Lower body weight and increasing age are significant risk factors for complications following bi-oblique proximal ulnar osteotomy in dogs

Alan Danielski The Ralph Veterinary Referral Centre, Marlow, UK
Department of Veterinary Medicine and Animal Production, University of Naples “Federico II,” Naples, Italy

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Isabel de Marcos Carpio Pride Veterinary Centre, Derby, UK

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Camilla Danielski Institute of Astrophysics of Andalucía, Granada, Spain

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Michael Farrell Vetlessons, London, UK

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Miguel Angel Solano The Ralph Veterinary Referral Centre, Marlow, UK

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DOI:
https://doi.org/10.2460/javma.23.05.0232
Volume/Issue:
Volume 261: Issue 11
Online Publication Date:
01 Aug 2023
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Abstract

OBJECTIVE

To report and evaluate the risk factors for complications following bi-oblique proximal ulnar osteotomy (PUO) in dogs.

ANIMALS

82 client-owned dogs (93 limbs).

METHODS

Clinical records of dogs treated with bi-oblique PUO over a 5-year period were reviewed. Postoperative radiographs were analyzed, and osteotomy location and angles were recorded; follow-up radiographs were reviewed to assess the degree of osteotomy healing. Complications were classified as minor, major, and catastrophic. Logistic regression analysis was performed to investigate possible associations between the predictor variables and occurrence of complications.

RESULTS

82 dogs (93 limbs) were included. Postoperative complications were documented in 39 limbs (13 major and 26 minor). The most common major complication was osteotomy nonunion (8 limbs), while the most common minor complication was delayed union (21 limbs). Statistical analysis revealed that lower body weight (P = .01) and older age (P = .04) were significantly associated with the development of postoperative complications.

CLINICAL RELEVANCE

In this study, lighter and older dogs were more likely to develop complications following bi-oblique proximal ulnar osteotomy. We did not identify an association between osteotomy angle and location on complication rate. Careful patient selection is therefore required to reduce the incidence of postoperative complications after bi-oblique PUO.

Abstract

OBJECTIVE

To report and evaluate the risk factors for complications following bi-oblique proximal ulnar osteotomy (PUO) in dogs.

ANIMALS

82 client-owned dogs (93 limbs).

METHODS

Clinical records of dogs treated with bi-oblique PUO over a 5-year period were reviewed. Postoperative radiographs were analyzed, and osteotomy location and angles were recorded; follow-up radiographs were reviewed to assess the degree of osteotomy healing. Complications were classified as minor, major, and catastrophic. Logistic regression analysis was performed to investigate possible associations between the predictor variables and occurrence of complications.

RESULTS

82 dogs (93 limbs) were included. Postoperative complications were documented in 39 limbs (13 major and 26 minor). The most common major complication was osteotomy nonunion (8 limbs), while the most common minor complication was delayed union (21 limbs). Statistical analysis revealed that lower body weight (P = .01) and older age (P = .04) were significantly associated with the development of postoperative complications.

CLINICAL RELEVANCE

In this study, lighter and older dogs were more likely to develop complications following bi-oblique proximal ulnar osteotomy. We did not identify an association between osteotomy angle and location on complication rate. Careful patient selection is therefore required to reduce the incidence of postoperative complications after bi-oblique PUO.

Contributor Notes

Corresponding author: Dr. Danielski (alan.danielski@gmail.com)
Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
01 Nov 2023
  • 1.

    Schulz KS, Krotscheck U. Canine elbow dysplasia. In: Slatter D, ed. Textbook of Small Animal Surgery. 3rd ed. Saunders; 2003:1927-1952.

  • 2.

    O’Neill DG, Brodbelt DC, Hodge R, Church DB, Meeson RL. Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Med Genet. 2020;7(1):1-15. doi:10.1186/s40575-020-0080-5

    • Search Google Scholar
    • Export Citation
  • 3.

