Download PDF
Vet Comp Orthop Traumatol 2009; 22(03): 183-189
DOI: 10.3415/VCOT-08-08-0074
Original Research
Schattauer GmbH

Can owners and clinicians assess outcome in dogs with fragmented medial coronoid process?

N.J. Burton
1   University of Bristol School of Clinical Veterinary Science, Bristol, United Kingdom
,
M.R. Owen
1   University of Bristol School of Clinical Veterinary Science, Bristol, United Kingdom
,
G.R. Colborne
1   University of Bristol School of Clinical Veterinary Science, Bristol, United Kingdom
,
M.J. Toscano
1   University of Bristol School of Clinical Veterinary Science, Bristol, United Kingdom
› Author Affiliations
Further Information

Publication History

Received:13 August 2008

Accepted:10 March 2008

Publication Date:
17 December 2017 (online)

    Permissions and Reprints

Summary

Objectives: To investigate the long term reliability of clinician and owner visual analogue score (VAS) for dogs with unilateral forelimb lameness attributable to fragmented medial coronoid process (FMCP) when compared to objective gait analysis. Methods: Nine dogs with unilateral thoracic limb lameness due to FMCP underwent inverse dynamics gait analysis at initial presentation, and at one, two, six and 12 months following diagnosis. Total support moments were calculated and a total support moment ratio (TSMR) derived as an objective assessment of thoracic limb asymmetry. A VAS questionnaire for lameness was completed by the owner of each dog for each visit. Video footage of each dog walking and trotting at each visit was compiled, assigned to random order and subjected to VAS for lameness by a specialist in small animal surgery. Data from owner and clinician VAS lameness questionnaires were compared to the thoracic limb TSMR.

Results: Statistical analysis demonstrated a significant negative correlation between TSMR and owner VAS at four weeks post treatment but at no other period of evaluation. There was no significant correlation between TSMR and clinician VAS score at any evaluation period.

Clinical Significance: Assessments by owner and clinicians using VAS appear to be of limited use as a long term outcome measure for dogs with unilateral lameness due to FMCP when compared to objective gait analysis. There is a tendency for owners to underestimate forelimb lameness with increasing time which is not supported by quantitative measures of gait.

Keywords

Elbow dysplasia - gait analysis - fragmented medial coronoid process - inverse dynamics
 

