A new approach to treatment selection in dogs with cruciate ligament rupture: patient-specific treatment recommendations

Lampart, Marina; Knell, Sebastian; Pozzi, Antonio

doi:10.17236/sat00261

Cited by 3 publications

(3 citation statements)

References 101 publications

(183 reference statements)

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“…Qualitative subjective assessment of stifle joint stability revealed a sensitivity and specificity of 100% for all tests and all observers, which is in line with the first part of our third hypothesis. This result should be interpreted carefully because our model using CCL transection mimics hyperlax stifles, which present with instability that is easily detected by MLTs 4,6 . Other available studies investigating the accuracy of CD and TCT found less favorable results 7,31 .…”

Section: Discussionmentioning

confidence: 73%

“…This result should be interpreted carefully because our model using CCL transection mimics hyperlax stifles, which present with instability that is easily detected by MLTs. 4,6 Other available studies investigating the accuracy of CD and TCT found less favorable results. 7,31 cruciate ligament rupture or rupture of both cruciate ligaments as "intact" or "unstable" in vitro.…”

Section: Discussionmentioning

confidence: 98%

“…1,2 Most CCLR cases are treated surgically, although subclassifying CCLR based on clinical presentation may help defining more specific treatment recommendations. 3,4 CCLR is diagnosed primarily by physical examination, often by manual laxity tests (MLT) such as the cranial drawer test (CD) and the tibial compression test (TCT). 5,6 Excessive cranial tibial translation (CTT) during testing suggests CCLR.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the accuracy and intra‐ and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study

et al. 2023

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Objectives To investigate the accuracy and intra‐ and interobserver reliability of the cranial drawer test (CD), tibial compression test (TCT), and the new tibial pivot compression test (TPCT) in an experimental setting resembling acute cranial cruciate ligament rupture (CCLR) and to elucidate the ability to subjectively estimate cranial tibial translation (CTT) during testing. Study design Experimental ex vivo study. Sample population Ten cadaveric hindlimbs of large dogs. Methods Kinetic and 3D‐kinematic data was collected while three observers performed the tests on each specimen with intact (INTACT) and transected cranial cruciate ligament (CCLD) and compared using three‐way repeated‐measures ANOVA. Subjectively estimated CTT (SCTT), obtained during a separate round of testing, was compared to kinematic data by Pearson correlation. Results CTT was significantly higher for CCLD than for INTACT for all tests, resulting in 100% sensitivity and specificity. TPCT induced the highest CTT and internal rotation. Intra‐ and interobserver agreement of translation was excellent. For rotation and kinetics, agreement was more variable. SCTT strongly correlated with the objectively measured values. Conclusion The CD, TCT and the new TPCT were all accurate and reliable. The high translations and rotations during TPCT are promising, encouraging further development of this test. SCTT was reliable in our experimental setting. Clinical significance Veterinary manual laxity tests are accurate and reliable in acute CCLR. The TPCT might have potential for the assessment of subtle and rotational canine stifle instabilities. The high reliability of SCTT implies that grading schemes for stifle laxity, similar to human medicine, could be developed.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the accuracy and intra‐ and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study

et al. 2023

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Economic Considerations on Costs and Pricing of Two Surgical Techniques for Treating Cranial Cruciate Disease in Dogs

Wemmers¹,

Pawlak²,

Medl³

et al. 2023

Animals

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In surgical treatment of cranial cruciate ligament disease in dogs, Tibial Plateau Levelling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA) are commonly established procedures and have proven effective in restoring limb function. Unlike clinical outcome, economic aspects have not been studied as extensively. However, the surgical intervention poses an enormous financial burden on patients’ owners. In a veterinary practice setting, this study compares prices for TPLO and TTA and examines prices differences as well as potential cost drivers. Charges for veterinary treatments are based on the Gebührenordnung für Tierärztinnen und Tierärzte (GOT), which is mandatory for veterinarians in Germany but allows a certain range in billing. This study found that TPLO is charged at a higher price than TTA; however, this might not cover the additional costs of this procedure. The price is also associated with weight, heavier dogs being more expensive. The underlying strategies for pricing decisions may be based on costs, as efforts for TPLO and heavier dogs are higher in terms of a prolonged surgical time, the number of staff involved and in surgeons’ training. Price setting may also be based on a quality promise, suggesting better clinical outcome in a more expensive procedure. Future investigations should involve economic considerations and consider cost-effectiveness analysis when evaluating surgical treatment options.

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Multiparametric Comparison of Two TTA-Based Surgical Techniques in Dogs with Cranial Cruciate Ligament Tears

Figueirinhas,

Gonzalo-Orden,

Rodriguez

et al. 2023

Animals

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Tearing of the cranial cruciate ligament causes hindlimb lameness in dogs. Different surgical procedures have been proposed to treat this condition. In this study, two different TTA-based techniques and implants were compared. A total of 30 dogs were separated into two groups according to the technique and implant used (Porous TTA® or Model Xgen®). The aim of the study was to assess whether one of these techniques has better functional recovery of the joint, better bone consolidation after the osteotomy procedure and fewer osteoarthritic changes. We compared both groups up to 3 months after surgery. No significant differences were found in any of the assessed parameters. Thus, both procedures were found to be equally effective and safe.

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A new approach to treatment selection in dogs with cruciate ligament rupture: patient-specific treatment recommendations

Cited by 3 publications

References 101 publications

Evaluation of the accuracy and intra‐ and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study

Evaluation of the accuracy and intra‐ and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study

Economic Considerations on Costs and Pricing of Two Surgical Techniques for Treating Cranial Cruciate Disease in Dogs

Multiparametric Comparison of Two TTA-Based Surgical Techniques in Dogs with Cranial Cruciate Ligament Tears

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