VCOT July 2025 – Ortho Part 1: TPLO Remnants, MPL Locking Plates & Implant Stress Risers

VCOT September 2025 – Ortho Part 2: Toy Breed Menisci & Growth-Guided Tibial Plateau Correction

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the September 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by examining how biology and biomechanics shape long-term orthopedic outcomes in small dogs. One study challenges assumptions about meniscal injury prevalence in toy-breed dogs with cranial cruciate ligament disease, while the second explores how growth itself may become a powerful ally in the treatment of proximal tibial physeal fractures. In this episode: ✅ Kikuchi et al. — Used arthroscopy to evaluate the incidence of medial meniscal injury in toy-breed dogs weighing 5 kg or less with cranial cruciate ligament rupture. The authors identified meniscal injury in 36.3% of affected stifles, demonstrating that significant meniscal pathology remains common even in very small patients. Yorkshire Terriers showed particularly high rates of complete cruciate rupture and meniscal injury, with over 55% of Yorkies affected. The study highlights the importance of thorough meniscal assessment, especially in dogs with complete ruptures, higher relative body weight, and severe lameness.  ✅ Turner et al. — Evaluated postoperative changes in tibial plateau angle (TPA) following repair of Salter-Harris Type I and II proximal tibial physeal fractures. Across 32 dogs, the authors observed a mean 5.89° reduction in TPA during early healing, demonstrating that significant dynamic correction occurs after surgery. Interestingly, adding a tibial tuberosity tension band did not significantly affect correction, suggesting that cranially placed K-wires alone create sufficient temporary physeal tethering to guide growth and level the tibial plateau over time. Together, these studies remind us that successful orthopedic surgery requires understanding not only the injury itself, but also how biology continues to influence outcomes long after the procedure is complete. 🎓 Journal Articles Discussed * Kikuchi et al. — Incidence of Medial Meniscus Injury Detected by Arthroscopy in Toy Breed Dogs (≤5 kg) with Cranial Cruciate Ligament Rupture * Turner et al. —Tibial Plateau Angle Changes following Repair of Salter–Harris Type 1 and 2 Fractures in Dogs 📚 From the September 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 September 2025 – Ortho Part 1: Supercutaneous Plating & 3D-Printed HIF Guides

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the September 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by exploring a common surgical objective: maximizing stability while minimizing surgical trauma. One study evaluates an innovative fracture fixation strategy that combines the biological advantages of external skeletal fixation with the mechanical benefits of locking plate technology. The second investigates whether 3D-printed patient-specific guides can improve the accuracy and safety of transcondylar screw placement in dogs with humeral intracondylar fissures. In this episode: ✅ İnal et al. — Evaluated supercutaneous locking plates (SLPs) for the management of non-articular radial, ulnar, and tibial fractures in dogs and cats. Applied externally above the skin using locking screws, SLPs achieved a median healing time of approximately 50 days, with most patients bearing weight within 1–2 days postoperatively. Although 24% of cases developed minor screw-track discharge, no implants required removal and all complications were managed conservatively. The findings suggest SLPs may provide a low-profile alternative to traditional external fixators while preserving fracture biology and minimizing soft tissue disruption.  ✅ Kershaw et al. — Investigated the use of 3D-printed patient-specific guides (PSGs) for transcondylar screw placement in canine humeral intracondylar fissures. Using a novice surgeon model in paired cadaver limbs, PSGs produced significantly more accurate entry and exit points than traditional aiming devices. Most notably, three of seven screws placed with standard aiming devices would have violated the joint, whereas zero articular penetrations occurred with PSG-guided placement. The study highlights the potential for patient-specific technology to improve surgical precision and reduce catastrophic technical errors.  Together, these studies demonstrate that advances in orthopedic surgery increasingly focus on working smarter rather than working bigger—using technology and biomechanics to achieve safer, more predictable outcomes. 🎓 Journal Articles Discussed * Inal et al. — Minimally Invasive Radial–Ulnar and Tibial Fracture Management with Supracutaneous Locking Plates in Dogs and Cats * Kershaw et al. — Patient-specific Guides Improve the Accuracy and Safety of Transcondylar Screw Placement—A Cadaveric Study in the Canine Humerus 📚 From the September 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 July 2025 – Ortho Part 2: Tibial Torsion in MPL & The Future of Hip Resurfacing