  • References

  • 1 Groendalen J, Groendalen T. Arthrosis in the elbow joint of young rapidly growing dogs. Nord Med 1981; 33: 1-16.
    PubMedGoogle Scholar
  • 2 Olsson SE. The early diagnosis of fragmented coronoid process and osteochondrosis dissecans of the canine elbow joint. J Am Anim Hosp Assoc 1983; 19: 616-626.
    PubMedGoogle Scholar
  • 3 Kirberger RM, Fourie SL. Elbow dysplasia in the dog: Pathophysiology, diagnosis and control. J S Afr Vet Assoc 1998; 43-54.
    PubMedGoogle Scholar
  • 4 van Ryssen B, van Bree HA. Arthroscopic findings in 100 dogs with elbow lameness. Vet Rec 1997; 140: 360-362.
    CrossrefPubMedGoogle Scholar
  • 5 Olsson SE. Lameness in the dog. A review of lesions causing osteoarthritis of the shoulder, elbow, hip, stifle and hock joints. Scientific Presentations of the American Animal Hospital Association Annual Meeting 1975; 42: 363-370.
    PubMedGoogle Scholar
  • 6 Wind AP, Packard MR. Elbow incongruity and developmental elbow disease in the dog. Part 1. J Am Anim Hosp Assoc 1986; 22: 711-724.
    PubMedGoogle Scholar
  • 7 Trostel RR. Canine Elbow Dysplasia: Anatomy and Pathogenesis. Comp Con Educ Pract Vet 2003; 25: 754-762.
    PubMedGoogle Scholar
  • 8 Mason DR, Schulz KS, Fujita Y. In vitro force mapping of normal canine humeroradial and hume-roulnar joints. Am J Vet Res 2005; 66: 132-135
    CrossrefPubMedGoogle Scholar
  • 9 Huibregtse BA, Johnson AL, Muhlbauer MC. The effect of treatment of fragmented coronoid process on the development of osteoarthritis of the elbow. J Am Anim Hosp Assoc 1994; 30: 190.
    PubMedGoogle Scholar
  • 10 Tobias TA. Surgical removal of fragmented medial coronoid process in the dog: Comparative effects of surgical approach and age at the time of surgery. J Am Anim Hosp Assoc 1994; 30: 360-368.
    PubMedGoogle Scholar
  • 11 Bouck GR, Miller CW, Taves CL. A comparison of surgical and medical treatment of fragmented coronoid process and osteochondrosis dissicans of the canine elbow. Vet Comp Orthop Traumatol 1995; 8: 177-183.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Ness MG. Treatment of fragmented medial coronoid process in young dogs by proximal ulnar osteotomy. J Small Anim Pract 1998; 39: 15-18.
    CrossrefPubMedGoogle Scholar
  • 13 Meyer-Lindenberg A, Langhann AFehr. Arthrotomy verses arthroscopy in the treatment of the fragmented medial coronoid process of the ulna (FCP) in 421 dogs. Vet Comp Orthop Traumatol 2003; 16: 204-210.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Fitzpatrick N, Smith TJ, Evans RB. Subtotal coronoid ostectomy for the treatment of medial coronoid disease in 263 dogs. Vet Surg 2009; 38: 233-245.
    CrossrefPubMedGoogle Scholar
  • 15 Schulz KS, Cook JL, Kapatkin AS. et al. Evidence-Based Surgery: Time for Change. Vet Surg 2006; 35: 697-699.
    CrossrefPubMedGoogle Scholar
  • 16 Cook JL. Outcomes-based patient care in veterinary surgery: What is an outcome measure?. Vet Surg 2007; 36: 187-189.
    CrossrefPubMedGoogle Scholar
  • 17 Brown DC. Outcomes based medicine in Veterinary Surgery: Getting Hard Measures of Subjective Outcomes. Vet Surg 2007; 36: 289-292.
    CrossrefPubMedGoogle Scholar
  • 18 Breur GJ, Kim J. Should gait analysis be a part of clinical orthopaedic reports?. J Small Anim Pract 2008; 49: 113-114.
    CrossrefPubMedGoogle Scholar
  • 19 Lequesne M. Indices of severity and disease activity for osteoarthritis. Semin Arthritis Rheum 1991; 20: 48-54.
    CrossrefPubMedGoogle Scholar
  • 20 Theiler R, Ghosh P, Brooks P. Clinical, biochemical and imaging methods of assessing osteoarthritis and clinical trials of agents claiming ‘chondromodulating’ activity. Osteoarthritis Cartilage 1994; 2: 1-23.
    CrossrefPubMedGoogle Scholar
  • 21 Bellamy N. Instruments to assess osteoarthritis – Current status and future needs. Ann Rheum Dis 1995; 54: 692-693.
    CrossrefPubMedGoogle Scholar
  • 22 Innes JF, Barr ARS. Can owners assess outcome following treatment of canine cruciate ligament deficiency?. J Small Anim Pract 1998; 39: 373-378.
    CrossrefPubMedGoogle Scholar
  • 23 Quinn MM, Keuler NS, Lu Y. et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales and force plate gait analysis in dogs. Vet Surg 2007; 36: 360-367.
    CrossrefPubMedGoogle Scholar
  • 24 Waxman AS, Robinson DA, Evans RB. et al. Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness. Vet Surg 2008; 37: 241-246.
    CrossrefPubMedGoogle Scholar
  • 25 Burton NJ, Dobney JA, Owen MR. et al. Joint angle, moment and power compensations in dogs with fragmented medial coronoid process. Vet Comp Orthop Traumatol 2008; 2: 110-118.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Meutstege FJ. Aims of the International Elbow Working Group. Abstracts of the 7th annual meeting of the International Elbow Working Group (IEWG) Constance, Germany. Vet Comp Orthop Traumatol 1996; 9: 58-71.
    PubMedGoogle Scholar
  • 27 Hornof WJ, Wind AP, Wallack ST. et al. Canine elbow dysplasia – The early radiographic detection of fragmentation of the coronoid process. Vet Clin North Am Small Anim Pract 2000; 30: 257-266.
    CrossrefPubMedGoogle Scholar
  • 28 Burton NJ, Comerford EJ, Bailey M. et al. Digital analysis of ulnar trochlear sclerosis in Labrador Retrievers. J Small Anim Pract 2007; 48: 220-224.
    CrossrefPubMedGoogle Scholar
  • 29 Bennett D, Tennant B, Lewis DG. et al. A reappraisal of anterior cruciate ligament disease in the dog. J Small Anim Pract 1988; 29: 275-297.
    CrossrefPubMedGoogle Scholar
  • 30 Hudson JT, Slater MR, Taylor L. et al. Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. Am J Vet Res 2004; 65: 1634-1643.
    CrossrefPubMedGoogle Scholar
  • 31 DeCamp CE, Soutas-Little RW, Hauptman J. Kinematic gait analysis of the trot in healthy greyhounds. Am J Vet Res 1993; 54: 627-634.
    PubMedGoogle Scholar
  • 32 Allen K, Decamp CE, Braden TD. Kinematic gait analysis of the trot in healthy mixed breed dogs. Vet Comp Orthop Traumatol 1994; 7: 148-153.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Rumph PF, Kincaid SA, Visco DM. Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hind limb lameness. Vet Surg 1995; 24: 384-389.
    CrossrefPubMedGoogle Scholar
  • 34 Budsberg SC. Long term temporal evaluation of ground reaction forces during development of experimentally induced osteoarthritis in dogs. Am J of Vet Res 2001; 62: 1207-1211.
    PubMedGoogle Scholar
  • 35 Marsolais GS, Dvoak G, Conzemius MG. Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs. J Am Vet Med Assoc 2002; 220: 1325-1330.
    CrossrefPubMedGoogle Scholar
  • 36 Theyse LFH, Hazewinkel HAW, Brom WE. Force plate analyses before and after surgical treatment of unilateral fragmented coronoid process. Vet Comp Orthop Traumatol 2000; 13: 135-140.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Colborne GR, Innes JF, Comerford EJ. et al. Distribution of power across the hind limb joints in Labrador Retrievers and Greyhounds. Am J Vet Res 2005; 66: 1563-1571.
    CrossrefPubMedGoogle Scholar
  • 38 Colborne GR. Are sound dogs mechanically symmetric at trot? No, actually. Vet Comp Orthop Traumatol 2008; 21: 294-301.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 39 Voss K, Imhof J, Kaestner S. et al. Force plate analysis at the walk and trot in dogs with low-grade hind-limb lameness. Vet Comp Orthop Traumatol 2007; 4: 299-304.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Horstman CL, Conzemius MG, Evans R. et al. Assessing the efficacy of perioperative oral carprofen after cranial cruciate surgery using noninvasive, objective pressure platform gait analysis. Vet Surg 2004; 33: 286-292.
    CrossrefPubMedGoogle Scholar