Concerns have been raised about the predictability of achieving appropriate tibial plateau angles (TPA), the occurrence of axis shift and tibial length reduction following cranial closing wedge ostectomy (CCWO). The primary objective of this review was to quantify typical errors in achieving target TPA with CCWO, with secondary objectives of assessing axis shift and length reduction. Retrospective or prospective studies of CCWO used as the primary treatment, from any date and in English, were eligible for inclusion. Searches were performed in EMBASE, Ovid MEDLINE, Agricola, Scopus, Web of Science, and CAB abstracts. Risk of bias was assessed, and data were screened for outliers and influential cases. Extracted data from 11 included studies were tabulated and underwent meta-analysis using R. Mean errors in TPA after CCWO ranged from - 0.6-2.9°, indicating the possibility of both under- and over-correction depending on the selected technique. Errors were relatively consistent for technique subgroups. Mean axis shifts ranged from 3.4° to 5.2°, and length reduction ranged from 0.4% to 3.2% of initial length, based on 6/11 and 3/11 studies, respectively. Data had high heterogeneity, many studies had small populations, and reporting standards were inconsistent. Concerns about the predictability of postoperative TPA may be overstated. With the limited data available, limb shortening does not appear to be a clinically important consideration. Axis shift will occur to varying degrees and must be considered during CCWO planning, as it influences the postoperative TPA. Careful choice of CCWO technique may allow clinicians to reliably achieve predictable TPA values.

BACKGROUND: Similar to other high-level athletic disciplines, the western performance horse experiences a variety of orthopaedic conditions as a result of rigorous sport-specific physical demands. While musculoskeletal injury rates have been quantified in other equine disciplines, these data are lacking for the western performance athlete.
OBJECTIVE: To identify the most common anatomical regions of lameness in western performance horses being evaluated at the nation\'s largest sanctioned shows over a 10-year study period.
METHODS: Retrospective review of clinical records.
METHODS: Records of diagnostic analgesia of western performance horses competing at nationally sanctioned shows were retrospectively reviewed over a 10-year period to identify affected limb(s) and lameness localisation patterns.
RESULTS: A total of 2267 lameness examinations on 2512 horses were included. The average lameness grade was 2.21/5 with 1504/2267 (56%) cases being primarily forelimb in origin while 1173/2267 (44%) were hindlimb related. Forelimb lameness localised to the distal limb in 40% of cases. The proximal metatarsus/distal tarsus was an identified source of lameness in 16% of cases, followed by the stifle in 9% of cases. All-around western performance horses most commonly presented with a single hindlimb lameness (315/1188, 26.5%) in contrast to reining horses that presented with a single forelimb lameness (135/616, 22%).
CONCLUSIONS: Determining the source of lameness through diagnostic analgesia remains challenging, but the continued assessment of response to diagnostic analgesia may help characterise discipline-specific injuries in western performance horses.
UNASSIGNED: Retrospective review of subjective responses to diagnostic analgesia.
CONCLUSIONS: The distal forelimb and distal tarsus/proximal metatarsus were the two most common anatomical regions of lameness based on response to diagnostic analgesia.

OBJECTIVE:  The aim of this study was to evaluate epoxy-pin external skeletal fixation technique for the treatment of open fractures in calves and foals.
METHODS:  Twenty-eight calves and four foals (weighing 45-105 kg) with fractures distal to the stifle or elbow made the subject for the retrospective study. The pins (2.0-3.0-mm Kirschner wires, crossed at 60-90°) were fixed at least at two locations in both proximal and distal bone fragments as per the case situation. The pins in the same plane were bent (∼2 cm from the skin) towards the fracture site or joint and were joined using an adhesive tape (additional pins used when required) to make a temporary scaffold of connecting bars or rings. Thoroughly mixed epoxy putty was applied along the pin scaffold (the epoxy columns were 20-25 mm diameter) and allowed to set for 45 to 60 minutes. All animals were evaluated based on various clinical and radiographic observations made at regular intervals.
RESULTS:  The epoxy-pin fixation was easy to apply and provided stable fixation of bone as indicated by early weight bearing, and fracture healing within 45 to 60 days (17/32 cases). The functional recovery was good to very good in 14 animals and satisfactory in nine cases by 12 months after removal of the fixator.
CONCLUSIONS:  The multiplanar epoxy-pin external skeletal fixation provides stable fixation of unstable open fractures distal to the stifle or elbow joint; hence, it can be used to treat a variety of fractures in calves and foals weighing up to approximately 100 kg, especially open infected fractures of lower limb, which are difficult to treat by conventional techniques.