    Hebel M, Panek WK, Ruszkowski JJ, et al. Computed tomography findings in a cohort of 169 dogs with elbow dysplasia - a retrospective study. BMC Vet Res. 2021;17(1):296. doi:10.1186/s12917-021-02997-5

    • Search Google Scholar
    • Export Citation
  • 4.

    Farrell M, Heller J, Solano M, Fitzpatrick N, Sparrow T, Kowaleski M. Does radiographic arthrosis correlate with cartilage pathology in Labrador Retrievers affected by medial coronoid process disease? Vet Surg. 2014;43(2):155-165. doi:10.1111/j.1532-950X.2014.12092.x

    • Search Google Scholar
    • Export Citation
  • 5.

    Pulkkinen HSM, Reunanen VLJ, Hyytiäinen HK, Junnila JJT, Laitinen-Vapaavuori OM, Lappalainen AK. The intra- and intertester repeatability of radiographic elbow incongruity grading is high in chondrodystrophic dog breeds. Vet Radiol Ultrasound. 2020;61(3):329-335. doi:10.1111/vru.12853

    • Search Google Scholar
    • Export Citation
  • 6.

    Might KR, Hanzlik KA, Case JB, et al. In vitro comparison of proximal ulnar osteotomy and distal ulnar osteotomy with release of the interosseous ligament in a canine model. Vet Surg. 2011;40(3):321-326. doi:10.1111/j.1532-950X.2011.00805.x

    • Search Google Scholar
    • Export Citation
  • 7.

    Fitzpatrick N, Caron A, Solano MA. Bi-oblique dynamic proximal ulnar osteotomy in dogs: reconstructed computed tomographic assessment of radioulnar congruence over 12 weeks. Vet Surg. 2013;42(6):727-738. doi:10.1111/j.1532-950X.2013.12014.x

    • Search Google Scholar
    • Export Citation
  • 8.

    Böttcher P, Bräuer S, Werner H. Estimation of joint incongruence in dysplastic canine elbows before and after dynamic proximal ulnar osteotomy. Vet Surg. 2013;42(4):371-376. doi:10.1111/j.1532-950X.2013.01085.x

    • Search Google Scholar
    • Export Citation
  • 9.

    Ness MG. Treatment of fragmented coronoid process in young dogs by proximal ulnar osteotomy. J Small Anim Pract. 1998;39(1):15-18. doi:10.1111/j.1748-5827.1998.tb03663.x

    • Search Google Scholar
    • Export Citation
  • 10.

    Meyer-Lindenberg A, Fehr M, Nolte I. Short- and long-term results after surgical treatment of an ununited anconeal process in the dog. Vet Comp Orthop Traumatol. 2001;14(2):101-110. doi:10.1055/s-0038-1632683

    • Search Google Scholar
    • Export Citation
  • 11.

    Turner BM, Abercromby RH, Innes J, McKee WM, Ness MG. Dynamic proximal ulnar osteotomy for the treatment of ununited anconeal process in 17 dogs. Vet Comp Orthop Traumatol. 1998;11(2):76-79. doi:10.1055/s-0038-1632614

    • Search Google Scholar
    • Export Citation
  • 12.

    Fitzpatrick N, Yeadon R. Working algorithm for treatment decision making for developmental disease of the medial compartment of the elbow in dogs. Vet Surg. 2009;38(2):285-300. doi:10.1111/j.1532-950X.2008.00495.x

    • Search Google Scholar
    • Export Citation
  • 13.

    Fitzpatrick N, Yeadon R, Smith TJ. Early clinical experience with osteochondral autograft transfer for treatment of osteochondritis dissecans of the medial humeral condyle in dogs. Vet Surg. 2009;38(2):246-260. doi:10.1111/j.1532-950X.2008.00492.x

    • Search Google Scholar
    • Export Citation
  • 14.

