VCOT May 2025 – Ortho Part 2: TTT Spacer Pins & The Working Length Myth

VCOT May 2025 – Ortho Part 2: TTT Spacer Pins & The Working Length Myth

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the May 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) with two studies that challenge long-held assumptions about orthopedic fixation.  One paper examines whether a novel spacer pin technique can provide the same stability as traditional tibial tuberosity transposition fixation while reducing implant-related complications. The second tackles one of the most debated concepts in fracture fixation: plate working length and whether leaving holes empty near a fracture gap truly provides biomechanical advantages. In this episode: ✅ Sullivan et al. — An ex vivo biomechanical study comparing three fixation methods for tibial tuberosity transposition (TTT) in the treatment of medial patellar luxation. The authors evaluated traditional tension band wiring, dual-pin fixation, and a novel spacer pin technique. All constructs demonstrated comparable stiffness and failure strength, with each tolerating more than 1,000 Newtons of force before failure. Importantly, the spacer pin avoided implant placement directly through the patellar ligament insertion, potentially reducing soft tissue irritation and implant-associated complications while maintaining equivalent biomechanical stability.  ✅ Trefny et al. — A biomechanical investigation of working length in locking compression plate constructs using a distal radius fracture model. Contrary to conventional wisdom, constructs with short working lengths (screws placed adjacent to the fracture gap) were approximately 30% stiffer and generated lower plate strain than constructs with longer working lengths. While long working length constructs initially benefited from load sharing through transcortical contact, the authors highlight the biologic risks associated with repeated bone-end contact, including high interfragmentary strain, bone resorption, and eventual implant fatigue failure.  Together, these studies demonstrate that orthopedic success often comes down to understanding where forces are actually being transmitted—and avoiding assumptions that may no longer hold true. 🎓 Journal Articles Discussed * Sullivan et al. — Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs * Trefny et al. — Effect of Plate Screw Configuration on Construct Stiffness and Plate Strain in a Synthetic Short Fragment Small Gap Fracture Model Stabilized with a 12-Hole 3.5-mm Locking Compression Plate 📚 From the May 2025 issue of VCOT 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample:  https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

VCOT May 2025 – Ortho Part 1: Universal DFO Guides, Giant-Breed CCL Surgery & Radius Exposure

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the May 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by focusing on a question that underpins every successful orthopedic procedure: how can better planning improve surgical outcomes? From universal deformity correction guides and giant-breed cranial cruciate surgery to rethinking surgical exposure of the canine radius, these studies challenge traditional assumptions and demonstrate how thoughtful planning can improve precision, reduce complications, and simplify orthopedic procedures. In this episode: ✅ Cheon et al. — Evaluated a novel universal distal femoral osteotomy (DFO) guide designed to replace patient-specific 3D-printed cutting guides. Using an adjustable titanium rail-and-pin system, the universal guide achieved correction accuracy within 2 degrees, matching custom 3D-printed guides without requiring CT-based manufacturing or production delays. The findings suggest that a reusable, shelf-ready system can provide the same surgical precision while dramatically simplifying preoperative logistics.  ✅ Guénégo et al. — Reviewed outcomes of AMA-based cranial closing wedge osteotomy (CCWO) in 204 giant-breed dogs (>50 kg) with cranial cruciate ligament disease. By aligning the anatomical and mechanical axes and eliminating excessive shear forces, the procedure achieved grade 4 bone healing in 100% of dogs by eight weeks and an exceptionally low surgical site infection rate of just 0.5%. Double locking plate fixation, postoperative antibiotics, and a 15-day Robert Jones bandage were key components of the protocol.  ✅ Lin et al. — Compared the traditional craniomedial approach (CMA) and the craniolateral approach (CLA) to the canine radius in cadavers. The CLA provided significantly greater exposure (19.4 cm² vs. 13.8 cm²) while avoiding the median neurovascular bundle and allowing simultaneous access to the ulna through the same incision. These findings suggest the CLA may offer substantial advantages for fracture reduction, plating, and minimally invasive fixation techniques.  Together, these studies highlight a simple but powerful principle: better orthopedic outcomes begin long before the first screw is placed. 🎓 Journal Articles Discussed * Cheon et al. — Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs * Guénégo et al. — Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg: Magnitude of the Craniocaudal Angulation of the Proximal Tibia and Rate of Surgical Site Infection * Lin et al. — Does the Craniolateral Approach Provide Better Exposure to the Radius than the Craniomedial Approach for Internal Fracture Fixation in Dogs? 📚 From the May 2025 issue of VCOT 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample:  https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery May 2026 – Ortho Part 2: SDFT Luxation Without Casts & Smarter THR Templating

