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Animals
Special Issues
Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation
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Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation

A special issue of Animals (ISSN 2076-2615). This special issue belongs to the section "Veterinary Clinical Studies".

Deadline for manuscript submissions: closed (30 July 2024) | Viewed by 13439

Special Issue Editors

Prof. Dr. L. Miguel Carreira

E-Mail Website
Guest Editor
Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
Interests: orthopedics; surgery; CO2 LASER surgery; brain surgery; plastic and reconstruction; rehabilitation; transplantation; sports medicine
Dr. João Alves

E-Mail Website
Guest Editor
GNR – Guarda Nacional Republicana Portuguesa, Lisbon, Portugal
Interests: orthopedics; surgery; rehabilitation; sports medicine

Special Issue Information

Dear Colleagues,

Bones, muscles, ligaments, tendons, and joints are key structures of the musculoskeletal system. Their functions and relationships affect the patient’s mobility and quality of life. Illness or injury in any of them is associated with a lack of daily performance of the body and patient activity. This Special Edition on “Small Animals’ Orthopedic Surgery, Physical Therapy, and Rehabilitation” aims to present the state of the art around basic and clinical research issues with an impact on patient care, involving broad conditions of the musculoskeletal system. Three scientific branches, i.e., orthopedic surgery, physical therapy, and rehabilitation, comprise patient orthopedic rehabilitation. In fact, physical therapy and rehabilitation protocols are particularly important in the orthopedic surgery outcome, helping the patient to return to their normal life more quickly and optimizing the body’s physical ability.

Prof. Dr. L. Miguel Carreira
Dr. João Alves
Guest Editors

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Keywords

  • orthopedic rehabilitation physical therapy
  • orthopedic surgery
  • osteoarthritis
  • musculoskeletal system
  • surgical sports medicine
  • balance and stability
  • orthopedic pain

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Published Papers (9 papers)

