Quiz Question
In Fracka 2023 et al., on patient-specific guides, which of the following was significantly improved in tibial alignment when using PSGs versus generic guides?
🔍 Key Findings
- 3D-printed patient-specific guides (PSGs) improved tibial cut alignment in the frontal plane compared to generic guides (mean error 1.03° vs 2.41°, p = .036).
- All tibial cuts using PSGs were within 3° of target alignment, while 2/8 of the generic group were outliers.
- PSGs significantly improved sagittal alignment of both distal (p = .018) and cranial (p = .043) femoral cuts.
- No significant difference was found in varus-valgus femoral alignment or closing angle between PSG and generic guide groups.
- Tibial sagittal slope alignment was not significantly different between groups.
- PSGs provided better intraoperative usability, including improved visibility, no loosening, and ease of use.
- Femoral sizing and component fit were equivalent between PSGs and generic guides, ensuring proper prosthesis alignment.
- PSGs may offer training advantages for novice surgeons, especially in anatomically complex or deformed joints.
Veterinary Surgery
5
2023
3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement
2023-5-VS-fracka-1
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 Husi 2023 et al., on TPLO vs TPLO-IB biomechanics, how did the TPLO-IB construct affect rotational stability compared to TPLO alone?
🔍 Key Findings
- TPLO alone failed to neutralize rotational instability under tibial pivot compression (TPT), despite a negative TCT.
- TPLO combined with lateral augmentation (TPLO-IB) restored both craniocaudal and rotational stability to near-intact levels.
- Cranial tibial translation was 6× greater after TPLO vs intact stifles when tested with TPT (p < .001).
- No significant difference in cranial tibial translation or internal rotation between intact stifles and TPLO-IB group during TCT, eTPT, or iTPT.
- TPLO-IB did not overconstrain the stifle, avoiding excessive external rotation.
- External tibial rotation (eTPT) was more sensitive than TCT in detecting persistent instability after TPLO.
- Excellent intraobserver reliability for both eTPT and iTPT (ICC > 0.9).
- Study supports intraoperative use of TPT to identify cases needing additional rotational stabilization.
Veterinary Surgery
5
2023
Comparative kinetic and kinematic evaluation of TPLO and TPLO combined with extra-articular lateral augmentation: A biomechanical study
2023-5-VS-husi-3
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, how was analgesic success defined?
🔍 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.
Veterinary Surgery
5
2023
Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery
2023-5-VS-aldrich-2
In Knudsen 2024 et al., on CTA diagnosis, what was the maximum reported sensitivity of multidetector CTA for detecting meniscal lesions?
🔍 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-1
In Brincin 2023 et al., on radiographic follow-up post-MPL surgery, what percentage of asymptomatic dogs had isolated radiographic findings that altered 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-1
In Longo 2023 et al., on CT trochlear measurements, what was the most reliable parameter for determining the need for trochleoplasty in dogs with MPL?
🔍 Key Findings
- Dogs with MPL had significantly shallower femoral trochlear grooves compared to controls, based on CT-measured femoral trochlear groove angle (FTGA).
- FTGA >134° in small breeds (SB) and >128° in medium/large breeds (MLB) were associated with MPL and can serve as surgical thresholds for considering trochleoplasty.
- FTA and FTRIA measurements were less reliable, showing lower sensitivity/specificity than FTGA.
- Inter-rater reliability for FTGA was excellent (ICC > 0.9), supporting its use in clinical decision-making.
- FTGA differed significantly between SB and MLB dogs, suggesting anatomical variation influences MPL predisposition.
- Dogs with MPL but with FTGA below threshold may not benefit from trochleoplasty, supporting individualized surgical planning.
- CT provides more precise and reproducible evaluation of trochlear morphology than radiography or ultrasound.
- The study introduces a CT protocol using P25 and P50 reference points for consistent FTGA measurement.
Veterinary Surgery
3
2023
Computed tomographic measurements of the femoral trochlea in dogs with and without medial patellar luxation
2023-3-VS-longo-1
In Rocheleau 2024 et al., on arthroscopic meniscal suturing, what was the overall complication 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-2
In Wylie 2025 et al., on femoral implant accuracy, what was the overall effect of internal brace augmentation on pivot shift grades at 6 weeks?
🔍 Key Findings
- Accurate femoral isometric placement was achieved in 63% of cases, significantly more with SwiveLock (78.6%) than FASTak (38.9%).
- Inaccurate placement was associated with increased internal tibial rotation at follow-up (p = .009), suggesting potential implant failure.
- Pivot shift grade improved in 90.9% of stifles postoperatively, regardless of implant positioning accuracy.
- SwiveLock implants had a faster learning curve and higher placement accuracy than FASTak.
- Higher patient weight was linked to more accurate implant placement (p = .012), likely due to easier anatomical landmark identification.
- No correlation found between implant type or positioning accuracy and final pivot shift grade at 6 weeks.
- Minor and major complications were low and not significantly different between implant types.
- A simplified 2-grade pivot shift system was proposed for clinical use (Grade 1: glide, Grade 2: clunk), aiding intraoperative decision-making.
Veterinary Surgery
7
2025
Evaluation of femoral isometric placement accuracy of internal brace implants and its impact on stifle stability in the management of pivot shift phenomenon following TPLO
2025-7-VS-wylie-3
In Kikuchi 2025 et al., on arthroscopic MMI in toy breeds, which variable was **not** part of the final regression model predicting MMI?
🔍 Key Findings
- Medial meniscus injury (MMI) occurred in 36.3% of stifles with CrCLR in toy breed dogs (<5 kg)
- Complete CrCLR was significantly associated with MMI (15.3% of complete vs. 3.4% of partial)
- Severe lameness (grade 3) increased the likelihood of MMI compared to mild lameness (grade 1)
- Higher body weight, even within the toy breed range, was positively associated with MMI
- Yorkshire Terriers had the highest MMI incidence (55.6%), but this was not a significant independent factor due to multicollinearity
- Arthroscopy identified more meniscal damage (including small radial tears and bucket-handle lesions) than gross examination might detect
- MMI was classified as mild (radial tear) or severe (bucket-handle or flap) with implications for partial meniscectomy
- Arthroscopy was used in all cases, underscoring its utility in small-breed stifle assessment
Veterinary and Comparative Orthopaedics and Traumatology
5
2025
Incidence of Medial Meniscus Injury Detected by Arthroscopy in Toy Breed Dogs
2025-5-VCOT-kikuchi-4
Quiz Results
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Key Findings