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Objective To describe the clinical signs and histologic changes in cats clinically affected with medial humeral epicondylitis (MHE) and evaluate long-term outcome after either conservative or surgical treatment. Study Design Prospective cohort study. Animals Client-owned cats (n = 17) with MHE. Methods Cats diagnosed with MHE, based on clinical signs, radiographs and computed tomography (CT), were prospectively recruited. Cats were treated conservatively for an initial 4 weeks, followed by either surgery or continued conservative treatment. Followup examinations were performed at 6 and 12 weeks and at 6–49 months. Results Cats had a mean age of 10.3 years and presented for chronic lameness. Examination revealed pain on palpation caudodistal to the medial epicondyle and by exerting antebrachial supination/pronation with elbow and carpal flexion. Lameness was restricted to 1 limb although CT revealed bilateral disease in 11/17 cats. Free mineralized joint bodies were identified in 9/17 cats. Nine cats were treated surgically and 8 cats were treated conservatively. Intraoperative findings included new bone formation at the origin of the humeral head of the flexor carpi ulnaris muscle with displacement and adhesions of the ulnar nerve. Microscopic examination revealed neurogenic myopathy in 4/9 cats treated surgically. Seven of 9 cats treated surgically were free from lameness by 12 weeks. Seven of 8 cats treated conservatively were chronically lame throughout the study. Conclusions Cats with forelimb lameness should be evaluated for MHE. This condition is associated with free joint bodies and neurogenic myopathy. Surgical treatment is associated with excellent outcome in the majority of cats.

Objective: To (1) evaluate radiographic changes associated with osteoarthrosis (OA) before and after tibial tuberosity advancement (TTA) and (2) determine if these changes are indicative of limb function as determined by kinetic gait analysis. Study Design: Prospective clinical study. Animals: Dogs (n=35) with cranial cruciate ligament (CCL) deficient stifles (38). Methods: Variables recorded were: complete or partial CCL rupture, meniscal lesions, arthroscopically graded cartilage lesions, complications, and revision surgeries. Radiographic evaluation and kinetic gait analysis (vertical ground reaction forces [GRFs]) were conducted pre- and 4–16 months postoperatively (mean, 5.9 months). Radiographs were evaluated without knowledge of operative findings and functional outcome. A score (0–3) based on new bone production at 11 specific sites was used to grade OA. Soft tissue changes were classified separately as normal or excessive. Preoperative scores were correlated with clinical variables. Postoperative scores and progression of OA scores were correlated with clinical variables and GRFs. Results: OA remained unchanged in 17 joints and progressed in 21 (55%). Dogs with meniscal lesions had higher OA scores preoperatively, but not at follow-up. Dogs with severe cartilage lesions at surgery had more progression of OA. GRFs improved after surgery and were not correlated with any of the radiographic OA scores. Conclusion: Progression of OA was greater in the presence of severe cartilage lesions at surgery. OA scores were not correlated with GRFs. Clinical Relevance: Progression of OA is generally expected to occur after TTA despite improvement of limb function.

Summary Objective: To assess functional outcome in dogs with cranial cruciate ligament (CrCL) disease after tibial tuberosity advancement (TTA) using force plate gait analysis, and to evaluate parameters potentially influencing outcome. Study design: Prospective clinical study. Animals: Consecutive clinical patients (n=37) with CrCL-deficient stifles (n=40). Methods: The stifle joints were examined arthroscopically prior to TTA. Meniscal release was not performed if the medial meniscus was intact. Open medial arthrotomy and partial meniscectomy were performed in the presence of meniscal tears. Vertical ground reaction forces were measured preoperatively and at follow-up examinations four to 16 months postoperatively (mean: 5.9 months). The ground reaction forces of a group of 65 healthy dogs were used for the comparison. The potential effects of clinical parameters on functional outcome were evaluated statistically. Results: Complete CrCL rupture was identified in 28 joints, and partial CrCL rupture in 12 joints. The medial meniscus was damaged in 21 stifles. Vertical ground reaction forces were significantly higher at follow-up (P

Summary Objectives: This in vitro study compares the femorotibial shear in canine stifles with intact and transected cranial cruciate ligaments (CrCL), before and after tibial tuberosity advancement (TTA) by measuring the distance between origin and insertion of the cruciate ligaments. Methods: Radiodense markers were inserted into bones at the attachment sites of the cruciate ligaments in sixteen cadaveric stifles of adult dogs. Each stifle was then mounted in a testing apparatus. The distances between the markers were measured on mediolateral radiographs, performed on each stifle under three different situations: intact, after CrCL transection, and after performing a TTA. Stifles were loaded to create a constant tibiofemoral reaction force by maintaining the load parallel to the patellar ligament. Radiographs were taken in a preloaded and loaded state in the intact stifle and only in a loaded state after CrCL transection, and after performing a TTA. Results: Loading the stifle joints after transection of the CrCL resulted in a mean lengthening of the CrCL marker distance of 22.4%. Loading the transected CrCL stifles after performing a TTA resulted in a mean shortening of the CrCL marker distance by 3.0% compared to the loaded intact condition.Clinical significance: This study demonstrates that, in loaded stifles with transected CrCLs, TTA causes a caudal shift in the cranial shear force, counteracting cranial subluxation of the tibia.

To describe the clinical signs and histologic changes in cats clinically affected with medial humeral epicondylitis (MHE) and evaluate long-term outcome after either conservative or surgical treatment.Prospective cohort study.Client-owned cats (n = 17) with MHE.Cats diagnosed with MHE, based on clinical signs, radiographs and computed tomography (CT), were prospectively recruited. Cats were treated conservatively for an initial 4 weeks, followed by either surgery or continued conservative treatment. Followup examinations were performed at 6 and 12 weeks and at 6-49 months.Cats had a mean age of 10.3 years and presented for chronic lameness. Examination revealed pain on palpation caudodistal to the medial epicondyle and by exerting antebrachial supination/pronation with elbow and carpal flexion. Lameness was restricted to 1 limb although CT revealed bilateral disease in 11/17 cats. Free mineralized joint bodies were identified in 9/17 cats. Nine cats were treated surgically and 8 cats were treated conservatively. Intraoperative findings included new bone formation at the origin of the humeral head of the flexor carpi ulnaris muscle with displacement and adhesions of the ulnar nerve. Microscopic examination revealed neurogenic myopathy in 4/9 cats treated surgically. Seven of 9 cats treated surgically were free from lameness by 12 weeks. Seven of 8 cats treated conservatively were chronically lame throughout the study.Cats with forelimb lameness should be evaluated for MHE. This condition is associated with free joint bodies and neurogenic myopathy. Surgical treatment is associated with excellent outcome in the majority of cats.

SummaryA proximal tibial osteotomy technique for the repair of complete or partial rupture of the cranial cruciate ligament in dogs is described and the results of a series of 100 consecutively operated stifle joints are presented. Although the majority of dogs regained full function of the operated limb within four months of surgery, the overall complication rate was high.