🔍 Key Findings

Objective: Validate a new 3D CT-based method for measuring tibial torsion in dogs with MPL, comparing it to a traditional method.

Sample: 40 tibiae from client-owned dogs with MPL (primarily small-breed).

Repeatability (intraobserver):

• New method: ICC = 0.99 → excellent agreement

Reproducibility (interobserver):

• New method: ICC = 0.83 → high agreement
• Traditional method: ICC = 0.52 → moderate agreement

Torsion angle measurements:

• New method avg: 16.00° ± 8.77
• Traditional method avg: 8.76° ± 4.92

Conclusion: The new method is more repeatable, reproducible, and provides higher torsion values than the traditional Aper method, especially reliable for small-breed dogs.

🔍 Key Findings

• Liposomal bupivacaine (LB) infiltration did not reduce the need for rescue analgesia compared with placebo in dogs undergoing TPLO.
• CMPS-SF pain scores were not significantly different between LB and placebo groups at any postoperative time point.
• % body weight distribution (%BWdist) to the operated limb did not differ significantly between treatment groups across all time points.
• No correlation was found between CMPS-SF scores and %BWdist, suggesting these metrics assess different aspects of postoperative pain.
• Postoperative carprofen administration was standardized, and LB did not provide additional detectable analgesic benefit.
• Three-layer infiltration technique (joint capsule, fascia, subcutis) was used consistently across all cases.
• Adverse events were minor and comparable between LB and placebo groups.
• Post hoc analysis suggested a much larger sample size (58–436 dogs) would be needed to detect significant differences in %BWdist.

🔍 Key Findings

• Cricoarytenoid lateralization (CAL) resulted in a significantly greater increase in rima glottidis area at both immediate (205%) and 15-day (199%) time points compared to thyroarytenoid lateralization (TAL) (152% and 127%, respectively).
• TAL group showed a significant reduction in rima glottidis area between immediate and 15-day postoperative measurements (P < .05), while CAL group had no significant reduction over time.
• No dogs in either group showed postoperative complications, including aspiration pneumonia, at the 15-day follow-up.
• All dogs showed improved clinical signs, including decreased stridor and increased exercise tolerance by day 15.
• CAL produced more stable postoperative glottic area, potentially due to preserved anatomical tension, whereas TAL might experience tension loss due to thyroid cartilage repositioning.
• Both procedures were technically effective and performed under the same protocol by a single board-certified surgeon.
• Endoscopic image analysis was used to quantify rima glottidis area, demonstrating a reliable objective method for surgical outcome assessment.
• Clinical outcome did not differ between groups, despite CAL showing a larger rima glottidis area.

🔍 Key Findings

• Surgically managed TTAF resulted in excellent clinical outcomes at skeletal maturity, with all dogs having normal limb function and no stifle instability.
• Surgical treatment significantly altered proximal tibial morphology, including decreased tibial plateau angle (TPA) and increased patellar position (PP) compared with the contralateral limb.
• Axial tibial tuberosity position (TTP-A) increased and transverse position (TTP-T) decreased in surgically treated stifles, indicating distal and caudal tuberosity migration.
• Non-surgically managed TTAF did not significantly alter tibial morphology or PP, but outcomes were more variable.
• Medial patellar luxation developed in 2/6 non-surgically treated dogs, whereas none occurred in surgically managed cases.
• Pins-only and pin–tension band constructs produced similar radiographic changes and outcomes.
• Despite morphologic changes, no dogs developed cruciate ligament instability at follow-up.
• Non-surgical management yielded good to excellent owner-reported outcomes, but carried a potential increased risk of patellar luxation.

🔍 Key Findings

Synovitis was present in 100% of canine stifles with CCL disease (n = 163).

The most frequent severity score was 3/5 (55.2%), followed by 4/5 (24.5%).

Higher synovitis scores were significantly associated with:

• Higher median cartilage scores (p = .042, OR = 2.1 per unit increase)
• Longer duration of clinical signs (p < .001, OR = 1.27 per month)

Bodyweight (p = .083) and sex (p = .17) were not statistically significant in multivariable analysis.

Bucket handle meniscal tears were not associated with synovitis severity.

Clinical implication: Earlier intervention may help reduce synovitis and slow OA progression.

