Quiz Question

In McKay 2023 et al., on patellar tendon augmentation, which of the following was **only observed** in the combined TBW augmentation group?

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Correct. Patellar fractures were only reported in the combined group (11%), likely due to dual transosseous tunnels.
Incorrect. The correct answer is Patellar fracture.
Patellar fractures were only reported in the combined group (11%), likely due to dual transosseous tunnels.

2023-8-VS-mckay-4

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In Mayhew 2023 et al., on BOAS surgery effects, which surgical procedures were consistently performed in all dogs in the study?

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Correct. All dogs underwent laryngeal ventriculectomy and soft palate resection; alaplasty was performed in 14/16.
Incorrect. The correct answer is Laryngeal ventriculectomy and soft palate resection.
All dogs underwent laryngeal ventriculectomy and soft palate resection; alaplasty was performed in 14/16.

🔍 Key Findings

  • Owner-reported regurgitation improved after CMS, especially post-eating and during activity (P = .012 and P = .002)
  • No significant improvement in VFSS measures of SHH or GER postoperatively (P > .05 for all comparisons)
  • Laryngeal ventriculectomy and soft palate resection were performed in all dogs, alaplasty in 14/16
  • Aspiration pneumonia occurred in 1 dog immediately post-op and resolved with treatment
  • Post-op esophagoscopy results varied, with persistent esophagitis in some cases
  • Clinical response was variable, with ~25–30% of dogs being “non-responders” based on owner scoring
  • 13/16 dogs showed partial or full clinical improvement, despite no change in objective SHH/GER indicators
  • Final follow-up at median 36.5 months showed some dogs still on medical therapy; one underwent further surgery

Mayhew

Veterinary Surgery

2

2023

Effect of conventional multilevel brachycephalic obstructive airway syndrome surgery on clinical and videofluoroscopic evidence of hiatal herniation and gastroesophageal reflux in dogs

2023-2-VS-mayhew-4

Article Title: Effect of conventional multilevel brachycephalic obstructive airway syndrome surgery on clinical and videofluoroscopic evidence of hiatal herniation and gastroesophageal reflux in dogs

Journal: Veterinary Surgery

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In Clough 2022 et al., on CBLO-TTT construct testing, what is the clinical implication of combining CBLO and TTT?

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Correct. The study supports the feasibility of combined CBLO-TTT to address both stifle instability and patellar luxation.
Incorrect. The correct answer is It offers a viable option for concurrent MPL and CCL treatment..
The study supports the feasibility of combined CBLO-TTT to address both stifle instability and patellar luxation.

🔍 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-5

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 Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), which procedure consistently under-corrected the tibial plateau angle despite a target TPA of 0°?

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Correct. Group C (mCCWO) aimed for 0° TPA but achieved a mean of 4.76°, reflecting consistent under-correction.
Incorrect. The correct answer is mCCWO.
Group C (mCCWO) aimed for 0° TPA but achieved a mean of 4.76°, reflecting consistent under-correction.

🔍 Key Findings

  • All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
  • Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
  • Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
  • Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
  • Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
  • Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
  • All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
  • Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.

Story

Veterinary Surgery

8

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-8-VS-story-4

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Jenkins 2022 et al., on medial epicondylar fissure fracture, what was the most significant risk factor for developing MEFF?

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Correct. Larger screw size relative to condylar height (>41%) significantly increased MEFF risk (P = .004, OR 1.52).
Incorrect. The correct answer is Using screws with a size-to-condylar height ratio >41%.
Larger screw size relative to condylar height (>41%) significantly increased MEFF risk (P = .004, OR 1.52).

🔍 Key Findings

  • MEFF occurred in 11.4% (10/88 elbows) following medial-to-lateral transcondylar screw placement in dogs with HIF.
  • Screw size to condylar height ratio >41% significantly increased MEFF risk (P = .004, OR 1.52).
  • MEFF was not recognized intraoperatively in 60% of cases and was only seen on follow-up or retrospective imaging review.
  • Screw loosening was the most common complication (11.2%), observed both with and without MEFF.
  • MEFF tended to increase the risk of screw loosening (P = .06), but was not statistically significant.
  • Most MEFFs did not require treatment and healed radiographically by 14–17 weeks in monitored cases.
  • Shaft screws were used in all MEFF cases, but shaft vs cortical design was not significantly associated with MEFF.
  • The clinical impact of MEFF was minor in most cases, although long-term significance is unknown.