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11 pages, 4763 KiB  
Article
Effects of the Direction of Two Kirschner Wires on Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition in Miniature Breed Dogs: An Ex Vivo Study
by Sanghyun Nam, Youngjin Jeon, Haebeom Lee and Jaemin Jeong
Animals 2024, 14(15), 2258; https://doi.org/10.3390/ani14152258 - 3 Aug 2024
Viewed by 754
Abstract
This study evaluates the impact of Kirschner wire (K-wire) insertion direction on the biomechanical properties of combined tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTT) procedures in small-breed dogs with cranial cruciate ligament rupture and medial patella luxation. Twenty-one cadaveric tibiae [...] Read more.
This study evaluates the impact of Kirschner wire (K-wire) insertion direction on the biomechanical properties of combined tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTT) procedures in small-breed dogs with cranial cruciate ligament rupture and medial patella luxation. Twenty-one cadaveric tibiae were divided into two groups; the specimens were divided into two groups; one underwent TPLO-TTT with a proximal pin placement (Group TTP), and the other received TPLO-TTT with a distal pin placement (Group TTD). For both pin placements, two additional subgroups were formed: one with a 0.56 mm tension band (Groups TTP0.56 and TTD0.56) and the other with a 0.76 mm tension band (Groups TTP0.76 and TTD0.76). The tensile force was applied, and failure load and mode were recorded. The distal pin direction in Group TTD0.56 exhibited a significantly higher mean failure load (380.1 N) compared to the proximal pin direction in Group TTP0.56 (302.2 N, p = 0.028). No significant differences were observed among the other groups. This study concludes that distal pin placement can provide similar or improved mechanical stability in cases with limited space for proximal pin placement during combined TPLO and TTT procedures. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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11 pages, 2861 KiB  
Article
Assessing the Effectiveness of Modified Tibial Plateau Leveling Osteotomy Plates for Treating Cranial Cruciate Ligament Rupture and Medial Patellar Luxation in Small-Breed Dogs
by Eunbin Jeong, Youngjin Jeon, Taewan Kim, Dongbin Lee and Yoonho Roh
Animals 2024, 14(13), 1937; https://doi.org/10.3390/ani14131937 - 30 Jun 2024
Cited by 1 | Viewed by 1101
Abstract
In small-breed dogs with concurrent cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL), correcting both disorders is are essential for restoring normal gait. However, the previously described surgical treatment, using two osteotomy technique, poses a high risk of fracture and instability. [...] Read more.
In small-breed dogs with concurrent cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL), correcting both disorders is are essential for restoring normal gait. However, the previously described surgical treatment, using two osteotomy technique, poses a high risk of fracture and instability. Addressing CCLR and MPL with a single osteotomy and implant was considered superior to the conventional method. Therefore, a pre-contoured modified tibial plateau leveling osteotomy (PCM–TPLO) plate facilitating medial shifting of the proximal tibia was developed. We compared postoperative alignment and strength between this novel plate group and a conventional tibial plateau leveling osteotomy (TPLO) plate group using eight small-breed dog cadavers each. Additionally, we investigated the potential of the novel plate as an alternative to tibial tuberosity transposition. Postoperative alignment and strength were assessed through radiographs and mechanical testing. Measurements including tibial plateau angle, mechanical medial proximal tibial angle, and number of screws within the joint were also analyzed. There were no significant differences in all measured parameters. For the novel plate, the medial displacement ratio of the proximal tibia was confirmed to be approximately 30%, and the result was thought to be appropriate. These findings suggest that the PCM–TPLO plate could be a promising alternative for treating concurrent CCLR and MPL in small-breed dogs. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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12 pages, 1612 KiB  
Article
Bacterial Contamination of Environmental Surfaces of Veterinary Rehabilitation Clinics
by Henry G. Spratt, Nicholas Millis, David Levine, Jenna Brackett and Darryl Millis
Animals 2024, 14(13), 1896; https://doi.org/10.3390/ani14131896 - 27 Jun 2024
Viewed by 770
Abstract
The presence of potentially pathogenic bacteria on veterinary clinic surfaces may be problematic. In this study, we collected swab samples (Fisherbrand, double transport swabs with Stuart’s liquid medium) and water samples from five veterinary rehabilitation clinics. Swabs and water samples were transported to [...] Read more.
