Quiz Question
In Lee 2022 et al., on TPLO accuracy, what was observed regarding postoperative TPA in both groups?
🔍 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.
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-3
In Peycke 2022 et al., on CBLO in immature dogs, what was the most common **complication** from improper screw placement in CBLO?
🔍 Key Findings
- CBLO was effective for stifle stabilization in skeletally immature dogs with CrCL injuries, avoiding disruption of proximal tibial growth plates.
- Radiographic union of the osteotomy occurred in a mean of 6 weeks (range: 4–8 weeks), indicating rapid bone healing.
- Full limb function was restored in all cases by long-term follow-up (mean 23 months), including dogs with initial complications.
- Two dogs developed 19° valgus deformities due to screw interference with the proximal tibial physis; both were corrected surgically with return to function.
- One dog developed 10° recurvatum due to over-rotation of the tibial plateau, but retained full function without revision.
- CCS (countersink compression screw) caused early apophyseal closure in older dogs but had no adverse clinical effects.
- In contrast, K-wire or plate-only fixation preserved open apophysis, suggesting implant choice may influence growth.
- No meniscal injuries were observed, and all CrCL injuries were managed arthroscopically — 6 complete, 6 partial, 4 avulsions.
Veterinary Surgery
3
2022
Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs
2022-3-VS-peycke-2
In Banks 2024 et al., on CCWO outcomes, what was the **median postoperative TPA** in small dogs?
🔍 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.
Veterinary Surgery
8
2024
A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
2024-8-VS-banks-4
In Rocheleau 2024 et al., on arthroscopic meniscal suturing, which group had the highest meniscal repair success rate?
🔍 Key Findings
- Arthroscopic meniscal suturing was performed in 43 client-owned dogs, involving 44 meniscal repairs (one dog was bilateral). All injuries involved the caudal horn of the medial meniscus and were associated with cranial cruciate ligament (CrCL) disease.
- All dogs underwent simultaneous TPLO, with some also receiving an internal brace (IB). Most repairs used simple vertical mattress sutures.
- The overall complication rate was 34.1% (15/44). Most complications were attributed to the TPLO/TPLO+IB and did not compromise the meniscal repair outcome.
- No median time to “acceptable” or “full” function was reported, but most dogs showed improvement in lameness and LOAD scores (p < .001), indicating good to excellent outcomes.
- Meniscal repair success rate was 88% (38/44), with TPLO + IB outperforming TPLO-only (93.3% vs 71.4%). Follow-up was performed at 8 weeks (40 dogs) and 6 months (16 dogs).
- Six failures occurred, all managed with arthroscopic meniscectomy, leading to normal activity in those dogs. Two IB-associated failures led to CrCL instability.
- The authors concluded the technique was safe, practical, and effective, with a reasonable complication rate.
- The findings support arthroscopic suturing as a feasible alternative to meniscectomy or meniscal release, offering long-term benefits for preserving the meniscus.
Veterinary Surgery
5
2024
Short‐term outcomes of 43 dogs treated with arthroscopic suturing for meniscal tears
2024-5-VS-rocheleau-3
In Schmutterer 2024 et al., what was the observed peak pressure in the lateral meniscus at 125° flexion?
🔍 Key Findings Summary
- Biomechanical study on 14 hindlimbs from Retrievers (cadaveric)
- Three stifle flexion angles tested: 125°, 135°, and 145°
- Contact Force Ratio (CFR) was significantly higher at 125° and 135° than at 145° (p < 0.001)
- Center of force shifted caudally with increasing flexion — especially in medial meniscus
- Lateral meniscus peak pressure was significantly higher at 125° than 145° (p = 0.049)
- Mean pressures on lateral meniscus decreased with extension, while medial meniscus pressure remained constant
- Relevance: Helps interpret meniscal load in early cruciate disease and in surgical modeling
Veterinary and Comparative Orthopedics and Traumatology
3
2024
Evaluation of Meniscal Load and Load Distribution in the Sound Canine Stifle at Different Angles of Flexion
2024-3-VCOT-schmutterer-3
In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, which neurologic sign was most significantly more common in extreme brachycephalic breeds (EBBs) preoperatively?
🔍 Key Findings
- Extreme brachycephalic breeds (EBBs) presented more acutely and at younger ages, most often with neurological signs compared to other breeds.
- Preoperative signs such as facial nerve paresis, vestibular syndrome, and Horner’s syndrome were significantly more common in EBBs.
- EBBs showed more severe imaging findings, including higher rates of otitis interna (46.3% vs. 8.5%) and brainstem changes (17.5% vs. 3%).
- Intraoperative complications were more frequent in EBBs (11.1% vs. 5.3%), but this difference did not reach statistical significance (p = .078).
- Perioperative complication rates did not differ significantly between EBBs and other breeds (23.5% vs. 29.3%).
- Surgical time was significantly longer in EBBs (median 115 vs. 95 minutes; p = .011).
- MRI or combined CT/MRI were more frequently used in EBBs, likely due to the higher prevalence of neurological signs.
- Despite anatomical challenges, complication rates in EBBs were comparable, supporting TECA-LBO safety in these breeds.