Jenkins

Veterinary Surgery

4

2022

Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure

2022-4-VS-jenkins-1

Article Title: Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure

Journal: Veterinary Surgery

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In Evers 2023 et al., on needle arthroscopy, what was a common limitation of needle arthroscopy compared to standard arthroscopy?

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Correct. Visibility scores were significantly lower for needle arthroscopy across all meniscal regions.
Incorrect. The correct answer is Poor visualization of meniscal horns.
Visibility scores were significantly lower for needle arthroscopy across all meniscal regions.

🔍 Key Findings

  • Needle arthroscopy (NA) had 95% sensitivity and 100% specificity for detecting medial meniscal tears using standard arthroscopy (SA) as the reference.
  • NA correctly identified meniscal status in 25/26 dogs, missing only one stable nondisplaced tear.
  • NA took less time than SA: 8 ± 3 min vs. 15 ± 9 min (P = .0041).
  • Visibility scores were significantly lower with NA than SA for all meniscal horns (medial and lateral) .
  • Probing difficulty was greater with NA, especially for the lateral meniscus (P = .0017).
  • NA caused no measurable morbidity: lameness scores were unchanged before and after the procedure (P = .25).
  • NA was possible in sedated dogs, though 10/26 required additional anesthesia due to delays.
  • NA missed 1 lateral tear, likely due to reduced access and lack of shaving compared to SA.

Evers

Veterinary Surgery

7

2023

Accuracy of needle arthroscopy for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture

2023-7-VS-evers-2

Article Title: Accuracy of needle arthroscopy for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture

Journal: Veterinary Surgery

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In Miller 2025 et al., on spinal drill guide accuracy, what was a reported technical benefit of the SOP plate when used with the 3D-printed guides?

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Correct. The plate helped realign vertebrae during screw placement, effectively serving as a reduction aid.
Incorrect. The correct answer is Acted as a reduction guide.
The plate helped realign vertebrae during screw placement, effectively serving as a reduction aid.

🔍 Key Findings

  • 3D-printed, SOP plate-specific guides enabled safe screw placement from T12–L5 in canine cadavers and models.
  • All 140 screw trajectories were classified as Zdichavski Grade 1, indicating optimal placement without vertebral canal breach.
  • Screw angles (cranial-caudal and transverse) matched preoperative planning, with no significant deviation.
  • Entry/exit point deviations were <1 mm on average, deemed clinically negligible.
  • Drill guides were quick to place (<30 sec per vertebra) and improved ease of surgery.
  • Plates acted as effective reduction tools, guiding alignment during screw placement in mobile spines.
  • Minor technical challenges arose from cadaveric spine mobility, mitigated by sequential screw insertion.
  • Technique may enable future use in fracture/luxation reduction, pending further cadaveric and clinical trials.

Miller

Veterinary Surgery

6

2025

Development and testing of an animal-specific and string-of-pearls (SOP) plate specific, three-dimensionally (3D) printed drilling guide: A proof of concept study for canine thoracolumbar spinal stabilization

2025-6-VS-miller-3

Article Title: Development and testing of an animal-specific and string-of-pearls (SOP) plate specific, three-dimensionally (3D) printed drilling guide: A proof of concept study for canine thoracolumbar spinal stabilization

Journal: Veterinary Surgery

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In Papacella-Beugger 2024 et al., on neuronavigation, what percentage of screws were deemed appropriately placed?

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Correct. 85% (17/20) of screws were well-positioned using spinal neuronavigation:contentReference[oaicite:0]{index=0}
Incorrect. The correct answer is 85%.
85% (17/20) of screws were well-positioned using spinal neuronavigation:contentReference[oaicite:0]{index=0}

🔍 Key Findings Summary

  • Cadaveric study using 3 miniature breed dogs (6 hemipelves) to assess spinal neuronavigation accuracy for lumbar plate fixation
  • 20 screws placed using CBCT-based navigation with real-time tracking
  • 85% (17/20) of screws were safely and accurately placed
  • Median deviation of screw entry points from plan: 1.8 mm
  • All 3 misplaced screws occurred in a single cadaver, attributed to inexperienced drill handling
  • Custom 3D-printed lightweight tracking array was necessary due to small spinous processes in miniature dogs
  • No iatrogenic canal perforations or vertebral damage in any specimen
  • Concludes neuronavigation offers precise, safe placement of spinal implants in small dogs, with minimal anatomic disruption

