Risk factors exist for femoral fracture after cementless THA using porous-coated implants, and should be critically evaluated during the patient selection. These risks should be weighed against the benefits of the system, and measures to minimize femoral fracture in at-risk patients studied.

Thirteen dogs with cardiac tamponade resulting from pericardial effusion were prospectively evaluated to determine feasibility and outcome of thoracoscopic partial pericardiectomy. A lateral thoracoscopic approach allowed adequate exposure to remove a 4- to 5-cm-diameter section of pericardium in all dogs. Complete resolution of cardiac tamponade occurred in all dogs for which there was follow-up (11 dogs). Ten of 13 dogs (76.9%) had neoplastic pericardial effusion. One of these dogs remains alive at 220 days postoperatively and is asymptomatic. The mean survival of the remaining 9 patents with neoplastic effusion was 128 days (range, 14-544 days; median, 38 days). Three of 13 patients (23.1%) had idiopathic pericardial effusion. Two of these dogs remain alive at 585 and 1,250 days postoperatively. One dog with idiopathic pericardial effusion developed cardiomyopathy and was euthanized 18 days after the procedure. Results indicate that the procedure was technically successful in all dogs. No anesthetic complications occurred. Procedural complications included phrenic nerve transection (1 dog), lung laceration (1 dog), and moderate intraoperative bleeding (1 dog). No adverse clinical manifestations of the complications were apparent. We conclude that thoracoscopic partial pericardiectomy is technically feasible and offers several advantages over conventional open thoracic surgical pericardiectomy.

Histologic changes in meniscal cartilage correlate with gross appearance of the cartilage at time of surgery for rupture of the CCL. On the basis of minimal histologic changes, routine removal of grossly normal menisci does not appear to be warranted.

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Thirteen dogs with cardiac tamponade resulting from pericardial effusion were prospectively evaluated to determine feasibility and outcome of thoracoscopic partial pericardiectomy. A lateral thoracoscopic approach allowed adequate exposure to remove a 4-to 5-cm-diameter section of pericardium in all dogs. Complete resolution of cardiac tamponade occurred in all dogs for which there was follow-up (11 dogs). Ten of 13 dogs (76.9%) had neoplastic pericardial effusion. One of these dogs remains alive at 220 days postoperatively and is asymptomatic. The mean survival of the remaining 9 patents with neoplastic effusion was 128 days (range, 14-544 days; median, 38 days). Three of 13 patients (23.1%) had idiopathic pericardial effusion. Two of these dogs remain alive at 585 and 1,250 days postoperatively. One dog with idiopathic pericardial effusion developed cardiomyopathy and was euthanized 18 days after the procedure. Results indicate that the procedure was technically successful in all dogs. No anesthetic complications occurred. Procedural complications included phrenic nerve transection (1 dog), lung laceration (l dog), and moderate intraoperative bleeding (1 dog). No adverse clinical manifestations of the complications were apparent. We conclude that thoracoscopic partial pericardiectomy is technically feasible and offers several advantages over conventional open thoracic surgical pericardiectomy. P ericardial effusion can result from many causes, 1 and may result in cardiac tamponade when the intraperi-cardial pressure rises sufficiently to affect cardiac function by compressing the heart and limiting diastolic filling. 2 Consequently, stroke volume, arterial pulse pressure, and venous return are significantly decreased and perfusion of vital tissues is impaired. The animal may die if intraperi-cardial pressure is not decreased. 2 Initial management of cardiac tamponade often includes pericardiocentesis. 3 In almost all cases caused by neoplasia and in 40-50% of the cases caused by idiopathic pericardial effusion, cardiac tamponade recurs following pericardio-centesis. 3 In these cases, a partial or total pericardiectomy performed through a lateral thoracotomy or median ster-notomy is often advocated for treatment. These techniques are expensive and have the potential for substantial post-operative complications. Problems with standard open tho-racic surgical procedures include postoperative pain, hy-poventilation, hypothermia, acid-base disturbances, shock, oliguria, and prolonged anesthesia time. 3,4 The purpose of this study was to investigate a less invasive technique for performing a partial pericardiectomy using thoracoscopy in the dog. Materials and Methods Dogs Thirteen dogs with pericardial effusion were referred to the Veterinary Specialty Hospital of San Diego from 1992 through 1996. Peri-cardial effusion with cardiac tamponade was confirmed with 2-dimensional echocardiography characterized by some degree of right atrial and/or right ventricular collapse. The presence or absence of a cardiac From the V...

Objective To determine the effect of the method used to attach OrthoFiber #5 to a 1/8‐in Securos toggle rod on the mechanical properties of the resulting construct. Study design Prospective bench top mechanical analysis. Sample population One hundred twenty‐eight OrthoFiber #5‐toggle rod suture constructs. Methods Toggle–suture constructs (groups A‐H) were prepared by using 8 methods to attach OrthoFiber #5 to a 1/8‐in toggle rod (n = 16 constructs/group). A servohydraulic materials‐testing machine was used to test each toggle–suture construct in tension. Mean load to failure, cycles to failure, construct stiffness, and suture elongation under static and cyclic loading were compared among types of constructs. Results Mean load to failure was greatest (>500 N) for constructs D (P ≤ .048) and G (P ≤ .048). Mean construct stiffness of D (53.52 N/mm) and E (53.6 N/mm) was greater than that of the 6 other constructs (P ≤ .040). Construct A sustained the most elongation in acute (23.47 mm; P < .001) and cyclic (18.53 mm; P < .003) loading. Cycles to failure was greater for construct C (622 cycles) compared with constructs A, B, and H (P = .008, P = .009, and P = .010, respectively). Conclusion The method used to attach OrthoFiber #5 to a 1/8‐in toggle rod influenced the mechanical properties of the construct. No one construct outperformed other groups in all areas of testing, but construct D was superior when mean load to failure and construct stiffness were considered. Clinical impact Construct D, with OrthoFiber #5, passed straight through the toggle rod eyelet, may provide superior stability and resistance to fatigue failure to toggle‐in repairs of coxofemoral luxations.

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A 13-yr-old female Cape clawless otter (Aonyx capensis) presented with an acute mild right pelvic limb lameness that progressed to a non-weight-bearing lameness. Diagnosis of a ruptured cranial cruciate ligament (CCL) was made based on positive cranial drawer during physical examination and was supported by radiographs. A surgical repair with a tibial plateau leveling osteotomy (TPLO) and bone anchor with an OrthoFiber suture was performed. The tibial plateau angle was reduced from 30 to 5 degrees. The otter returned to normal function after 12 wk of exercise restriction. Twelve months after surgery, the left CCL ruptured and a TPLO was performed. No complications developed after either surgery, and the otter had an excellent return to function. This is the first report of a cranial cruciate ligament rupture and TPLO procedure in a mustelid, supporting its application to noncanid and felid species.