Veterinary Surgery
5
2023
Influence of extreme brachycephalic conformation on perioperative complications associated with total ear canal ablation and lateral bulla osteotomy in 242 dogs (2010–2020)
2023-5-VS-banks-1
In Almeida 2025 et al., on TPLO and partial CCL rupture, where was the greatest increase in ligament thickness observed postoperatively?
🔍 Key Findings
- Transecting the CCL remnant during TPLO did not reduce patellar ligament thickening (PLT) at any measured point (proximal, mid, distal).
- Transection also failed to reduce postoperative patellar ligament shortening (PLL) at 6 weeks.
- Both groups (transected vs non-transected) showed significant thickening and shortening, with greatest PLT increase at the midpoint.
- Increased PLT was positively correlated with tibial plateau rotation (p = 0.02) and postoperative TPA (p = 0.04).
- No correlation between TT-O (tibial tuberosity width index) and PLT, suggesting narrow osteotomies did not influence PLT in this population.
- Partial CCL rupture was not significantly protective; dogs with partial tears still developed ligament thickening.
- Post-TPLO mid-patellar ligament thickening may relate to Gelpi retractor placement and osteotomy mechanics rather than CCL status.
- Authors do not recommend CCL transection during TPLO to prevent desmitis, citing possible increased instability and degeneration.
Veterinary and Comparative Orthopaedics and Traumatology
4
2025
Effect of Cranial Cruciate Ligament Transection during TPLO on Patellar Desmitis in Dogs with Partial Cranial Cruciate Ligament Rupture
2025-4-VCOT-almeida-2
In Knudsen 2024 et al., on CTA diagnosis, what was the approximate percentage of menisci correctly classified in second readings?
🔍 Key Findings
- Multidetector CTA had high sensitivity (up to 100%) and specificity (up to 96%) for detecting medial meniscal tears in dogs.
- Observer experience significantly influenced diagnostic accuracy, with more experienced observers showing higher agreement and better performance.
- Training effect was evident, as less experienced observers improved between first and second readings.
- Positive likelihood ratios ≥4.6 and negative likelihood ratios ≤0.08 were observed, suggesting CTA is clinically useful for confirming or ruling out meniscal injury.
- CTA allowed identification of full and partial thickness lesions, with good visualization in sagittal, transverse, and frontal reconstructions.
- Approximately 90% of menisci were correctly classified in second readings.
- No adverse reactions were noted from the contrast injection; sedation was used instead of general anesthesia.
- CTA was less invasive and potentially more cost-effective compared to arthroscopy, especially in settings without MRI access.
Veterinary Surgery
8
2024
Diagnosis of medial meniscal lesions in the canine stifle using multidetector computed tomographic positive-contrast arthrography
2024-8-VS-knudsen-3
In Moreira 2024 et al., on predictive equations for TPA correction, which CCWO technique produced the **greatest** tibial shortening at high wedge angles?
🔍 Key Findings
- A linear relationship was observed between wedge angle and tibial plateau angle (TPA) correction across all four CCWO techniques.
- All techniques produced predictable TPA corrections using linear regression-derived equations, allowing wedge angle extrapolation to achieve a target postoperative TPA of 5°.
- TLA shift (tibial long axis) increased with wedge angle and influenced final TPA; greatest in Frederick & Cross method.
- Tibial shortening (mTL%) varied by technique, being most severe (up to 40.9%) in traditional Slocum & Devine CCWO and least in newer techniques (7.5–12%).
- The Oxley mCCWO technique showed lower TLA shift compared to the Frederick & Cross and Christ techniques, though similar to Slocum & Devine; tibial shortening was more pronounced than other modified techniques at wedge angles ≤40°.
- Techniques varied in craniocaudal translation and wedge apex positioning, influencing planning accuracy and mechanical axis alignment.
- The corrective wedge angle equations reliably predicted TPA within 4–6° across varied tibial conformations.
- The study supports equation-based planning over static TPA–5° subtraction to reduce risk of under- or over-correction.
Veterinary Surgery
8
2024
Predicting tibial plateau angles following four different types of cranial closing wedge ostectomy
2024-8-VS-moreira-2
In Brincin 2023 et al., on radiographic follow-up post-MPL surgery, what was the likelihood of dogs on NSAIDs at recheck requiring a change in management?
🔍 Key Findings
- Routine follow-up radiographs after MPL surgery influenced management in only 3% of asymptomatic cases.
- Isolated radiographic abnormalities were rare (3.3%) and even less likely to alter treatment unless accompanied by clinical concerns.
- Dogs with both radiographic changes and clinical/owner concerns had 32× higher odds of a management change (OR 32.16, P < .001).
- Lameness, NSAID use, or prior unplanned visits significantly increased the odds of altered post-op plans.
- Owner-reported concerns alone led to a change in only 1.6% of cases without corroborating clinical findings.
- Radiographic follow-up was deemed unnecessary in dogs without owner concerns or abnormal physical findings.
- Hands-on clinical exam remains critical, though video-based rechecks may aid triage in uncomplicated cases.
- The study supports selective radiographic follow-up, reducing unnecessary imaging, stress, and clinician workload.
Veterinary Surgery
3
2023
The value of routine radiographic follow up in the postoperative management of canine medial patellar luxation
2023-3-VS-brincin-4
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings