Hind Limb Lameness In Dogs Research Articles

Multiparametric Comparison of Two TTA-Based Surgical Techniques in Dogs with Cranial Cruciate Ligament Tears.

Tearing of the cranial cruciate ligament causes hindlimb lameness in dogs. Different surgical procedures have been proposed to treat this condition. In this study, two different TTA-based techniques and implants were compared. A total of 30 dogs were separated into two groups according to the technique and implant used (Porous TTA® or Model Xgen®). The aim of the study was to assess whether one of these techniques has better functional recovery of the joint, better bone consolidation after the osteotomy procedure and fewer osteoarthritic changes. We compared both groups up to 3 months after surgery. No significant differences were found in any of the assessed parameters. Thus, both procedures were found to be equally effective and safe.

Biomechanical cyclic loading test of a synthetic ligament fixation system used for intra-articular stabilization of deficient canine stifles.

Background:Cranial cruciate ligament rupture (CCLr) is the most common cause of hind limb lameness in dogs. Currently, surgical management of CCLr is mostly performed using tibial osteotomy techniques to modify the biomechanical conformation of the affected stifle. These surgical techniques have a significant complication rate, associated with persistent instability of the stifle which may lead to chronic postoperative pain. Over the last decade, studies have been published on various techniques of anatomical caudal cruciate ligament reconstruction in veterinary practice, using physiological autografts or woven synthetic implants.Aim:The aim of this ex vivo biomechanical study is to investigate the ex vivo dynamic biomechanical behavior of a synthetic implant [ultrahigh molecular weight polyethylene (UHMWPE) implant] fixed with interference screws for the treatment of CCLr in dogs, according to a fatigue protocol (48 hours per test).Methods:Seven stifles from four skeletally mature canine cadavers were implanted with the synthetic implant. It was fixed with four interference screws inserted in transversal and oblique tunnels in both the distal femur and the proximal tibia. For each case, 100,000 cycles were performed at 0.58 Hz, with traction loads ranging from 100 to 210 N.Results:Neither screw-bone assembly rupture nor a pull-out issue was observed during the dynamic tests. Linear stiffness of the implants associated with a fixation system with four interference screws increased over time. The final displacement did not exceed 3 mm for five of the seven specimens. Five of the seven synthetic implants yielded to a lengthening in functional range (0–3 mm). Linear stiffness was homogeneous among samples, showing a strong dynamic strength of the interference screw-based fixations of the UHMWPE implant in the femoral and tibial bones.Conclusion:This study completes the existing literature on the biomechanical evaluation of passive stifle stabilization techniques with a testing protocol focused on cyclic loading at a given force level instead of driven by displacement. These biomechanical results should revive interest in intra-articular reconstruction after rupture of the CCLr in dogs.

Hip dysplasia: understanding the options (conservative management)

Canine hip dysplasia (CHD) is a common cause of hind limb lameness in dogs, and may be managed either conservatively or surgically. There is no single treatment option that is appropriate for every dog. This article looks at the evidence for the usefulness of conservative management, and discusses the different options within conservative management: optimisation of body weight; modulation of exercise; physiotherapy; and medical management, including use of analgesics, the prostaglandin receptor antagonist grapiprant, and various supplements. Conservative management should be multimodal, employing various of these options in combination as appropriate for the individual patient.

Association of tibial plateau leveling osteotomy with proximal tibial osteosarcoma in dogs.