The presence of potentially pathogenic bacteria on veterinary clinic surfaces may be problematic. In this study, we collected swab samples (Fisherbrand, double transport swabs with Stuart’s liquid medium) and water samples from five veterinary rehabilitation clinics. Swabs and water samples were transported to a microbiology lab for processing. At the lab, swabs were used to inoculate Hardy’s Cdiff Banana Broth (for Clostridium difficile [Cdiff]) and five different types of bacterial growth media, including Hardy CHROM MRSA agar (methicillin-resistant Staphylococcus aureus [MRSA] and S. pseudintermedius [SIM]), mannitol salt agar (S. aureus [SA]), eosin methylene blue agar (enterics [ENT]), Pseudomonas isolation agar (Pseudomonas spp. [PS]), and tryptic soy agar [TSA] (non-specific). The most prominent presumptive species cultured was Cdiff (on nearly 55% of swabs). Bacillus spp. and enteric bacteria were encountered on nearly 35% of swabs, with MRSA and SIM on just over 10% of swabs. The most contaminated sample site was harnesses/life jackets used with the underwater treadmill (33% of swabs). The underwater treadmill water had total bacterial counts from 1,600 to 2,800 cfu/mL. Of all presumptive bacterial species detected, SIM tends to be more pathogenic for dogs. Targeted cleaning/disinfecting in these clinics could help reduce risks for both animals and caregivers utilizing these clinics. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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13 pages, 4213 KiB  
Article
Evaluation of the Tibial Plateau–Patella Angle (TPPA) in Dogs
by Nedim Zaimovic, Dragan Lorinson, Karin Lorinson, Alexander Tichy and Barbara Bockstahler
Animals 2024, 14(12), 1798; https://doi.org/10.3390/ani14121798 - 16 Jun 2024
Viewed by 1411
Abstract
Estimating a dog’s patellar position involves various methods, which categorize it as norma, alta (high), or baja (low). However, they require various calculations. We aimed to evaluate the clinical applicability of a new method, the tibial plateau–patella angle (TPPA). This could aid in [...] Read more.
Estimating a dog’s patellar position involves various methods, which categorize it as norma, alta (high), or baja (low). However, they require various calculations. We aimed to evaluate the clinical applicability of a new method, the tibial plateau–patella angle (TPPA). This could aid in planning patella luxation surgery, estimating the patella position after TPLO and various osteotomies. We conducted a two-step study: first, on 15 stifles without pathologies from nine canine cadavers, and second, using 100 patient X-rays from the archive. Three stifle angle positions (45 ± 5°, 90 ± 5°, and 135 ± 5°) and three weight groups (S, M, and L) were evaluated in the first part of this study. Based on these results, the second part of this study was conducted using 100 pathology-free radiographs at the optimal stifle angle (90 ± 5°) from the archive. All radiographs were measured by three observers with varying levels of experience. Our results indicate that the stifle angle significantly impacted the TPPA, whereby lower values were detected with higher stifle angles, which remained consistent within the weight groups. High inter- and intra-observer agreement was achieved. The physiological TPPA values ranged from 26.7° to 48.8°, remaining consistent within the various weight groups. Observer 3 in Group S exhibited a 20% (insignificant) deviation, possibly due to challenges in determining the caudal point of the tibial plateau. In contrast with humans, TPPA values in dogs are negatively correlated with stifle angles, independent of weight. Our reliable and reproducible protocol suggests the potential benefits of training on small-breed dogs stifles. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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11 pages, 1057 KiB  
Article
A Preliminary Report on the Combined Effect of Intra-Articular Platelet-Rich Plasma Injections and Photobiomodulation in Canine Osteoarthritis
by J. C. Alves, Ana Santos and L. Miguel Carreira
Animals 2023, 13(20), 3247; https://doi.org/10.3390/ani13203247 - 18 Oct 2023
Cited by 3 | Viewed by 1821
Abstract
Osteoarthritis (OA) is highly prevalent in the canine population. Due to the multiple dimensions of the disease, a multimodal approach is usually favored by clinicians. To evaluate the combined treatment with intra-articular platelet-rich plasma (PRP) and photobiomodulation in dogs with bilateral hip OA, [...] Read more.
Osteoarthritis (OA) is highly prevalent in the canine population. Due to the multiple dimensions of the disease, a multimodal approach is usually favored by clinicians. To evaluate the combined treatment with intra-articular platelet-rich plasma (PRP) and photobiomodulation in dogs with bilateral hip OA, thirty dogs were assigned to a PRP group (PRPG, n = 10), a photobiomodulation group (PBMTG, n = 10), or a combined therapies group (PRP+PBMTG, n = 10). The PRPG received two intra-articular administrations of platelet-rich plasma 14 days apart. The PBMTG received photobiomodulation with a therapeutic laser, with three sessions every other day in week one; two sessions in week two; a single session in week three; and one session/month on follow-up evaluation days. The PRP+PBMTG received the two combined therapies. The response to treatment was evaluated with weight-bearing distribution and the