Fitzpatrick Referrals

Eashing, United Kingdom

Fitzpatrick Referrals

Eashing, United Kingdom

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Goldhammer M.A.,Tierarztliche Klinik Dr. Schneider Haiss | Smith S.H.,University of Edinburgh | Fitzpatrick N.,Fitzpatrick Referrals | Clements D.N.,University of Edinburgh
Veterinary Journal | Year: 2010

Validation of radiographic and arthroscopic scoring of joint pathology requires their comparison with histological measures of disease from the same joint. Fragmentation of the medial coronoid process (FMCP) is a naturally occurring disease of the canine elbow joint that results in osteoarthritis, and the objectives of this study were to compare the severity of histopathological changes in the medial coronoid process (MCP) and medial articular synovial membrane with gross radiographic scoring of elbow joint osteophytosis and the arthroscopic assessment of the MCP articular cartilage surface... Radiographic scoring of osteophytosis and the arthroscopic scoring of visual cartilage pathology of the MCP correlated moderately well with the histopathological evaluation of cartilage damage on the MCP and synovial inflammation in the medial part of the joint, but not with bone pathology in the MCP. Marked cartilage pathology on the MCP was identified in joints with either no radiographic evidence of osteophytosis or with mild cartilage damage that was evident arthroscopically. © 2009 Elsevier Ltd.


Yeadon R.,Fitzpatrick Referrals | Fitzpatrick N.,Fitzpatrick Referrals | Kowaleski M.P.,Tufts University
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2011

Objective: To report surgical technique, morphometric effects and clinical outcomes for tibial tuberosity transposition-advancement (TTTA), sulcoplasty and para-patellar fascial imbrication for management of concomitant medial patellar luxation (MPL) and cranial cruciate ligament (CCL) disease in 32 dogs. Study design: Case series. Methods: A previous technique for tibial tuberosity advancement was modified to incorporate lateral and distal tibial tuberosity transposition. Preoperative, immediate, and six to eight week postoperative radiographs were reviewed with morphometry of a range of tibial and stifle anatomic parameters. Findings of sequential clinical examinations to six to 20 months postoperatively were recorded. Results: Thirty-nine stifles were treated by surgery. Medial patellar luxation grade ranged from II to IV/IV. The CCL rupture was complete in 17/39 stifles, and incomplete in 22/39. Complications occurred in 11/39 stifles including MPL recurrence (n = 4). Resolution of subjectively-assessed lameness occurred in 29/39 stifles at the six to eight week assessment. Resolution of lameness was eventually documented in 35/39 stifles (4/39 lost to follow- up), and was maintained at the six to 20 month reassessment where available. The TTTA induced relative patella baja in 31/39 stifles. Magnitude of actual tibial tuberosity advancement was lower than that predicted by cage size. Clinical significance: Tibial tuberosity transposition- advancement is a potential treatment modality for concomitant CCL disease and MPL in the dog, but refinement of planning is required, while biomechanical and kinematic effects remain unknown. © Schattauer 2011.


Danielski A.,Fitzpatrick Referrals | Vanhaesebrouck A.,University of Cambridge | Yeadon R.,Vets Now Referrals
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2012

This report describes the management of clinically significant, single level cervical spinal canal stenosis associated with articular facet hypertrophy in a three-year-old Great Dane dog, by combined surgical decompression and spinal stabilization. Spinal column stabilization was achieved by ventral application of two String of Pearls locking plates and subsequent decompression was accomplished by unilateral facetectomy. The six-month postoperative reassessment examination confirmed satisfactory clinical outcome with a complete return to normal activity, resolution of neurological deficits and maintenance of implant positioning. © Schattauer 2012.