OBJECTIVE To assess for any association between a history of tibial plateau leveling osteotomy (TPLO) and subsequent development of proximal tibial osteosarcoma in dogs. DESIGN Matched case-control study. ANIMALS 34 client-owned dogs in which proximal tibial osteosarcoma was diagnosed between January 2005 and December 2012 (cases) and 79 dogs without osteosarcoma, matched 3:1 to cases (when possible) by age, breed, and initial examination date (controls). PROCEDURES Information on each case and control was collected from the medical records and other sources regarding date of birth, sex and neuter status, body weight, breed, and whether TPLO had been performed ≥ 1 year ago. A multivariable conditional logistic regression model was constructed to evaluate associations of body weight and history of TPLO with the outcome of proximal tibial osteosarcoma in dogs. RESULTS After adjusting for body weight in the multivariable model, dogs with a history of TPLO were 40 times as likely to develop proximal tibial osteosarcoma as were dogs with no history of TPLO. In addition, each 1-kg (2.2-lb) increase in body weight was associated with an 11% increase in the odds of proximal tibial osteosarcoma. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that dogs with a history of TPLO were at increased risk of developing osteosarcoma of the proximal region of the tibia relative to dogs with no such history. Therefore, it is important for proximal tibial osteosarcoma to be included among the differential diagnoses for new or worsening hind limb lameness in dogs that underwent TPLO ≥ 1 year previously.

Posturography and dynamic pedobarography in lame dogs with elbow dysplasia and cranial cruciate ligament rupture

BackgroundThe usefulness of studying posture and its modifications due to locomotor deficiencies of multiple origins has been widely proven in humans. To assess its suitability in the canine species, static posturography and dynamic pedobarography were performed on lame dogs affected with unilateral elbow dysplasia and cranial cruciate ligament rupture by using a pressure platform. With this objective, statokinesiograms and stabilograms, the percentage of pressure distribution between limbs, paw area, mean pressure, and peak pressure, were obtained from lame and sound dogs. These data were compared with Peak Vertical Force values originated from a force platform in the same recording sessions.ResultsSignificant differences were found in the parameters mentioned above between sound and lame dogs and limbs.ConclusionsPosturography and pedobarography are useful and reliable for the monitoring of fore and hindlimb lameness in dogs, providing a new set of parameters for lameness detection.

Vertical head and pelvic movement symmetry at the trot in dogs with induced supporting limb lameness

Compensatory limb loading has been studied in lame dogs; however, little is known about how these compensations relate to motion of the head and pelvis, assessment of which is an important component of lameness examinations. The aim of this study was to describe the patterns of vertical head and pelvic motion symmetry at the trot in dogs with induced supporting limb lameness in the forelimbs or hind limbs. Ten sound dogs were trotted on a treadmill before and after temporary induction of moderate lameness (grade 2/5) in each limb. Reflective markers were located on the head, pelvis and right forelimb, and kinematic data were captured with a motion capture system. Upper body symmetry parameters were calculated, including differences in the highest (HDmax) and in the lowest (HDmin) positions of the head, and in the highest (PDmax) and in the lowest (PDmin) positions of the mid-pelvis, with a value of zero indicating symmetry. The head was lowered more during the sound limb stance phase and lowered less during the lame limb stance phase in supporting forelimb lameness (HDmin: 4.6mm in dogs when sound, −18.3mm when left limb lameness was induced and 20.5mm when right limb lameness was induced). The mid-pelvis was lowered more during the sound limb stance phase and lowered and lifted less during the lame limb stance phase in supporting hind limb lameness (PDmin: 1mm in dogs when sound, −10.1mm in left limb lameness and 8.4mm in right limb lameness). The hip of the lame side, measured at the level of the greater trochanter, had an increased downwards displacement during the lame limb swing phase (−21mm in left hind limb lameness, P=0.005; 23.4mm in right hind limb lameness, P=0.007). Asymmetry in the lowering of the head or mid-pelvis is a more sensitive indicator of supporting forelimb and hind limb lameness, respectively, than asymmetry in the raising of the head. Increased displacement of the hip (‘hip drop’ of the lame side during its swing phase) is a good indicator of hind limb lameness in dogs.

Comparison of High-field and Low-field Magnetic Resonance Imaging of Stifle Joint Disorders in Dogs.

