Computed tomographic assessment of the completeness of arthroscopic subtotal coronoidectomy in dogs with medial coronoid disease

Renner, Carina; Medl, Nikola

doi:10.1002/vetr.1069

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…Of 29 dogs evaluated, 12 had calcified bodies, and 14 had scar tissue formation suspected secondary to the first arthroscopic procedure (31). In contrast, Renner et al (32) evaluated immediate or short-term postoperative CT scans for bony remnants and found that 73% of cases had remaining lesions, mostly at the radial incisure. That study reported that only 5% of radial incisure lesions were removed and 72% of apical lesions were removed completely.…”

Section: Discussionmentioning

confidence: 99%

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process

Cruz¹,

Mason

2022

Front. Vet. Sci.

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ObjectiveDocument the outcomes of bilateral arthroscopic subtotal coronoidectomy for the fragmented medial coronoid process, quantify persistent lameness that required additional treatment (PRP), and document the outcomes of dogs that followed up with PRP injections.Study designRetrospective study.Sample populationOverall, 115 dogs underwent arthroscopy alone and 31 received PRP at least 6 weeks after arthroscopy. The owner's response rate was ~50% (73 dogs).MethodsCollected data included signalment, unilateral or bilateral clinical signs, intra-articular chondroprotective injection during the procedure, if PRP intra-articular injection was received postoperatively, and if it was received, the time from the initial surgery to administration was recorded. Outcomes were assessed via standardized owner questionnaires using the Liverpool Osteoarthritis in Dogs (LOAD) score, the Canine Brief Pain Inventory (CBPI) score, and the overall quality of life (QOL) assessment.ResultsApproximately 20% of the patients received PRP post-operatively due to persistent lameness following surgery. Similar pain scores were found between the two groups with an average of 11–13 LOAD score, 13–15 CBPI score, and good quality of life. Older animals at the time of surgery and those that received pain-relieving medications after the procedure were more painful and affected their functional outcome. PRP as an adjunctive therapy achieved a perceived good to excellent quality of life in ~90% of pets in this population.ConclusionArthroscopy and subtotal coronoidectomy followed by PRP, if needed, seemed to decrease pain, and improve lameness in the long term.Clinical significancePRP should be considered as adjunctive therapy in dogs with the limited response to arthroscopy alone.

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Section: Discussionmentioning

confidence: 99%

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process

Cruz¹,

Mason

2022

Front. Vet. Sci.

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“…37 A more recent study reviewing 92 elbow joints on CT immediately following arthroscopic MCP fragment removal and subtotal coronoid osteotomy (SCO) revealed apical lesions to have been completely removed in 72% of cases but only 5% of radial lesions to have been completely debrided. 33 Nine percent of elbows had free bony remnants in the joint and 84% within the soft tissues of the previously placed instrument port. A fissured MCP rather than fragmentation was positively associated with an increased propensity for incomplete fragment removal.…”

Section: Mcp Fragment Removalmentioning

confidence: 96%

“…30 The use of 1.9 mm over 2.4/2.7 mm arthroscopes appear favored by some authors in more recent studies evaluating the elbow joint. [31][32][33] Arthroscopically assisted correction of axial humeroulnar incongruity has been described. 34 Acute adjustment via a proximal ulnar transverse osteotomy with a magnitude of adjustment based on arthroscopic measurement with a graduated hook probe was performed in four dogs with MCP fragments, when present, being removed concurrently.…”

Section: Arthroscopic Assessment Of Congruitymentioning

confidence: 99%

“…A cadaver study evaluating graduated radial shortening and lengthening in normal elbow joints with 1.9 mm arthroscopic inspection and measurement with a graduated hook probe revealed high accuracy and precision of measurement 30 . The use of 1.9 mm over 2.4/2.7 mm arthroscopes appear favored by some authors in more recent studies evaluating the elbow joint 31–33 …”

Section: Arthroscopic Assessment Of Congruitymentioning

confidence: 99%

“…In a study reviewing the CT and arthroscopic findings in dogs with medial compartment erosion it was noted that 10 dogs diagnosed on CT with fragmentation of the MCP had no evidence of fragments on arthroscopy 37 . A more recent study reviewing 92 elbow joints on CT immediately following arthroscopic MCP fragment removal and subtotal coronoid osteotomy (SCO) revealed apical lesions to have been completely removed in 72% of cases but only 5% of radial lesions to have been completely debrided 33 . Nine percent of elbows had free bony remnants in the joint and 84% within the soft tissues of the previously placed instrument port.…”