Papacella

Veterinary and Comparative Orthopedics and Traumatology

6

2024

Spinal Neuronavigation for Lumbar Plate Fixation in Miniature Breed Dogs

2024-6-VCOT-papacella-beugger-1

Article Title: Spinal Neuronavigation for Lumbar Plate Fixation in Miniature Breed Dogs

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Thomsen 2024 et al., on CT accuracy for liver tumors, which anatomical level had the highest accuracy?

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Correct. Accuracy was 88% when localizing by division, compared to 74.3% at the lobe level.
Incorrect. The correct answer is Liver division.
Accuracy was 88% when localizing by division, compared to 74.3% at the lobe level.

🔍 Key Findings

  • CT localization of liver masses was more accurate by division (88%) than by lobe (74.3%)
  • Inter-radiologist agreement was excellent for division (kappa up to 0.885) and only moderate–good for lobe
  • Quadrate and right lateral lobes had significantly lower localization accuracy compared to left lateral or medial lobes
  • CT localization of the left division was most accurate (90.1%) compared to central (77.1%) and right (88.3%)
  • Portal and hepatic venous phases were equally helpful for localization (each ~30–38% usefulness)
  • No significant associations found between histopathologic diagnosis and localization accuracy
  • Lobe-level CT localization should be interpreted with caution, especially for the quadrate and right lateral lobes
  • Radiologist experience likely influenced accuracy, with the most experienced radiologist performing best

Thomsen

Veterinary Surgery

7

2024

Computed tomography scan accuracy for the prediction of lobe and division of liver tumors by four board-certified radiologists

2024-7-VS-thomsen-1

Article Title: Computed tomography scan accuracy for the prediction of lobe and division of liver tumors by four board-certified radiologists

Journal: Veterinary Surgery

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In Stoneburner 2024 et al., on MIS survey results, what was the most commonly cited barrier to performing more MIS procedures?

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Correct. This was the top-ranked barrier to MIS expansion in the survey.
Incorrect. The correct answer is Lack of consistent caseload.
This was the top-ranked barrier to MIS expansion in the survey.

🔍 Key Findings

  • The survey included 111 practicing surgeons and 28 residents from ACVS, ECVS, and ANZCVS. 98.2% had performed soft tissue minimally invasive surgery (MIS).
  • In the past year, surgeons reported a median caseload of 90% basic laparoscopy, 0% advanced laparoscopy, and 10% thoracoscopy; for residents: 100% basic laparoscopy, 0% advanced, 0% thoracoscopy.
  • Laparoscopic ovariectomy and OHE were the most commonly performed MIS procedures, with most respondents proficient in basic laparoscopy, but few performing advanced laparoscopy or thoracoscopy.
  • Top barriers to MIS adoption were: lack of consistent caseload, lack of training, difficult learning curve, equipment limitations, and cost.
  • 76.6% of surgeons and 92.9% of residents received MIS training during residency. Those trained had completed residency median 6 years ago, compared to 22 years ago for those without MIS training (p < .001). Perceived adequate training correlated with higher proficiency.
  • MIS was recognized as having a steep learning curve, but patient benefits (mean score 4.0/5) were the top motivation — less pain, faster recovery, improved visualization.
  • The authors conclude basic laparoscopy is widely adopted, but advanced and thoracoscopic MIS remain underutilized. Training and access are key to future growth.
  • Expanded training and improved access to equipment are necessary to promote broader integration of MIS into veterinary soft-tissue surgery.

Stoneburner

Veterinary Surgery

5

2024

Laparoscopy and thoracoscopy in small animal surgery: A 2020 survey of small animal surgical diplomates and residents

2024-5-VS-stoneburner-4

Article Title: Laparoscopy and thoracoscopy in small animal surgery: A 2020 survey of small animal surgical diplomates and residents

Journal: Veterinary Surgery

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Quiz Results

Topic: Surgical Techniques & Planning
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