Bologna Healing Stifle Injury Index: A Comparison of Three Surgical Techniques for the Treatment of Cranial Cruciate Ligament Rupture in Dogs

Abstract

The aim of this retrospective study was to test the efficacy of the Bologna Healing Stifle Injury Index (BHSII) in assessing the medium-term outcomes of dogs treated for cranial cruciate ligament rupture. This tool can be used for comparison across surgical interventions. The study population included 53 dogs with unilateral cranial cruciate ligament rupture treated using either Paatsama, Tight-Rope or tibial tuberosity advancement techniques, and 20 orthopedically sound dogs for comparative purposes. The BHSII was utilized for all the treated dogs at the time of surgery, and 1, 3, and 6 months postoperatively, while it was utilized twice in the control group. Although all the techniques achieved a successful outcome at the end of the evaluation, the application of the BHSII permitted differentiating results at each time point and stimulating discussion regarding the rapidity and degree of the healing process for each technique. It also pointed out some incongruities between the owner's and the clinician's assessment of the process. These achievements demonstrated that the BHSII should be considered by the research and clinical communities as an effective and easy tool which can be used as a repeatable and standardized method of comparison of the progress at different time points toward a final good outcome in dogs treated for cranial cruciate ligament rupture.

Development and testing of a stifle function score in dogs

“…We are aware of two other stifle injury scores in veterinary medicine ( 14 , 16 , 17 ). Both testing instruments have been used to compare normal dogs to dogs after surgical correction of CCLR.…”

“…Furthermore, this study was not performed with blinding relative to the stifle condition, and this scoring system had the weakest sensitivity and specificity with GRF measures. The other scoring system compared different surgical techniques during the healing process with evaluations 1, 3, and 6 months after surgery ( 16 , 17 ). Because the scoring system used in this study had owner assessment as a large part of the score and the comparison of dogs 1 month after surgery compared to normal dogs, there is the potential for tremendous bias in scoring these patients.…”

“…A validated stifle scoring system would be beneficial to evaluate patient progress for canine patients during recovery from CCLR. Two such systems have been proposed and are currently being evaluated ( 14 – 17 ). While both of these systems have been validated to differentiate dogs with and without cruciate ligament rupture, there has been a little comparison between these subjective scoring systems and objective measures, such as GRFs.…”

Evaluation of forelimb gait variation overground at a walk in sound and lame dogs using a combination of diagnostic techniques

“…Combined tests for evaluation of lameness are therefore reported and clinically used in human orthopaedics [ 12 – 14 ], which produces more accurate results than each method separately [ 11 ]. Recently, combined tests for stifle function in dogs, including subjective and objective variables, have been suggested [ 15 , 16 ].…”

The Effect of Cranial Cruciate Ligament Rupture on Range of Motion in Dogs

“…Goniometry has been used in canine orthopaedics [ 20 ] to assess the treatment efficacy of diseases involving shoulders [ 21 ], elbows [ 19 , 22 , 23 ], stifles [ 19 , 24 , 25 , 26 , 27 , 28 , 29 ] and hip joints [ 30 , 31 ]. The most common injury involving the canine stifle joint is cranial cruciate ligament (CCL) rupture [ 32 , 33 ].…”