The most common cause of hindlimb lameness in dogs is cranial cruciate ligament rupture. In 48-77.3% of the population this trauma leads to secondary damage of the meniscus. Depending on the magnetic strength of the used device, different diagnostic accuracy can be achieved. The examination sensitivity of magnetic resonance imaging is affected by many factors which are independent of diagnostic strength, such as correct positioning of the patient, size of the stifle joint examined, or selection of the right protocol of sequences. Sensitivity of meniscus damage detection was 100% and 90%, respectively, in high- and low-field magnetic resonance. The best results were reported during examination of the stifle in dogs above 10 kg b.w. at a flexion angle of 145°, and in sagittal and dorsal planes. Regardless of the magnetic strength applied, imaging of the whole cranial cruciate ligament is difficult. Moreover, MRI allows the detection of the first signs of osteoarthritis, which were observed 4 and 6 weeks after rupture of the cranial cruciate ligament using high and low-field MRI. This also applies to lesions in the subchondral bone or a bone marrow which occurred in association with insufficiency of the stifle joint, and were mainly localized in the epiphysis of the femur and tibia. The present article provides a comparison of different examination protocols and images of damaged stifle structures, such as menisci, ligaments and bones of the stifle joint visualized with low-field and high-field magnetic resonance. Magnetic resonance arthrography is also discussed.

The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency

<p><strong>Objective: </strong>To assess weight bearing of dogs treated for unilateral cranial cruciate ligament insufficiency with a custom stifle orthotic.</p><p><strong>Background: </strong>Cranial cruciate ligament (CCL) insufficiency is the most common cause of hind limb lameness in dogs. While there are numerous options for surgical management, surgery is not always an option. Recently, the use of canine stifle orthotics has also emerged as a means to non-surgically manage patients with cranial cruciate ligament insufficiency. <strong></strong></p><p><strong>Evidentiary value:</strong> This is a retrospective study of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic.</p><p><strong>Methods: </strong>Medical records (January 2005- December 2012) of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic were reviewed. Temporospatial gait analysis was performed using a pressure sensing walkway at baseline and 90 days or greater post orthotic placement to identify weight bearing with total pressure index % (TPI%).</p><p><strong>Results: </strong>TPI% improved significantly by 5.1% in the affected limb when compared to baseline (<em>p</em> = 0.0020). At final gait analysis, TPI% significantly improved by 3% in the affected limb with the orthotic off when compared to the unaffected limb (<em>p</em> = 0.0020).</p><p><strong>Conclusion: </strong>Custom canine stifle orthotics allow for improved weight bearing in the affected limb.</p><p><strong>Application</strong>: Custom canine stifle orthotics should be considered for cases with concurrent medical conditions or financial constraints that do not allow for surgical intervention.</p>

Accuracy of pressure plate kinetic asymmetry indices and their correlation with visual gait assessment scores in lame and nonlame dogs

To determine the accuracy of pressure plate kinetic asymmetry indices (ASIs) for diagnosis of unilateral hind limb lameness in dogs and their correlation with visual gait assessment (VGA) scores. 9 healthy dogs and 16 dogs with previously diagnosed unilateral rupture of the cranial cruciate ligament and concurrent unilateral hind limb lameness. Dogs were walked over a pressure plate to determine paw contact area (PCA), peak vertical pressure (PVP), peak vertical force (PVF), and vertical impulse (VI) of both hind limbs. An ASI was calculated for each gait variable. Simultaneously, gait was assessed visually and scored by use of a numeric rating scale (0 to 10). The ASI of each variable was tested for its usefulness in discrimination between lame and nonlame dogs and for correlation with VGA scores. Sensitivity and specificity of ASIs to discriminate between lame and nonlame dogs were excellent for PVF, VI, and PCA; these values were substantially lower for ASI of PVP. Cutoff values to discriminate between lame and nonlame dogs were determined by use of ASIs for PVF, VI, and PCA; however, this could not be done for ASI of PVP. Correlations between ASIs of PVF, VI, and PCA and VGA scores were higher than correlation between the ASIs of PVP and VGA scores. Results indicated that ASIs of PVF and VI determined via analysis of pressure plate measurements were reliable indicators of clinical lameness in dogs, but the ASI of PVP was not. The ASI of PCA is an interesting new variable for assessment of limb loading symmetry.