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the July 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by examining how a deeper understanding of anatomy and biomechanics can fundamentally change surgical planning.  One study introduces a novel method for evaluating tibial torsional deformity in dogs with medial patellar luxation, while the second explores a promising bone-preserving alternative to traditional total hip replacement. In this episode: ✅ Isono et al. — Investigated tibial torsional malalignment in small-breed dogs with medial patellar luxation (MPL) using advanced CT analysis. The authors introduced the Proximal Tibia Metatarsal Angle (PTMTA), a new measurement designed to quantify rotational deformity throughout the entire hind limb. Normal dogs demonstrated a PTMTA of approximately 7 degrees, while Grade IV MPL patients averaged 32.8 degrees, with some exceeding 40 degrees. The findings suggest that severe MPL may be driven by substantial tibial rotational deformity, emphasizing the importance of evaluating the entire limb when planning corrective osteotomies.  ✅ Perez Neto et al. — Evaluated a novel short-stem hip resurfacing arthroplasty (HRA) implant as a potential alternative to conventional total hip replacement. Using cadaveric femurs from large-breed dogs, the authors demonstrated that although the implant reduced maximum load capacity by approximately 22%, implanted femurs still withstood forces exceeding six times body weight before failure. Importantly, fractures occurred in the same location as intact femurs, suggesting that the implant preserved natural load transmission patterns while maintaining substantial mechanical strength.  Together, these studies demonstrate that better orthopedic outcomes begin with understanding the underlying mechanics of the limb—and sometimes preserving anatomy may be just as important as replacing it. 🎓 Journal Articles Discussed * Isono et al. — Tibial Torsion Malalignment in Small Dogs with Medial Patellar Luxation * Perez Neto et al. — Biomechanical Evaluation of a Femoral Implant for Hip Resurfacing Arthroplasty in Dogs: An Ex Vivo Study 📚 From the July 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 July 2025 – Ortho Part 1: TPLO Remnants, MPL Locking Plates & Implant Stress Risers

In this Simini Small Animal Surgery Podcast episode, we continue our orthopedic coverage from the July 2025 issue of Veterinary and Comparative Orthopaedics and Traumatology (VCOT) by exploring how seemingly small surgical decisions can have major biomechanical consequences.  From preserving partial cruciate ligament remnants during TPLO to modern fixation strategies for tibial tuberosity transposition and the persistent challenge of stress concentration in locking plates, these studies provide practical insights for improving surgical outcomes and reducing complications. In this episode: ✅ Almeida et al. — Investigated whether transecting the remaining fibers of a partially ruptured cranial cruciate ligament during TPLO influences postoperative patellar ligament thickening or shortening. Evaluating 56 stifles, the authors found no difference in postoperative patellar ligament changes between dogs whose remnants were transected and those whose remnants were preserved. Importantly, preserving the residual ligament may provide ongoing biomechanical support by limiting cranial tibial translation during gait and potentially reducing future meniscal injury and osteoarthritis progression.  ✅ Eskelinen et al. — Evaluated a locking plate and pin fixation technique for tibial tuberosity transposition (TTT) in 65 medial patellar luxation surgeries. The technique achieved resolution of lameness in all patients and successful correction in 64 of 65 stifles. In cases where the surgical protocol was followed precisely, there were zero tibial tuberosity fractures, avulsions, or luxation recurrences, highlighting the importance of rigid fixation and meticulous implant placement.  ✅ Hawker et al. — Examined whether locking head inserts (LHIs) improve the mechanical performance of locking compression plate constructs. Despite testing constructs with up to nine inserts torqued to 4 Nm, the authors found no measurable improvement in plate strain, construct stiffness, or compressive displacement. The findings challenge the assumption that filling empty combi holes strengthens plate constructs and reinforce the importance of thoughtful plate selection and working-length management instead.  Together, these studies emphasize a central orthopedic lesson: sometimes the best surgical decision is not adding more hardware—but understanding which details actually matter. 🎓 Journal Articles Discussed * Almeida et al. — Effect of Cranial Cruciate Ligament Transection during TPLO on Patellar Desmitis in Dogs with Partial Cranial Cruciate Ligament Rupture * Eskelinen et al. — Outcome and Complications Following Medial Patellar Luxation Corrective Surgery with Tibial Tuberosity Transposition Using a Locking Plate and a Pin Fixation: 45 Unilateral and 20 Single-Session Bilateral Procedures * Hawker et al. — The Effect of Locking Head Inserts on the Biomechanical Properties of a 3.5-mm Broad Locking Compression Plate When Used in an Open Fracture-Gap Model 📚 From the July 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 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]