🔍 Key Findings

• Oxley's modified CCWO did not achieve the target TPA of 5° in most cases, even with planning.
• Mean planned TPA was 7.6°, higher than target, and consistent across dog sizes.
• Postoperative TPAs were significantly higher in small dogs (median 7°) than in large dogs (median 4.5°).
• Distalization >7.5 mm of the osteotomy from the patellar tendon led to increased under-correction of TPA.
• Only dogs with preoperative TPA >35° achieved post-planning TPAs close to the 5° target.
• Postoperative osteotomy positions were generally more distal than recommended (8.6 mm median).
• Virtual plate fit was appropriate for all dogs at 5 mm or 7.5 mm positions, suggesting no need for excessive distalization.
• Excessive correction leading to negative TPAs occurred in some cases, risking caudal cruciate ligament strain.

🔍 Key Findings

Subject: 7-year-old Labrador underwent cementless total knee replacement (TKR) due to severe stifle OA.

Clinical function:

• Improved ROM from 90° pre-op to 120° post-op.
• Weight-bearing increased from toe-touching to 70% bodyweight by 6 weeks post-op.
• No visible lameness by 14 weeks.

Implant performance:

• No complications at any follow-up points.
• No osteolysis, loosening, or metallosis at 6-year necropsy.

Wear evaluation:

• Mild UHMWPE insert wear, localized to caudal edges.

Histologic findings:

• Robust osseointegration at implant-bone interface.
• Fibrous tissue only in areas lacking porous coating.

Conclusion:

• Cementless TKR demonstrated excellent 6-year survival and functional outcomes.
• Support for considering early surgical intervention in severe stifle OA.

🔍 Key Findings

• Liposomal bupivacaine (LB) infiltration did not reduce the need for rescue analgesia compared with placebo in dogs undergoing TPLO.
• CMPS-SF pain scores were not significantly different between LB and placebo groups at any postoperative time point.
• % body weight distribution (%BWdist) to the operated limb did not differ significantly between treatment groups across all time points.
• No correlation was found between CMPS-SF scores and %BWdist, suggesting these metrics assess different aspects of postoperative pain.
• Postoperative carprofen administration was standardized, and LB did not provide additional detectable analgesic benefit.
• Three-layer infiltration technique (joint capsule, fascia, subcutis) was used consistently across all cases.
• Adverse events were minor and comparable between LB and placebo groups.
• Post hoc analysis suggested a much larger sample size (58–436 dogs) would be needed to detect significant differences in %BWdist.

🔍 Key Findings

• Proximal Tibia Metatarsal Angle (PTMTA) was significantly increased in dogs with grade 3 and 4 MPL, making it a useful marker for severity.
• PTMTA strongly correlated with Tibial Torsion Angle (TTA) (r = 0.733) and Crural Rotation Angle (CRA) (r = 0.643), integrating multiple morphological deformities.
• Grade 4 MPL cases showed significant internal tibial torsion, increased mMPTA, and decreased MDTT/PTW—indicating both rotation and medial displacement.
• DTMTA was significantly more negative in grade 4, indicating a consistent pattern of internal foot rotation with disease severity.
• PTMTA can be visually assessed during palpation, offering preoperative utility without CT.
• Among toy poodles, PTMTA showed significant differences even between grades 3 and normal, suggesting breed-specific severity patterns.
• Corrective osteotomy may need to address tibial as well as femoral deformities in severe MPL cases with high PTMTA.
• Younger dogs with grade 4 MPL had more severe deformities, possibly due to early onset or developmental progression.

🔍 Key Findings Summary

• 95 TPLO procedures reviewed retrospectively with follow-up radiographs
• Rock-back defined as increase in tibial plateau angle (TPA) ≥2° from immediate post-op to recheck
• 21% of stifles (20/95) experienced rock-back
• Mean ΔTPA among rock-back cases = 3.2° ± 2.6°
• No implant failures or tibial tuberosity fractures were reported in these cases
• Plate inclination and exit cut angle (ECA) were not associated with increased risk of rock-back (p = 0.4 and 0.2)
• Authors hypothesize that compression across osteotomy in vivo may mitigate torsional effects from ECA, unlike in gap-model studies
• Emphasizes that rock-back is relatively common, even with well-placed implants