Effect of exercise on kinetic gait analysis of dogs afflicted by osteoarthritis

To evaluate the effects of moderate exercise on kinetic gait analysis using a force platform in dogs with hindlimb lameness due to osteoarthritis (OA). Ten control dogs (Control) and 10 dogs presented with chronic and stable hindlimb lameness (OA) were recruited. Dogs were subjected to force platform gait analysis to determine baseline data. They were thereafter trotted for a distance of 1.2 km on a short leash, lead by the same handler at a gait convenient for each of them (ranging from slow to fast trot), after which the gait analysis was immediately repeated to determine post-exercise values. Peak and impulse of the vertical and braking / propulsion forces were analysed using a linear model for repeated measures and Bonferroni sequential correction. In the Control group, the differences between baseline and post-exercise data were not significant. Conversely, post-exercise peak (p = 0.020) and impulse (p = 0.009) values of the vertical force, as well as the peak of the propulsion force (p = 0.009) values were significantly lower than baseline in the OA group. This study demonstrates the significant effect of a moderate amount of exercise in exacerbating hindlimb lameness in dogs clinically afflicted by OA. It is suggested that: 1) exercise should be considered as a potential factor of variation in future force platform gait analyses and an effort should be made to limit bias in data recording; and 2) an exercise-based protocol could be added to the standard force platform gait analysis to potentially increase its sensitivity in the detection of lame dogs.

Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs

To determine the accuracy of asymmetry indices of ground reaction forces (GRF) for diagnosis of hind limb lameness in dogs. 36 healthy dogs and 13 dogs with naturally acquired cranial cruciate ligament rupture or hip dysplasia. Lameness for affected dogs ranged from not detectable to minor and constant. While dogs trotted on an instrumented treadmill, GRF variables were recorded and analyzed with asymmetry indices. Each index was tested for its ability to discriminate between healthy and affected dogs. Combinations of several indices were also assessed. Vertical force variables had better accuracy than craniocaudal force variables. Peak vertical force was the most accurate variable. Partial asymmetry during trotting was detected in healthy dogs. A multivariate approach that used peak vertical force and maximal rising slope yielded the optimum combination to distinguish between healthy and affected dogs. In addition, sensitivity of 92% or specificity of 95% may be achieved with 2 cutoff values while simultaneously maintaining specificity or sensitivity, respectively, at > 85%. Asymmetry indices of GRFs were accurate for detection of hind limb lameness in dogs. This is particularly relevant for study designs in which only a single gait evaluation is possible.

Decision making in the management of cranial cruciate ligament rupture

RUPTURE of the cranial cruciate ligament is one of the most common causes of chronic hindlimb lameness in dogs and accounts for a significant fraction of the case load of many referral surgeons, practices and teaching institutions. Difficulty in diagnosis and uncertainty as to the best method of treatment appear to be the main factors contributing to the high case load. This article describes the diagnostic signs and tests that the author finds most helpful and discusses the various treatment options.

Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hindlimb lameness.

When lameness occurs in a load-bearing limb, compensatory load adjustments are made in the other supporting limbs. The vertical component of the ground reaction force, as measured by force platform analysis, reflects these adjustments. This study describes the pattern of vertical ground reaction force redistribution during experimental, chronic hindlimb lameness in dogs. The peak and impulse of the vertical ground reaction force were measured and described in 13 dogs before, and at 2, 6, and 12 weeks after transection of the cranial cruciate ligament. These variables were compared among limbs. The vertical ground reaction force in the forelimbs did not change significantly during the course of the study. At 2, 6, and 12 weeks after surgery, means of peak vertical force in the limb that underwent surgery were 18.9%, 44.0%, and 61.3% respectively, of presurgical values. In the contralateral limb, corresponding values were 131.7%, 112.8% and 112.9% respectively. If one accepts the relationship of mechanical loading to musculoskeletal architecture and the now certain relationship between lameness and compensatory loading of other limbs, then the use of another limb of the same animal as a control is a potential study design flaw.