Extracorporeal shock wave therapy improves short‐term limb use after canine tibial plateau leveling osteotomy

Abstract

Objective To determine the influence of postoperative extracorporeal shock wave therapy (ESWT) on hind limb use after tibial plateau leveling osteotomy (TPLO). Study design Randomized, prospective clinical trial. Animals Sixteen client‐owned dogs, 2 to 10 years old weighing 18 to 75 kg. Methods Dogs were randomly assigned to treatment cohorts, TPLO with ESWT (ESWT, n = 9) or TPLO without ESWT (control, n = 7). Treatment consisted of 1000 pulses at 0.15 mJ/mm2 immediately and 2 weeks after surgery. Subjective pain, stifle goniometry, stifle circumference, peak vertical force (PVF) and vertical impulse (VI) were measured before surgery, prior to ESWT, and 2 and 8 weeks after surgery. Measures were compared between treatments at each time point and among time points for each treatment (P < .05). Results The PVF (5.5 ± 1.0 N/kg, mean ± SD) and VI (0.67 ± 0.14 N‐s/kg) of surgically treated limbs in the ESWT cohort were higher 8 weeks after surgery compared with preoperative (3.8 ± 1.1 N/kg, P < .0001 and 0.47 ± 0.21 N‐s/kg, P = .0012, respectively) values. In the control cohort, PVF (2.9 ± 1.3 N/kg, P = .0001) and VI (0.33 ± 0.20 N‐s/kg, P = .0003) 2 weeks after surgery and VI (0.42 ± 0.2 N‐s/kg, P = .0012) 8 weeks after surgery were lower (4.59 ± 2.33 N/kg and 0.592 ± 0.35 N‐s/kg, respectively) than before surgery. Other parameters did not differ between groups. Conclusion Weight bearing increased faster after TPLO in dogs treated with postoperative ESWT. Clinical significance This study provides evidence to consider adjunct ESWT after TPLO.

Effect of sedation or general anesthesia on elbow goniometry and thoracic limb circumference measurements in dogs with naturally occurring elbow osteoarthritis

“…The loss of joint motion and muscle atrophy are two common consequences of joint disease 1‐5 . In osteoarthritic joints, all tissues of the joint are subject to substantial alterations.…”

The effect of extracorporeal shockwave on liposomal bupivacaine in a tibial plateau leveling osteotomy model

“…9 Researchers in a subsequent study reported that dogs treated with liposomal bupivacaine after tibial plateau leveling osteotomy (TPLO) required significantly lower rescue doses of opioids compared with dogs treated with 0.5% bupivacaine HCl. 10 Extracorporeal shock wave therapy (ESWT) has been described as an effective nonpharmaceutical alternative to regional analgesia in man 14 and dogs 15,16 with orthopedic disease. Extracorporeal shock wave therapy is a focused, high-energy sound wave treatment initially used for lithotripsy, 17 although the device used for lithotripsy varies from orthopedic shock wave devices.…”

“…Extracorporeal shock wave therapy is a focused, high-energy sound wave treatment initially used for lithotripsy, 17 although the device used for lithotripsy varies from orthopedic shock wave devices. Extracorporeal shock wave therapy has been reported in veterinary medicine as effective for various conditions including an increase in short-term limb use after TPLO 15 and in treatment of tendinopathies 18,19 and osteoarthritis. [16][17][18][19][20] Extracorporeal shock wave therapy was also shown to accelerate bone healing after TPLO when treatment was performed at the surgical site immediately after incision closure and again at the time of suture removal.…”

“…Extracorporeal shock wave therapy (ESWT) has been described as an effective nonpharmaceutical alternative to regional analgesia in man 14 and dogs 15,16 with orthopedic disease. Extracorporeal shock wave therapy is a focused, high‐energy sound wave treatment initially used for lithotripsy, 17 although the device used for lithotripsy varies from orthopedic shock wave devices.…”

Rock back phenomenon in 32 dogs that underwent tibial plateau levelling osteotomy

“…A tibial plateau levelling osteotomy (TPLO) represents the best way to treat CCLD, despite more than 5 decades since the first surgical treatment described for this condition (Barnes et al 2019;Nanda and Hans 2019;Clark et al 2020;Vezzoni et al 2020). The magnitude of the cranial tibial impulse Veterinarni Medicina, 66, 2021 (02): 58-65 https://doi.org/10.17221/128/2020-VETMED (0° to 14°) (Warzee et al 2001;Reif et al 2002;Nanda and Hans 2019).…”