Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/619503
tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice PracTice To PracTice Peer reviewed 117 orthopedic devices can be used to supplement or replace surgical treatment of cranial cruciate ligament (ccL) insuffciency, shoulder injury, carpal and tarsal injury, hip luxation, and limb salvage with prosthetics. although use of orthopedic devices, including custom orthotics, braces, neoprene slings, support wraps, and prosthetics, often leads to a successful outcome, the expected outcome as well as objective and subjective outcome measurements should be discussed with the owner prior to device placement. CRANIAL CRUCIATE LIGAMENT INSUFFICIENCY ccL insuffciency is the most common cause of hindlimb lameness in dogs. 1 numerous surgical treatment options exist, but surgery is not always a possibility. concurrent medical problems, fnancial concerns, or staging procedures for bilateral ccL insuffciency are all reasons for either forgoing or delaying surgical treatment. recently, the use of canine stife braces has emerged as a potential therapeutic approach to managing ccL insuffciency. studies are under way investigating whether braces are truly able to stabilize the stife and eliminate cranial tibial thrust and internal rotation. Human Knee Braces Knee braces are used in human medicine to 2 : • enhance proprioception/joint position sense • Permit the injured limb to relax • reduce fatigue in the injured limb • Provide some mechanical protection against impact • slow movement down to allow muscles time to react and control motion. categories of knee braces in human medicine include the following: • Prophylactic braces prevent or reduce severity of knee injuries in contact sports. • Functional braces provide stability for unstable knees. • Rehabilitative braces allow protected and controlled motion during the rehabilitation of injured knees. • Patellofemoral braces improve patellar tracking and relieve anterior pain. of these braces, only functional knee braces are used in veterinary medicine. Indications The most common indication for a canine stife brace is ccL insuffciency, but these braces are also used for postoperative support for medial or lateral collateral ligament instability, postoperative support for patellar tendon rupture, and caudal cruciate ligament insuffciency. 3 s tife braces are not intended as frst-line treatment for canine ccL rupture. Preliminary reports suggest that custom-made stife braces stabilize the stife; however, surgery should be considered the gold standard treatment. 4 When deciding whether a patient would beneft from a stife brace prior, or as an alternative, to surgery, carefully consider the following factors: • dog's activity level • owner's expectations • owner's willingness to comply with necessary care. age should never be the sole reason for Canine OrthOpediC deviCes Brittany Jean Carr, DVM, CCRT, and David L. Dycus, DVM, MS, Diplomate ACVS (Small Animal) Veterinary Orthopedic & Sports Medicine Group, Annapolis Junction, Maryland FIGURE 1. Patient being casted for a left stife brace. Ideally, casting is performed with the patient standing and bearing weight on the affected limb.