Effects of low‐intensity pulsed ultrasound on radiographic healing of tibial plateau leveling osteotomies in dogs: a prospective, randomized, double‐blinded study

Kieves, Nina R.; Canapp, Sherman O.; Lotsikas, Peter J.; Christopher, Scott A.; Leasure, Christopher S.; Canapp, Debra; Gavin, Patrick R.

doi:10.1111/vsu.12798

Cited by 6 publications

(7 citation statements)

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“…Three studies only stated that they “randomly assigned” ( 32 , 49 ) or used a “simple randomization procedure” ( 51 ) without giving detailed information on the procedure applied. One study ( 47 ) assigned subjects via a randomized block cohort study on the basis of patient-related data that might had introduced a source of bias.…”

Section: Resultsmentioning

confidence: 99%

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Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

et al. 2022

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Tibial Plateau Leveling Osteotomy (TPLO) or Tibial Tuberosity Advancement (TTA) are commonly used surgical techniques for correction of cranial cruciate ligament (CCL) rupture in dogs. This systematic review aims to investigate whether one technique is superior to the other. Seventy-two studies on surgical management of CCL rupture have been identified and evaluated in regard of subjective and objective gait analysis criteria, development of osteoarthritis (OA), thigh circumference measurements, goniometry, joint stability, pain and complication rates. Almost half (47.2 %) of the studies were considered of low quality of evidence, leading to high heterogeneity in quality among studies; this posed a major limitation for an evidence-based systematic review of both surgical techniques. Out of 72 studies, there were only eleven blinded randomized clinical trials, of which five were rated with a low overall risk of bias. However, both techniques were considered to be successful management options. Subjective and objective gait analysis revealed no lameness at long-term evaluation for the majority of the patients. However, it appeared that TTA lead to better OA scores up to 6 months postoperatively, while TPLO had a lower rate of surgical site infections. In summary, no method can be clearly preferred, as most of the study evaluated were subpar. Studies with a high level of evidence are therefore urgently needed for such a common surgical procedure.

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Section: Resultsmentioning

confidence: 99%

“…Eleven studies were categorized as blinded, however only seven ( 35 , 36 , 38 – 40 , 47 , 54 ) of them described in detail a complete blinding of patients, personnel and outcome assessors. They were therefore considered to have a low risk of performance and detection bias ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

et al. 2022

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“…In total, there were 7 studies with LoE II with low RoB (Tables 2 and 3). Of these, 4 had positive outcomes, 21,23,24,27 2 had negative outcomes, 29,30 and 1 had improvement in only 1 subjective outcome 28 …”

Section: Resultsmentioning

confidence: 99%

“…Kieves et al conducted a study on the effects of LIPUS on radiographic healing and limb function in 50 dogs after TPLO (n = 25 each LIPUS and control) 30 . There were no significant differences in radiographic scores and objective gait analysis using a pressure sensing walkway between the LIPUS and sham group.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of postoperative rehabilitation interventions after cranial cruciate ligament surgery in dogs

et al. 2022

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Objective To critically evaluate the evidence for rehabilitation interventions following surgery for cranial cruciate ligament disease (CCLD) in dogs. Study design Systematic review. Methods Google Scholar and Pubmed databases were searched for studies evaluating postoperative CCLD rehabilitation interventions from 1990 until March 2020 per the international Prospective Register of Systematic Reviews (PROSPERO). Each study was assigned a level of evidence score from I to IV and a risk of bias (RoB) score by 2 reviewers, and by a third reviewer, when consensus was not reached. Results Nineteen studies met the inclusion criteria. Twelve comprised randomized, controlled trials (Level II), 6 were nonrandomized or nonblinded (Level III), and one was retrospective (Level IV). Nine studies had high RoB scores. Sixteen studies yielded positive results. Therapeutic exercise had the most studies with positive results but all had high RoB. Cold compression therapy had 3 supporting studies (2 Level II, low RoB). Extracorporeal shockwave yielded 2 positive Level II studies (low‐moderate and high‐moderate RoB) and photobiomodulation had 1 positive study (Level II, low RoB) with objective outcomes. A negative outcome was noted in 1 photobiomodulation study. There was 1 supporting study on electrical stimulation and there was none on low‐intensity pulsed ultrasound. Conclusion This systematic review supports the use of rehabilitation interventions in recovery of postoperative CCLD in dogs; however, many studies had a high risk of bias. Clinical significance There is a lack of class I level evidence in veterinary rehabilitation. This study supports therapeutic exercise and cold compression therapy for postoperative CCLD rehabilitation. Existing studies on other modalities are limited and demonstrate conflicting results.

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“…Established evidence exists for the benefits of pain management/anti‐inflammatory medication, exercise modification and weight management in managing CCL disease and improving postoperative recovery. In contrast, evidence of efficacy for physiotherapy (Romano and Cook 2015), nutraceuticals, extra‐corporeal shockwave therapy (Barnes and others 2019), low intensity pulsed ultrasound (Kieves and others 2018), and laser therapy (Kennedy and others 2018, Renwick and others 2018) remains weak, and results are often conflicting, with most studies involving only a small number of animals.…”

Section: How Has Treatment Changed In the Past 10 Years?mentioning

confidence: 99%

Update on the management of canine cruciate disease

Corr¹

2022

In Practice

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Background: Cranial cruciate ligament (CCL) disease remains one of the most common hindlimb orthopaedic conditions seen in dogs, and although surgical management provides good outcomes, prevention remains the holy grail. Aim of the article: This article presents a review of the current evidence and what has changed in the past 10 years to aid practitioners in decision‐making on the management of dogs with CCL disease.

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Effects of low‐intensity pulsed ultrasound on radiographic healing of tibial plateau leveling osteotomies in dogs: a prospective, randomized, double‐blinded study

Abstract: This study does not provide evidence to support the clinical application of LIPUS to stimulate the healing of stable, uncomplicated osteotomies to accelerate bone healing.

Cited by 6 publications

References 32 publications

Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

Systematic review of postoperative rehabilitation interventions after cranial cruciate ligament surgery in dogs

Update on the management of canine cruciate disease

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