Fitzpatrick N.,Fitzpatrick Referrals | Sajik D.,Fitzpatrick Referrals | Farrell M.,Fitzpatrick Referrals
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2013

Objective: To describe the surgical technique for pantarsal arthrodesis (PTA) in cats according to the principles of percutaneous plate arthrodesis with application of a precontoured dorsal plate, without external coaptation and to report the long-term clinical outcome. Materials and methods: Retrospective review was performed of all cats treated by percutaneous plate application using a new pre-contoured dorsal plate for PTA between 2008 and 2011. Inclusion criteria were clinical and radiographic records plus clinical follow-up to at least six weeks. Data recorded included signalment, indication for surgery, postoperative care, and complications encountered. Radiographs were assessed for arthrodesis progression and complications. Outcome was assessed using an owner questionnaire. Results: Eleven cats were treated for tarsal injuries and met the inclusion criteria. Mean age was 86 ± 45 months, weight 4.50 ± 0.92 kg. The only major short-term complication encountered was wound dehiscence requiring sedation and re-suturing. In the medium-term (23.3 months ± 11.6 months) eight out of nine cats returned to normal activity and one cat showed intermittent lameness. Long-term (34.3 months ±17.5 months) radiographic evaluation was performed in seven out of nine cats; six manifested complete arthrodesis and one sustained plate breakage. Based on owner questionnaire, all nine cats returned to normal activity in the long-term, even the case with plate breakage. Conclusion: Based on our results, PTA using a custom pre-contoured dorsal plate is a suitable salvage surgery for treatment of severe tarsal injuries in cats. © Schattauer 2013.


Danielski A.,Fitzpatrick Referrals | Bertran J.,Fitzpatrick Referrals | Fitzpatrick N.,Fitzpatrick Referrals
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2013

In this case series we describe the diagnosis and surgical treatment of five cats affected by clinical cauda equina syndrome as a result of degenerative lumbosacral stenosis. Radiographic and magnetic resonance imaging findings confirmed the suspected diagnosis of disc-associated lumbosacral disease. Cauda equina decompression was achieved by dorsal laminectomy followed by dorsal annulectomy and nuclear extirpation. Dorsal stabilization was achieved using miniature positive-profile pins inserted into the vertebral body of L7 and the wings of S1 with the free ends of the pins being embedded in a bolus of gentamicin-impregnated polymethylmethacrylate. Reassessment two years postoperatively using a previously validated feline specific owner questionnaire indicated satisfactory outcome with complete return to normal activity and resolution of signs of pain in all cases. © Schattauer 2013.


To report surgical technique, morphometric effects and clinical outcomes for tibial tuberosity transposition-advancement (TTTA), sulcoplasty and para-patellar fascial imbrication for management of concomitant medial patellar luxation (MPL) and cranial cruciate ligament (CCL) disease in 32 dogs. Case series. A previous technique for tibial tuberosity advancement was modified to incorporate lateral and distal tibial tuberosity transposition. Preoperative, immediate, and six to eight week postoperative radiographs were reviewed with morphometry of a range of tibial and stifle anatomic parameters. Findings of sequential clinical examinations to six to 20 months postoperatively were recorded. Thirty-nine stifles were treated by surgery. Medial patellar luxation grade ranged from II to IV/IV. The CCL rupture was complete in 17/39 stifles, and incomplete in 22/39. Complications occurred in 11/39 stifles including MPL recurrence (n=4). Resolution of subjectively-assessed lameness occurred in 29/39 stifles at the six to eight week assessment. Resolution of lameness was eventually documented in 35/39 stifles (4/39 lost to follow-up), and was maintained at the six to 20 month reassessment where available. The TTTA induced relative patella baja in 31/39 stifles. Magnitude of actual tibial tuberosity advancement was lower than that predicted by cage size. Tibial tuberosity transposition-advancement is a potential treatment modality for concomitant CCL disease and MPL in the dog, but refinement of planning is required, while biomechanical and kinematic effects remain unknown.


Belch A.,Fitzpatrick Referrals | Fitzpatrick N.,Fitzpatrick Referrals | Farrell M.,Fitzpatrick Referrals
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2012

Two Domestic Shorthaired cats were admitted after sustaining multiligamentous injuries of the stifle joint. In one cat, prosthetic ligamentous reconstruction was unsuccessful at maintaining normal stifle stability. Both cats were treated with stifle arthrodesis using internal fixation with a plate and screws without external coaptation. In one case, arthrodesis was achieved using a 2.7 mm 16-hole dynamic compression plate placed medially. In the second case, a 2.7 mm 14-hole dynamic compression plate was placed cranially. No major complications were noted, and both cats were able to return to good levels of activity in the medium term. © Schattauer 2012.


