Orthopedics

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When should you consider this procedure?

Which form of surgical treatment is best?

This study demonstrated that short-term administration of glucosamine-chondroitin sulfate does not significantly affect serum fructosamine concentrations in healthy dogs.

A Q&A with Dr. Ronald McLaughlin, a specialist in orthopedics, gait analysis and biomechanics.

Is there an early radiographic marker for hip dysplasia in dogs?

Identifying the cause of forelimb and hind limb lameness in dogs can be a challenge. Until recently, diagnostics in small animal orthopedics included visual gait analysis and radiographs. With advanced diagnostics becoming more readily available (objective gait analysis, CT scan, MRI, ultrasound, nuclear scintigraphy, arthroscopy, etc) clinicians can now obtain a definitive diagnosis to those challenging conditions.

Injuries to the carpus and tarsus are common in agility and sporting dogs. The carpal and tarsal joints act as sock absorbers for the limb during weight bearing. They are prone to injury due to their complexity and lack of muscular support. The complexity of these joints creates a diagnostic problem for many veterinarians. Many carpal and tarsal injuries, particularly those that go undiagnosed or untreated, can result in an increased risk of osteoarthritis and potential long-term lameness.

Fracture repair results in the creation of a bone-implant composite. Although most of our interventions for fracture repair are successful, at times it seems as though there are an endless number of errors that may prevent the fracture from healing. Fortunately, once the cause of the complication is recognized, the underlying problem can often be corrected and a successful outcome eventually attained.

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to control acute and chronic pain in veterinary patients. The presence and activity of two isoforms of the cyclooxygenase (COX) enzyme, a constitutive COX-1 and an inducible COX-2, have been investigated intensely since the early 1990s.

The ability to diagnose the cause of a lameness is essential to the small animal clinician. In our day to day practice settings, dogs and cats present with a variety of lamenesses. Many of these problems resolve with rest, or a diagnosis is readily available (cut pad, ingrown nail, etc?).

Traumatic fragmented medial coronoid process (TFMCP) is a condition in the elbow joint of dogs that appears to occur commonly in performance dogs. Unlike the classic condition of fragmented medial coronoid process (FMCP) affecting the elbow joints of skeletally immature large to giant breed dogs, jump down syndrome (TFMCP) appears to have no age or size limitations.

While considered a very common problem in small animal medicine, osteoarthritis is very likely the most under diagnosed, and misunderstood rheumatic disease in dogs and cats. Part of the problem veterinarians face with OA is that it is a slow, progressive and often insidious problem.

It is important to understand that when a dog presents with a dog with hip laxity (hip dysplasia) with or without secondary degenerative changes, that there is not one single way to manage every patient. Initially, one must decide if a particular patient is better suited for medical or surgical options.

Current treatment options for osteoarthritis are extensive and can be categorized into medical/ conservative or surgical therapies. Medical therapies may consist of weight control, exercise modification, rehabilitation therapy, pain management medications, oral joint protective compounds, and intra-articular treatments.

The most common hind limb orthopedic/sports medicine conditions afflicting active dogs are iliopsoas strains, cranial cruciate ligament (CCL) insuffiency and gracilis and semitendinosus contracture. Of the hind limb muscular injuries iliopsoas strain is, by a considerable margin, seen more frequently than gracilis and semitendinosus contracture.

There are numerous studies indicating the positive benefits of rehabilitation therapy following CCL surgery. In summary, rehabilitation therapy has been shown to improve muscle mass and attenuate muscle atrophy that occurs in the post-operative period, increase stifle joint ROM, especially extension, improve weight-bearing as measured by force plate analysis, and reduce the progression of osteoarthritis.

Soft tissue injuries and osteoarthritis are common conditions afflicting active dogs due to the repetitive forces placed on the joints. Microtrauma to the tendons, ligaments, and the articular surfaces of joints can occur, creating an environment for osteoarthritic development.

Metallic implants placed in the body should be corrosion-resistant, biocompatible, and must have adequate strength to withstand functional stress. Corrosion of metal occurs because of the electrochemical ions in body fluid. Most metal implants currently used in veterinary surgery are of 316L stainless steel.

Similar to dogs, joint disorders of the cat are common. Despite this fact, the reported treatment options for cats with joint disease are limited. The object of this presentation is to describe the clinical findings, surgical / arthroscopic findings and post-operative management of cats with joint disorders including elbow osteoarthritis and medial compartment disease, shoulder osteoarthritis and medial shoulder instability, and cranial cruciate ligament insufficiency.

Diagnosing and treating forelimb conditions in dogs can be very challenging. Many dogs present with a similar history including minimal responsive to rest and non-steroidal anti-inflammatory drugs and increased lameness following exercise and heavy activity. It can be difficult to localize the lesion on palpation as many dogs may show increased sensitivity in the shoulder and elbow from referred pain and compensation.

A working definition of antimicrobial prophylaxis in surgery is the administration of an antimicrobial drug to a patient, in the absence of infection, prior to surgery. The history of the use of these agents during surgery is interesting and reveals many of the problems which occur with their use.

Four studies on treating joint disease.

A roundtable discussion of joint health and disease in dogs and cats.

Owners and veterinarians often seek additional therapies for dogs with osteoarthritis that are safe and effective.