Canine Brief Pain Inventory, the Liverpool Osteoarthritis in Dogs, and the Canine Orthopedic Index. Evaluations were conducted before treatment and +8, +15, +30, +60, and +90 days after initial treatment. Normality was assessed with a Shapiro–Wilk test, and the groups’ results in each evaluation moment were compared using a Mann–Whitney U test. Animals of both sexes (male n = 19, female n = 11) were included in the sample, with a mean age of 7.8 ± 2.5 years and a body weight of 26.5 ± 4.7 kg. Joints were classified as mild (n = 6, three in PRPG, two in PBMTG, and one in PRP+PBMTG), moderate (n = 18, six in PRPG, five in PBMTG, and seven in PRP+PBMTG), and severe (n = 6, one in PRPG, three in PBMTG, and two in PRP+PBMTG). No differences were found between groups at the initial evaluation. All treatments produced clinically significant improvements compared to the assessment on treatment day. The combination of PRP and photobiomodulation produced greater, longer-lasting improvements. PRP and photobiomodulation can improve objective outcomes and client-reported outcome measures in dogs with OA. Their combined use leads to greater, longer-lasting, clinically significant improvements. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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16 pages, 1122 KiB  
Article
Knee Joint Osteoarthritis in Overweight Cats: The Clinical and Radiographic Findings
by Joanna Bonecka, Michał Skibniewski, Paweł Zep and Małgorzata Domino
Animals 2023, 13(15), 2427; https://doi.org/10.3390/ani13152427 - 27 Jul 2023
Cited by 4 | Viewed by 3485
Abstract
Despite a high prevalence of osteoarthritis (OA) reported in the domesticated cat population, studies on feline knee joint OA are scarcer. Knee joint OA is a painful, age-related, chronic degenerative joint disease that significantly affects cats’ activity and quality of life. In dogs [...] Read more.
Despite a high prevalence of osteoarthritis (OA) reported in the domesticated cat population, studies on feline knee joint OA are scarcer. Knee joint OA is a painful, age-related, chronic degenerative joint disease that significantly affects cats’ activity and quality of life. In dogs and humans, one may consider overweight as a risk factor for the development and progression of knee joint OA; therefore, this study aims to assess the severity of knee joint OA in the body-weight-related groups of cats concerning clinical symptoms and radiographic signs. The study was conducted on sixty-four (n = 64) cats with confirmed OA. The demographic data on sex, neutering, age, and breed were collected. Then, the body condition score (BCS) was assessed, and each cat was allocated to the underweight, normal-weight, or overweight group. Within clinical symptoms, joint pain, joint swelling, joint deformities, lameness, reluctance to move, and apathy were graded. Based on the radiographic signs, minor OA, mild OA, moderate OA, and severe OA were scored. Prevalence and co-occurrence of the studied variables were then assessed. Joint pain was elicited in 20–31% of the OA-affected joints, joint deformities in 21–30%, and lameness in 20–54%, with no differences between weight-related groups. Severe OA was detected in 10–16% of the OA-affected joints, with no differences between weight-related groups. Severe OA in feline knee joints appears with similar frequency in overweight, underweight, and normal-weight cats. However, the general prevalence of clinical symptoms and radiographic signs is different in overweight cats. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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10 pages, 1792 KiB  
Case Report
Reconstruction of the Quadriceps Extensor Mechanism with a Calcaneal Tendon–Bone Allograft in a Dog with a Resorbed Tibial Tuberosity Fracture
by Hyunho Kim, Haebeom Lee, Daniel D. Lewis, Jaemin Jeong, Gyumin Kim and Youngjin Jeon
Animals 2024, 14(16), 2315; https://doi.org/10.3390/ani14162315 - 9 Aug 2024
Viewed by 711
Abstract
A non-reducible tibial tuberosity fracture is a rare complication of tibial tuberosity transposition performed during correcting of medial patella luxation (MPL) in dogs. This condition severely disrupts the quadriceps extensor mechanism, leading to significant pelvic limb lameness. An 11-year-old, 1.8 kg spayed female [...] Read more.
A non-reducible tibial tuberosity fracture is a rare complication of tibial tuberosity transposition performed during correcting of medial patella luxation (MPL) in dogs. This condition severely disrupts the quadriceps extensor mechanism, leading to significant pelvic limb lameness. An 11-year-old, 1.8 kg spayed female Yorkshire Terrier sustained a comminuted left tibial tuberosity fracture during surgical correction of an MPL. Six months after surgery, the dog was markedly lame and unable to extend the left stifle. Radiographs revealed patella alta and resorption of the fragmented tibial tuberosity. A composite frozen allogeneic calcaneal tendon–bone block was utilized to reconstruct the tibial tuberosity and reattach the patellar ligament. Initial postoperative radiographs confirmed restoration of a normal patellar ligament to patella length ratio (1.42). Both the allogeneic bone used for tibial tuberosity reconstruction and the tendon used to reattach the patellar ligament were successfully integrated. The dog regained satisfactory limb function without recurrence of patella luxation, as reported by the owners 29 months postoperatively. The use of a calcaneal tendon–bone allograft effectively restored the functional integrity of the quadriceps extensor mechanism, providing a viable option for addressing quadriceps insufficiency resulting from the loss of the osseous tibial insertion. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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10 pages, 3413 KiB  
