them more practical for small thoracic cavities.
  • DS titanium clips offer enhanced security due to dual shanks and tissue-gripping design, reducing clip slippage.
  • Leak testing was cyclic and submerged, simulating physiologic ventilation and allowing robust evaluation.
  • Stapling failure occurred along the staple line, highlighting risks of air leakage due to staple misalignment or poor hilar access.
  • PLL and DS clips may be cost-effective and efficient alternatives for open or minimally invasive feline lung lobectomy.

Ritson

Veterinary Surgery

7

2025

Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

2025-7-VS-ritson-5

Article Title: Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

Journal: Veterinary Surgery

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In Clough 2022 et al., on CBLO-TTT construct testing, which outcome best describes the load-to-failure comparison between CBLO-TTT and CBLO alone?

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Correct. The study showed no significant difference in mean failure loads between CBLO-TTT and CBLO (P = .81).
Incorrect. The correct answer is CBLO-TTT and CBLO had similar load-to-failure values..
The study showed no significant difference in mean failure loads between CBLO-TTT and CBLO (P = .81).

🔍 Key Findings

  • Combined CBLO-TTT did not reduce load to failure compared to CBLO or TTT alone (P = .81 and P = .12, respectively).
  • CBLO-TTT maintains construct strength without significant compromise compared to individual procedures.
  • Most common failure mode in CBLO-TTT was displacement of the tibial crest segment with k-wire pullout and tension band untwisting.
  • No fulcrum effect was seen in CBLO-TTT, unlike TPLO-TTT combinations, likely due to preservation of buttress effect.
  • Patellar ligament avulsion occurred in both CBLO and CBLO-TTT, but not as a clinical concern — possibly artifact from cadaver model.
  • Load-to-failure testing was static and unidirectional, not accounting for cyclic fatigue or in vivo healing.
  • Plate size and saw blade variation were based on clinical realism, introducing potential variability but not affecting outcomes.
  • Study suggests feasibility of simultaneous surgical correction of CCL rupture and MPL using CBLO-TTT in dogs.

Clough

Veterinary Surgery

3

2022

Combined center of rotation of angulation‐based leveling osteotomy and tibial tuberosity transposition: An ex vivo mechanical study

2022-3-VS-clough-1

Article Title: Combined center of rotation of angulation‐based leveling osteotomy and tibial tuberosity transposition: An ex vivo mechanical study

Journal: Veterinary Surgery

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In Niida 2024 et al., on surgical residents and TPLO time, what was reported about osteotomy healing or union outcomes?

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Correct. Healing outcomes were not part of the study; cases needing reoperation were excluded.
Incorrect. The correct answer is Union was not assessed.
Healing outcomes were not part of the study; cases needing reoperation were excluded.

🔍 Key Findings

  • Resident involvement significantly increased TPLO surgery duration compared to cases performed by faculty surgeons (FS)-only. Residents required 54% more surgery time (GLSM, 153 min) than FS-only cases (GLSM, 99 min), representing a 1.54-fold increase.
  • The study did not report on short-term complication rates. No conclusions can be drawn from this source regarding complications between resident and faculty groups.
  • Bone plate contouring was not evaluated. The source does not provide data regarding contouring frequency or its comparison between groups.
  • Surgery duration significantly decreased after the first year of residency, but remained stable between second- and third-year residents. This was largely due to shorter tibial osteotomy durations, while arthroscopy times remained unchanged across residency years.
  • Meniscal treatment was performed in 80% of cases, and it was associated with increased surgical duration, but the study did not compare the frequency of medial meniscal release between resident and faculty cases.
  • The study did not evaluate osteotomy healing or revision surgery. Cases requiring immediate reoperation were excluded.
  • Bone union outcomes were not assessed at 8 weeks or any other time point.
  • The study concludes that resident participation significantly prolongs surgical time, but no data are provided regarding the effect on short-term clinical outcomes.

Niida

Veterinary Surgery

5

2024

The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

2024-5-VS-niida-5

Article Title: The impact of surgery resident training on the duration of tibial plateau leveling osteotomy and outcomes in dogs

Journal: Veterinary Surgery

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Quiz Results

Topic: Research & Evidence
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