Section: Mcp Fragment Removalmentioning

confidence: 99%

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Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease

Burton

2023

Veterinary Surgery

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ObjectiveTo summarize the current peer‐reviewed publications on minimally invasive surgery (MIS) for medial coronoid process disease (MCPD) in dogs.Study designInvited review.MethodsPubmed, CAB Abstracts and Scopus databases were utilized for literature review (1990–2023).ResultsMore than 60 papers have been published that involve MIS evaluation or treatment of MCPD. Six prospective trials incorporated quantitative gait analysis evaluating outcome following MCPD debridement, of which three included a control group. Whilst case numbers were limited, all studies employing a control group failed to demonstrate superiority of surgery over nonsurgical management. Of three studies employing gait analysis and no control group, all documented some improvement in function compared to pretreatment lameness. Multiple studies document progression of osteoarthritis in dogs following MCPD debridement although this may not be synonymous with worsened function. Subtotal coronoid osteotomy (SCO) is described as an alternative to MCP fragment removal, although the long‐term biomechanical consequences are currently unclear and quantitative data on the efficacy of this treatment in isolation for MCPD is awaited.ConclusionArthroscopy of the canine elbow joint is a safe means by which to evaluate MCP pathology. Quantitative longitudinal analysis of outcome following minimally invasive surgery for MCPD is required. Correlation with clearly defined subclassification inclusion criteria such as age, incongruity and the precise arthroscopic findings in each case are required to more accurately differentiate any superiority of surgery over nonsurgical management for this disease.

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Arthroskopische Entfernung des fragmentierten Processus coronoideus medialis bei Hunden

Hörtdörfer,

Steigmeier-Raith,

Zablotski

et al. 2024

Tierarztl Prax Ausg K Kleintiere Heimtiere

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Zusammenfassung Gegenstand und Ziel Ziel dieser Studie war es, den Behandlungserfolg von Hunden mit medialer Coronoiderkrankung (hier: fragmentierte Processus coronoideus [FPC]), nach arthroskopisch durchgeführter subtotaler Coronoidektomie mittels subjektiver und objektiver Ganganalyse sowie der Arthroseprogression zu beurteilen und mit den Befunden der postoperativen Computertomografie in Verbindung zu setzen. Insbesondere sollte hierbei die klinische Relevanz von postoperativ zurückbleibenden Restpartikeln evaluiert werden. Material und Methoden 30 Ellbogen von 24 Hunden verschiedener Rassen wurden frühestens 6 Monate nach ein- oder beidseitiger subtotaler Coronoidektomie klinisch orthopädisch und mit Hilfe der Ganganalyse sowie röntgenologisch nachuntersucht und die Ergebnisse mit den präoperativen Befunden der entsprechenden Untersuchungen sowie der postoperativen Computertomografie verglichen. Ergebnisse 79,2% (19/24) der Patienten verbesserten sich in der orthopädischen Untersuchung um mindestens einen Lahmheitsgrad, 66,7% (16/24) waren lahmheitsfrei. 60% (18/30 Gelenke) zeigten eine Zunahme des Arthrosegrades. In der postoperativen Computertomografie wurden bei 56,7% (17/30) der Gelenke kleine verbliebene Knochenpartikel (<1 mm) im Gelenkspalt oder dem Weichgewebe festgestellt. Es war kein signifikanter Zusammenhang zwischen einer persistierenden Lahmheit und postoperativ zurückgebliebenen Restpartikeln nachzuweisen. Auch ein Zusammenhang zwischen anhaltender Lahmheit und Arthroseprogression konnte nicht hergestellt werden. Schlussfolgerung Rückstände von kleinen Knochenpartikeln nach arthroskopisch durchgeführter subtotaler Coronoidektomie konnten in keinen Zusammenhang mit postoperativ verbleibenden Lahmheiten gebracht werden. Eine Arthroseprogression war trotz operativen Eingriffs nicht aufzuhalten. Klinische Relevanz Bleiben nach der subtotalen Coronoidektomie kleine Restpartikel (<1 mm) zurück, scheinen diese keinen Einfluss auf das klinische Ergebnis zu haben.

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Computed tomographic assessment of the completeness of arthroscopic subtotal coronoidectomy in dogs with medial coronoid disease

Cited by 4 publications

References 18 publications

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process

Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease

Arthroskopische Entfernung des fragmentierten Processus coronoideus medialis bei Hunden

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