Case Report
Reconstruction of Bilateral Chronic Triceps Brachii Tendon Disruption Using a Suture-Mediated Anatomic Footprint Repair in a Dog
by Jong-Pil Yoon, Hae-Beom Lee, Young-Jin Jeon, Dae-Hyun Kim, Seong-Mok Jeong and Jae-Min Jeong
Animals 2024, 14(11), 1687; https://doi.org/10.3390/ani14111687 - 5 Jun 2024
Viewed by 990
Abstract
A 2-year-old, intact female Pomeranian presented with bilateral forelimb lameness, characterized by the olecranon making contact with the ground. The patient experienced two separate incidents of falling, occurring four and three weeks before admission, respectively. Following each episode, non-weight-bearing lameness was initially observed [...] Read more.
A 2-year-old, intact female Pomeranian presented with bilateral forelimb lameness, characterized by the olecranon making contact with the ground. The patient experienced two separate incidents of falling, occurring four and three weeks before admission, respectively. Following each episode, non-weight-bearing lameness was initially observed in the left forelimb, followed by the development of crouch gait. Based on the physical examination, radiographic, and ultrasonographic findings, bilateral triceps brachii tendon disruption was diagnosed. Intraoperatively, excessive granulation tissue at the distal end of the tendon was excised. The footprint region of each triceps brachii tendon was decorticated with a high-speed burr until bleeding was observed. The triceps brachii tendon was reattached to completely cover its footprint on the olecranon using the Krackow suture technique. This method involves anchoring the suture through bone tunnels in the ulna. Trans-articular external skeletal fixation was applied to both forelimbs to immobile and stabilize the elbow joints for nine weeks. Subsequently, the dog gradually increased its walking activities while on a leash over a six-week period. At the three-year follow-up, the patient exhibited improved forelimb function and maintained a normal gait without signs of lameness. Suture-mediated anatomic footprint repair proved useful in this single case and may be an effective surgical alternative for the management of chronic triceps brachii tendon disruption in dogs. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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10 pages, 1421 KiB  
Case Report
Treatment of a Large Tibial Non-Union Bone Defect in a Cat Using Xenograft with Canine-Derived Cancellous Bone, Demineralized Bone Matrix, and Autograft
by Keun-Yung Kim, Minha Oh and Minkyung Kim
Animals 2024, 14(5), 690; https://doi.org/10.3390/ani14050690 - 22 Feb 2024
Viewed by 1212
Abstract
A 17-month-old domestic short-hair cat was referred due to a non-union in the left tibia. The initial repair, conducted 3 months prior at another animal hospital, involved an intramedullary (IM) pin and wire to address a comminuted fracture. Unfortunately, the wire knot caused [...] Read more.
A 17-month-old domestic short-hair cat was referred due to a non-union in the left tibia. The initial repair, conducted 3 months prior at another animal hospital, involved an intramedullary (IM) pin and wire to address a comminuted fracture. Unfortunately, the wire knot caused a skin tract, resulting in osteomyelitis. Although the wire knot was removed at that hospital, the draining tract persisted, continuously discharging exudate. Upon evaluation, the first surgery was reassessed and revised, involving the removal of the IM pin and the application of external skeletal fixation alongside an antibiotic susceptibility test. After 118 days post-revision surgery, while some cortical continuity was observed, a significant bone defect persisted, posing a substantial risk of refracture should the implant be removed. A second revision surgery was performed, utilizing a bone plate combined with cancellous bone autograft, recombinant human bone morphogenetic protein-2, and xenograft featuring a canine-derived cancellous chip mixed with demineralized bone matrix. Remarkably, the bone completed its healing within 105 days following the subsequent surgery. Radiography demonstrated successful management of the large bone defect up to the 2-year postoperative check-up. During telephone follow-ups for 3.5 years after surgery, no complications were identified, and the subject maintained a favorable gait. Full article
(This article belongs to the Special Issue Small Animal Orthopedic Surgery, Physical Therapy and Rehabilitation)
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