OBJECTIVE: The optimal surgical technique for treatment of cranial cruciate ligament rupture in canine has been scientifically discussed for decades. Despite the continuous debate, proximal tibial osteotomies such as tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA) are increasingly common. The objective of this review was to systematically evaluate the literature reporting outcome and complications associated with TPLO and TTA.
METHODS: A systematic search of literature databases identified articles published from August 2004 to February 2016 describing evaluations of short- or longterm outcomes as well as complications following TPLO or TTA.
RESULTS: Ninety-one studies were included in this review and assigned to one out of four evidence levels. Of those, 89 studies provided the lowest evidence level and only two were assigned to the third-best evidence level. A comparison of subjective gait analyses could not detect differences in the decrease of lameness between TPLO and TTA, while objective gait analysis supports the superiority of TPLO. Fewer patients treated with TPLO were diagnosed with postoperative joint instability and TPLO had a lower percent increase of osteoarthritis (OA) after surgery. Owner satisfaction was high for both techniques. For TPLO and TTA the average total, minor, major and catastrophic complication rates were 15.9 % and 20.8 %, 7.9 % and 11.6 %, 5.2 % and 13.2 % as well as 0.8 % and 5.6 %, respectively.
CONCLUSIONS: The assessed literature supports the hypothesis that TPLO is associated with lower complication rates, an improved clinical-functional outcome and less increase of OA compared to TTA. The results are indicative for a long-term restoration of normal limb function after TPLO. However, the strength of available evidence and the comparability of each study\'s results were poor and more comparative studies are needed to draw strong conclusions towards the superiority of the TPLO over the TTA.
UNASSIGNED: Die optimale chirurgische Technik zur Behandlung der Ruptur des vorderen Kreuzbands beim Hund ist seit Jahrzehnten ein viel diskutiertes Thema in der Kleintierorthopädie. Trotz anhaltender Diskussionen werden Osteotomietechniken der Tibia, die Tibial Plateau Leveling Osteotomy (TPLO) und das Tibial Tuberosity Advance ment (TTA), immer häufiger angewendet. In diesem Artikel werden die in der Literatur beschriebenen Ergebnisse und Komplikationen nach einer TPLO und TTA systematisch zusammengefasst und verglichen.
METHODS: Nach systematischer Literaturrecherche zu klinischen Studien über TPLO oder TTA wurden zwischen August 2004 und Februar 2016 publizierte Studien inkludiert, die über Kurz- oder Langzeitergebnisse und Komplikationen berichteten.
UNASSIGNED: Die 91 analysierten Studien wurden einer von vier Evidenzklassen zugeteilt. Zwei Studien entsprachen der drittbesten Evidenzklasse, 89 der niedrigsten Evidenzklasse. Ein Vergleich der Ergebnisse subjektiver Lahmheitsuntersuchungen zeigte keine eindeutigen Unterschiede zwischen den Techniken. Objektive Ganganalysen wiesen auf bessere Resultate nach TPLO hin. Die TPLO war mit einer geringeren postoperativen Zunahme der Osteoarthritis (OA) verbunden und bei weniger Patienten wurde postoperativ eine Gelenkinstabilität diagnostiziert. Die durchschnittlichen Gesamtkomplikationsraten betrugen für die TPLO und TTA 15,9 % bzw. 20,8 %, die gering-, mittel- und hochgradigen Komplikationsraten 7,9 % bzw. 11,6 %, 5,2 % bzw. 13,2 % sowie 0,8 % bzw. 5,6 %.
UNASSIGNED: Aktuelle Publikationen stützen die Hypothese, dass die TPLO mit besseren klinisch-funktionellen und radiologischen Ergebnissen, einer geringeren Zunahme der OA sowie geringeren Komplikationsraten einhergeht. Die Resultate der Studie lassen auf eine Lang-zeitwiederherstellung der normalen Giedmaßenfunktion nach einer TPLO schließen. Zu beachten sind jedoch das niedrige Evidenzniveau und die limitierte Vergleichbarkeit der Resultate verschiedener Studien. Um eindeutige Aussagen bezüglich der Überlegenheit der TPLO gegenüber der TTA ziehen zu können, bedarf es weiterer Vergleichsstudien.