    Caron A, Fitzpatrick N. Bi-oblique dynamic proximal ulnar osteotomy: surgical technique and clinical outcome in 86 dogs. Vet Surg. 2016;45(3):356-363. doi:10.1111/vsu.12464

    • Search Google Scholar
    • Export Citation
  • 15.

    Gilson SD, Piermattei DL, Schwarz PD. Treatment of humeroulnar subluxation with a dynamic proximal ulnar osteotomy. A review of 13 cases. Vet Surg. 1989;18(2):114-122. doi:10.1111/j.1532-950x.1989.tb01053.x

    • Search Google Scholar
    • Export Citation
  • 16.

    Pettitt RA, Tattersall J, Gemmill T, et al. Effect of surgical technique on radiographic fusion of the anconeus in the treatment of ununited anconeal process. J Small Anim Pract. 2009;50(10):545-548. doi:10.1111/j.1748-5827.2009.00821.x

    • Search Google Scholar
    • Export Citation
  • 17.

    Williams H, Arthurs G, Burton N, Kulendra E, Radke H, Parsons K. Lateral radial head subluxation as a complication following proximal ulnar osteotomy or ostectomy in eight dogs. Vet Comp Orthop Traumatol. 2019;32(3):250-256. doi:10.1055/s-0039-1683389

    • Search Google Scholar
    • Export Citation
  • 18.

    Cook JL, Evans R, Conzemius MG, et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg. 2010;39(8):905-908. doi:10.1111/j.1532-950X.2010.00763.x

    • Search Google Scholar
    • Export Citation
  • 19.

    Firoozbakhsh K, Moneim MS, Mikola E, Haltom S. Heat generation during ulnar osteotomy with microsagittal saw blades. Iowa Orthop J. 2003;23:46-50.

    • Search Google Scholar
    • Export Citation
  • 20.

    Brisman DL. The effect of speed, pressure, and time on bone temperature during the drilling of implant sites. Int J Oral Maxillofac Implants. 1996;11(1):35-37.

    • Search Google Scholar
    • Export Citation
  • 21.

    Toksvig-Larsen S, Ryd L, Lindstrand A. Temperature influence in different orthopaedic saw blades. J Arthroplasty. 1992;7(1):21-24. doi:10.1016/0883-5403(92)90027-n

    • Search Google Scholar
    • Export Citation
  • 22.

    Krause WR, Bradbury DW, Kelly JE, Lunceford EM. Temperature elevations in orthopaedic cutting operations. J Biomech. 1982;15(4):267-275. doi:10.1016/0021-9290(82)90173-7

    • Search Google Scholar
    • Export Citation
  • 23.

    Larsen ST, Ryd L. Temperature elevation during knee arthroplasty. Acta Orthop Scand. 1989;60(4):439-442. doi:10.3109/17453678909149314

  • 24.

    Eriksson AR, Albrektsson T, Albrektsson B. Heat caused by drilling cortical bone. Temperature measured in vivo in patients and animals. Acta Orthop Scand. 1984;55(6):629-631. doi:10.3109/17453678408992410

    • Search Google Scholar
    • Export Citation
  • 25.

    Farrell M, Mathieson A, Chung P, et al. In vitro performance testing of two arcuate oscillating saw blades designed for use during tibial plateau leveling osteotomy. Vet Surg. 2011;40(6):694-707. doi:10.1111/j.1532-950X.2011.00855.x

    • Search Google Scholar
    • Export Citation
  • 26.

    Kraus KH, Bayer BJ. Delayed unions, nonunions, and malunions. In: Tobias-Johnston: Veterinary Surgery: Small Animal. Saunders; 2012:647-656.

    • Search Google Scholar
    • Export Citation
  • 27.

    Welch JA, Boudrieau RJ, DeJardin LM, Spodnick GJ. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg. 1997;26(1):57-61. doi:10.1111/j.1532-950x.1997.tb01463.x

    • Search Google Scholar
    • Export Citation

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