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the May 2026 issue of Veterinary Surgery by examining two studies that reinforce an important surgical lesson: small technical details often determine long-term success. One study challenges the traditional reliance on postoperative immobilization following superficial digital flexor tendon (SDFT) luxation repair, while the other evaluates how radiographic positioning influences preoperative templating for canine total hip arthroplasty. In this episode: ✅ Viskjer et al. — A prospective study evaluating a modified block recession calcaneoplasty for treatment of canine SDFT luxation without routine postoperative tarsal immobilization. All dogs achieved full return to function, with objective gait analysis showing near-normal limb symmetry at long-term follow-up. The study demonstrated that carefully executed sulcus deepening can provide sufficient biomechanical stability without casts or splints, provided adequate calcaneal wall thickness is preserved. The key technical takeaway: maintain approximately 25% of calcaneal width on both the medial and lateral walls to avoid catastrophic fracture and recurrent luxation.  ✅ Zab et al. — A retrospective radiographic study comparing traditional extended hip radiographs with caudocranial flexed hip projections for canine THR templating. The authors found that extended views frequently created a false appearance of a stovepipe femoral canal, underestimating implant size in 88% of cases. Flexed views provided a more realistic representation of femoral canal morphology but tended to slightly overestimate final implant size due to magnification effects. The findings suggest that flexed hip projections may serve as a valuable alternative in dogs with severe osteoarthritis where standard positioning is difficult or impossible.  Together, these studies demonstrate that successful orthopedic outcomes often depend less on adding complexity and more on understanding the underlying biomechanics and anatomy. 🎓 Journal Articles Discussed * Viskjer et al. — Surgical management of luxation of the superficial digital flexor muscle tendon (SDFT) using a modified block recession calcaneoplasty without subsequent tarsal joint immobilization * Zab et al. — Comparison of canine femoral implant templating for total hip arthroplasty on 25 sets of craniocaudal extended and caudocranial flexed hip radiographs  📚 From the May 2026 issue of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery May 2026 – Ortho Part 1: Feline Achilles Repair, Internal Bracing & THR Stem Subsidence

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the May 2026 issue of Veterinary Surgery by exploring a common challenge across orthopedic reconstruction: how to restore stability while minimizing the complications associated with immobilization and implant-related concerns. From Achilles tendon reconstruction and multi-ligament stifle injuries in cats to postoperative stem migration after total hip replacement, these studies challenge long-held assumptions about how much external support—and how much radiographic concern—is truly necessary. In this episode: ✅ Bohin et al. — A multi-center retrospective study evaluating Achilles tendon repair in cats using a UHMWPE (ultra-high molecular weight polyethylene) synthetic implant. By using a load-sharing internal construct rather than rigid postoperative immobilization, surgeons achieved normal functional recovery in 11 of 12 limbs with long-term follow-up. The overall short-term complication rate was 15.4%, substantially lower than historical complication rates approaching 40% with traditional casts and transarticular fixation. The study highlights the importance of interference screw placement and infection prevention when using permanent braided implants.  ✅ Knell et al. — A retrospective case series describing coaptationless reconstruction of feline multi-ligament stifle injuries using knotless anchors, TightRope stabilization, and UHMWPE suture constructs. The technique achieved a remarkable 22 of 23 successful outcomes, with postoperative pain scores approaching normal by six months. The key lesson was that every deficient ligament must be reconstructed, particularly the caudal cruciate ligament, which proved essential for maintaining long-term stability without external coaptation.  ✅ Low et al. — A retrospective review of 177 canine total hip replacements using the BFX standard femoral stem. While 26 stems subsided more than 3 mm and seven subsided more than 5 mm, only a small fraction developed clinical complications. Instead, the strongest predictor of failure was the presence of an intraoperative femoral fissure, suggesting surgeons may be overemphasizing arbitrary radiographic subsidence thresholds while underappreciating the significance of intraoperative bone injury.  Together, these studies reinforce a central orthopedic principle: successful reconstruction often depends more on achieving stable internal mechanics than on relying on external protection or rigid radiographic rules. 🎓 Journal Articles Discussed * Bohin et al. — Outcomes of 11 cats with Achilles tendon (AT) rupture repair treated with a synthetic ultra-high-molecular-weight polyethylene (UHMWPE) * Knell et al. — A multiligament, internal brace, coaptationless stifle reconstruction technique for feline stifle luxation * Low et al. — Subsidence of the BFX standard stem after canine total hip replacement: A case series of 177 consecutive procedures 📚 From the May 2026 issue of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery May 2026 – Soft Tissue: Feline Cystolithotomy & AGASACA Margin Control

In this Simini Small Animal Surgery Podcast episode, we continue our soft tissue coverage from the May 2026 issue of Veterinary Surgery by examining two studies that challenge surgeons to balance technical precision, patient recovery, and long-term outcomes.  One study evaluates whether a minimally invasive approach to feline urolith removal truly improves surgical success, while the other explores how microscopic surgical decisions can dramatically alter recurrence risk in dogs with anal sac adenocarcinoma. In this episode: ✅ Boone et al. — A retrospective study comparing modified percutaneous cystolithotomy (PCCL-M) with traditional open cystotomy in cats undergoing urolith removal. Despite superior visualization, PCCL-M did not improve complete stone clearance, with residual urolith rates similar to open surgery (33.3% vs. 30%). However, PCCL-M resulted in smaller incisions, shorter hospitalization times, and fewer immediate postoperative lower urinary tract signs, suggesting the primary benefit is improved recovery rather than improved stone retrieval. The study reinforces the importance of postoperative imaging regardless of surgical approach.  ✅ Gordon et al. — A retrospective study evaluating the prognostic value of the R margin classification system in dogs with apocrine gland anal sac adenocarcinoma (AGASACA). Dogs with R1 margins experienced a 23-fold increase in local recurrence risk, with recurrence rates rising from 4% (R0) to 50% (R1). Importantly, achieving wider margins that occasionally included portions of the external anal sphincter did not result in a dramatic increase in major complications, supporting a more aggressive surgical approach when appropriate. The study also identified hypercalcemia and lymphovascular invasion as major predictors of poor outcome and metastasis.  Together, these studies emphasize that surgical success extends far beyond the procedure itself—requiring careful planning, objective postoperative assessment, and thoughtful long-term decision-making. 🎓 Journal Articles Discussed * Boone et al. — Outcomes and comparison of modified percutaneous cystolithotomy and traditional open cystotomy in 52 cats * Gordon et al. — Investigation of the “R” tumor margin classification and prognostic factors in apocrine gland anal sac adenocarcinoma of dogs 📚 From the May 2026 issue of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]