A 4-year-old Irish Setter was presented with a history of progressive left pelvic limb lameness. Orthopedic examination revealed pain on manipulation of the left stifle. Radiographs showed an osteolytic lesion in the subchondral bone of the medial tibial condyle. Fine-needle aspirates were taken, and cytology revealed numerous cohesive clusters of plump, oval to spindloid cells often with perivascular distribution and moderate cellular atypia. A diagnosis of sarcoma was made with synovial cell sarcoma (SCS) and histiocytic sarcoma being the 2 main differentials. Histopathology confirmed the diagnosis of sarcoma and provided the same differentials. All neoplastic cells were positive for vimentin, and approximately 5% of them also stained with pan-cytokeratin using immunohistochemical staining methods. Neoplastic cells did not express CD18. The combination of this immunohistochemical profile and cell morphology was consistent with an SCS. Synovial cell sarcoma is a rare and poorly understood canine tumor entity. This is the first extensive description of the cytologic features of this neoplasm. The literature was also reviewed, focusing on comparative aspects of dogs and people, with a special emphasis on the cell of origin and diagnostic tools. Controversies regarding the nomenclature of this tumor are also presented. The authors propose a new term (cytokeratin-positive joint-associated sarcoma) for addressing this neoplasm until the cell of origin of this tumor is elucidated.

To investigate the impact of a daily exercise dose on cartilage composition and thickness, by conducting a systematic review of randomized controlled trials (RCTs) involving healthy animals.
A narrative synthesis of the effect of a daily exercise dose on knee cartilage aggrecan, collagen and thickness was performed. A subset of studies reporting sufficient data was combined in meta-analysis using a random-effects model. Meta-regression analyses were performed to investigate the impact of covariates.
Twenty-nine RCTs, involving 64 comparisons, were included. In the low dose exercise group, 21/25 comparisons reported decreased or no effect on cartilage aggrecan, collagen and thickness. In the moderate dose exercise group, all 12 comparisons reported either no or increased effect. In the high dose exercise group, 19/27 comparisons reported decreased effect. A meta-analysis of 14 studies investigating cartilage thickness showed no effect in the low dose exercise group (SMD -0.02; 95% CI -0.42 to 0.38; I2 = 0.0%), large but non-significant cartilage thickening in the moderate dose exercise group (SMD 0.95; 95% CI -0.33 to 2.23; I2 = 72.1%) and non-significant cartilage thinning in the high dose exercise group (SMD -0.19; 95% CI -0.49 to 0.12; I2 = 0.0%). Results were independent of analyzed covariates. The overall quality of the studies was poor because of inadequate reporting of data and high risk of bias.
Our results suggest that the relationship between daily exercise dose and cartilage composition, but not necessarily cartilage thickness, may be non-linear. While we found inconclusive evidence for a low daily dose of exercise, a high daily dose of exercise may have negative effects and a moderate daily dose of exercise may have positive effects on cartilage matrix composition in healthy animals.

Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy.

Two healthy cats underwent elective surgical procedures under general anesthesia. One developed severe esophagitis leading to esophageal rupture, mediastinitis, and pyothorax. The other cat developed esophageal stricture, diverticulum formation, and suspected iatrogenic perforation. Both cats had signs of dysphagia and regurgitation beginning a few days after anesthesia. The first cat also had severe dyspnea due to septic pleural effusion and pneumomediastinum. In the second cat, endoscopy revealed diffuse esophagitis, an esophageal stricture, and a large esophageal diverticulum. Rupture of the esophageal wall occurred while inflating the esophagus for inspection. Due to the poor prognosis, both cats were euthanized. Necropsy revealed severe esophageal changes. Postanesthetic esophagitis has been previously described in dogs and cats; however, severe life-threatening esophageal injuries rarely occur as a sequel to general anesthesia. To the authors\' knowledge, esophageal rupture secondary to perianesthetic reflux has never been reported in cats.

Extra-articular prosthetic stabilization techniques have been used as a method of stabilization of the cranial cruciate ligament (CrCL)-deficient stifle for decades. During extra-articular prosthetic stabilization, the prosthesis is anchored to the femur and tibia, and tensioned in the attempt to resolve femorotibial instability. The position of the anchor points of the prosthesis is crucial for restoring a normal range of joint motion and mitigating alterations in prosthesis tension during motion. Recently developed techniques offer several innovations with potential advantages such as bone-to-bone fixation, prosthetic materials with better mechanical properties, and improved isometry of the anchor points. Whether these innovations provide clinically superior results to the traditional techniques such as lateral circumfabellar-tibial suture techniques has yet to be determined.

The stifle joint, a common location for lameness in dogs, is a complex arrangement of osseous, articular, fibrocartilaginous, and ligamentous structures. The small size of its component structures, restricted joint space, and its intricate composition make successful diagnostic imaging a challenge. Different tissue types and their superimposition limit successful diagnostic imaging with a single modality. Most modalities exploit the complexity of tissue types found in the canine stifle joint. Improved understanding of the principles of each imaging modality and the properties of the tissues being examined will enhance successful diagnostic imaging.