Fitzpatrick N.,Fitzpatrick Referrals | Solano M.A.,Fitzpatrick Referrals
Veterinary Surgery | Year: 2010

Objective: To evaluate risk factors for complications, including meniscal injury and infection, after tibial plateau leveling osteotomy (TPLO) in dogs. Study Design: Retrospective case series. Sample Population: Dogs (n=1000; 1146 stifles) with cranial cruciate ligament (CCL) rupture that had TPLO. Methods: Medical records (January 2004-March 2009) were reviewed for dogs operated sequentially by medial arthrotomy with instrumented meniscal inspection (IMI) and TPLO by a single experienced surgeon. Multiple logistic regression models were used to evaluate independent contribution of risk factors to the recorded complications. Results: Overall complication rate was 14.8%, of which 6.6% were major complications. Incidence of primary meniscal injury (PMI) was 33.2%, and subsequent meniscal injury (SMI) 2.8%. Postoperative infection occurred in 6.6% dogs. Bilateral CCL rupture was diagnosed in 14.6% dogs and no statistically significant complication incidence difference was recorded for simultaneous or staged bilateral surgical procedures. Administration of postoperative antibacterial therapy and being a Labrador reduced infection incidence, whereas increased body-weight and being an intact male increased infection risk. Increased body-weight and complete (versus partial) CCL rupture were significant predictors of overall complications. Conclusions: Incidence of SMI recorded in this study is similar to that reported previously involving arthroscopic meniscal inspection at time of TPLO. Infection was the single most important complication and antibiotic therapy was protective. Complication rate did not differ between bilateral simultaneous or staged procedures. Clinical Relevance: Complication rate after TPLO with arthrotomy and IMI is lower than previously reported, bilateral simultaneous TPLO is reasonable, and incidence of major complications compares favorably with general orthopedic procedures. © Copyright 2010 by The American College of Veterinary Surgeons.


Fitzpatrick N.,Fitzpatrick Referrals | Law A.Y.,Fitzpatrick Referrals | Bielecki M.,Fitzpatrick Referrals | Girling S.,Fitzpatrick Referrals
Veterinary Surgery | Year: 2014

Objective: To describe outcome after a minimum of 1 year for total hip replacement (THR) using BioMedtrix BFX™ biologic fixation implants in skeletally immature dogs (6-10 months of age). Study Design: Case series. Animals: Dogs (n=20). Methods: Medical records (November 2007-June 2010) of 20 dogs, 6-10 months old that had cementless THR were reviewed. Preoperative, immediate, 6-week and >1-year postoperative radiographs were compared. Clinical examination was performed at 6 weeks and >1 year postoperatively. Owner questionnaire was obtained at final follow-up. Results: Cementless THR using BFX™ implants was performed because of debilitating coxofemoral pain, resulting from canine hip dysplasia, after unsatisfactory outcome with medical management. Radiographs taken immediately, 6 weeks and at a mean of 29.8 months (range, 12-48 months) postoperatively revealed satisfactory implant positioning and stability. Significant change in measured cranial-caudal femoral stem fill and level (P<.001 and P=.006, respectively) were recorded at 6 weeks postoperatively without clinical significance. No further change in stem positioning occurred. Acetabular cup orientation remained unchanged throughout follow-up. Complications requiring further surgical intervention were not encountered. One minor superficial infection was recorded and treated. Lameness and pain on manipulation of the affected hip had greatly improved in all dogs by 6 weeks postoperatively. Conclusion: Cementless THR can safely be performed in skeletally immature dogs, providing satisfactory return to normal joint function and implant survivability for at least a mean of 29.8 months. © 2014 by The American College of Veterinary Surgeons.


Perry K.,Fitzpatrick Referrals | Perry K.,University of Edinburgh | Fitzpatrick N.,Fitzpatrick Referrals
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2010

Two Domestic Shorthaired cats were diagnosed with longstanding lameness attributed to cranial cruciate ligament deficiency without any history of trauma. One cat had a previous operation in which the lateral nylon suture technique was used, and the other cat was affected by a partial tear of the cranial cruciate ligament. Tibial tuberosity advancement was carried out in both patients, which resulted in long-term resolution of lameness for both. The results of these cases concur with previous studies performed on canine patients in terms of viability of technical application and satisfactory return to weight bearing postoperatively. Further investigation of tibial tuberosity advancement in feline patients is justified. © Schattauer 2010.

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