Three‐dimensional volume rendering planning, surgical treatment, and clinical outcomes for femoral and tibial detorsional osteotomies in dogs

Abstract

Objectives To describe a computed tomographic (CT) methodology for planning the correction of femoral and tibial torsion and report the clinical outcomes after femoral (FDO) and tibial (TDO) detorsional osteotomy in dogs affected by torsion malalignment and patellar luxation (PL). Study design Multicenter retrospective study. Animals Eighteen client‐owned dogs. Methods Dogs underwent CT to measure femoral (FTA) and tibial torsion angle (TTA). Abnormal femoral external torsion was defined when FTA <20°, abnormal femoral internal torsion if FTA >35°; abnormal tibial external torsion was defined when TTA < −10°, and abnormal tibial internal torsion when TTA >2°. The cortical arch length (CAL) was measured with CT and used intraoperatively to determine the magnitude of correction. The medical records and radiographs were reviewed and used to report clinical and radiographic outcomes. Radiographs were reviewed to evaluate postoperative limb alignment, patellar position, and bone healing. Results Twenty‐two detorsional osteotomies were performed. Mean preoperative FTA was 14° for medial‐PL and 45.2° for lateral‐PL. Mean preoperative TTA was 11° for medial‐PL. Physiological patellar tracking was restored in 22/22 of cases. CAL measurement allowed for correction of abnormal torsion in 19/22 of cases. Seventeen out 18 dogs had full or acceptable functional outcome. The median radiographic follow‐up was 3 months. Major complications occurred in 2/22 cases, which suffered an iatrogenic abnormal femoral internal torsion and a persistent hindlimb lameness. Conclusions CAL can be measured with CT and used intraoperatively to guide the correction of abnormal torsion in dogs. Clinical relevance Abnormal femoral and tibial torsion are predisposing factors for PL. A higher complication rate is expected when FDO and TDO are performed in the same hindlimb.

The SmARTR pipeline: a modular workflow for the cinematic rendering of 3D scientific imaging data

“…Enhanced by segmentation of anatomical regions of interest and virtual volume sectioning operations, DVR algorithms facilitate a detailed appreciation of complex anatomical structures and spatial relationships within biological samples. Indeed, volume rendering is crucial not only in medical and veterinary diagnostics 96–107 , pre-operative investigations 108–116 , and post-operative follow-up 114,117–120 but also in diverse qualitative and quantitative analyses widely employed in scientific disciplines such as paleontology 121–125 , evo-devo 29,126,127 , ecology 47,128–132 , and zoology 28,30,36,48,49,133–139 . However, although traditional DVR implemented through ray casting technology can generate aesthetically appealing images, it relies on simple lighting and local illumination techniques that hinder the production of realistic representation of 3D data 140–142 .…”

“…Enhanced by segmentation of anatomical regions of interest and virtual volume sectioning operations, DVR algorithms facilitate a detailed appreciation of complex anatomical structures and spatial relationships within biological samples. Indeed, volume rendering is crucial not only in medical and veterinary diagnostics [96][97][98][99][100][101][102][103][104][105][106][107] , pre-operative investigations [108][109][110][111][112][113][114][115][116] , and post-operative follow-up 114,[117][118][119][120] but also in diverse qualitative and quantitative analyses widely employed in scientific disciplines such as paleontology [121][122][123][124][125] , evo-devo 29,126,127 , ecology 47,[128][129][130][131][132] , and zoology 28,30,36,48,49,…”

Patient-Specific 3D-Printed Osteotomy Guides and Titanium Plates for Distal Femoral Deformities in Dogs with Lateral Patellar Luxation

“…In veterinary medicine, the use of 3D stereolithography has been reported in the literature for planning the correction of complex limb deformities or for fracture treatment [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Optimal surgical management requires accurate characterization of the deformity, adequate preoperative planning and careful and precise intraoperative execution.…”

“…Unlike generic cutting guides, which are designed based on average reference values, PSGs allow for customized bone cuts, reducing the use of intra-operative diagnostics and operating time, increasing accuracy of bone cuts and allowing for precise correction of complex deformities. In veterinary medicine, the use of PSGs has been described in the treatment of numerous orthopedic conditions, both spinal and appendicular, including corrective osteotomies for tibial and femoral deformities [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. The aim of this study was to describe the restoration of alignment in the sagittal, frontal and transverse planes in two patients with grade IV LPL treated with distal femoral trapezoid osteotomies (DF-TO) using VSP and patient-specific 3D-printed osteotomy guides and titanium plates.…”

Evaluation of Surgical Technique and Clinical Results of a Procedure-Specific Fixation Method for Tibial Tuberosity Transposition in Dogs: 37 Cases

“…5,30,31 Excellent results have been reported after correction of excessive femoral varus, external femoral torsion, and/or external tibial torsion, with no reluxation observed in three studies including a total of 104 cases. 8,9,32 Cases undergoing a corrective osteotomy were excluded from enrollment in this study. However, a complete preoperative morphometric analysis of the femur and tibia was not performed in the majority of our cases, as this was standard practice only in large breed dogs and dogs with grade 4 MPL.…”