@article{wallace_grimes_edwards_lux_tam_dickerson_carroll_scharf_colberg_kudej_et al._2022, title={Dogs >= five years of age at the time of congenital extrahepatic portosystemic shunt diagnosis have better long-term outcomes with surgical attenuation than with medical management alone}, volume={260}, ISSN={["1943-569X"]}, DOI={10.2460/javma.21.09.0417}, abstractNote={Abstract

OBJECTIVE
To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only.


ANIMALS
351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age.


PROCEDURES
Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time.


RESULTS
351 dogs (M, 119 [33.9%]; S, 232 [66.1%]) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155]). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155]). Perioperative mortality rate was 7.3%.


CLINICAL RELEVANCE
Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.
}, number={7}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Wallace, Mandy L. and Grimes, Janet A. and Edwards, Lauren and Lux, Cassie N. and Tam, Candace and Dickerson, Vanna M. and Carroll, Kenneth A. and Scharf, Valery F. and Colberg, Valerie and Kudej, Raymond K. and et al.}, year={2022}, month={Apr}, pages={758–764} }
 @article{curcillo_duffy_chang_moore_2021, title={Ex Vivo Biomechanical Assessment of a Novel Multi-Strand Repair of Canine Tendon Lacerations}, ISSN={["2567-6911"]}, DOI={10.1055/s-0041-1725014}, abstractNote={Abstract
          Objective This study aimed to evaluate the effect of increasing the number of suture strands traversing the transection site, level of suture purchase and depth of suture penetrance on the biomechanical properties of repaired gastrocnemius tendons.
          Study Design Thirty-eight adult cadaveric gastrocnemius tendons were randomized, transected and repaired with either two-, four- or six-strand locking multi-level repair. Tensile loads required to create a 1 and 3 mm gap, yield, peak and failure loads and failure mode were analysed. Significance was set at p < 0.05.
          Results Mean ± standard deviation yield, peak and failure force for six-strand repairs was 90.6 ± 22.1 N, 111.4 ± 15.2 N and 110.3 ± 15.1 N respectively. This was significantly greater compared with both four-strand (55.0 ± 8.9 N, 72.9 ± 7.8 N and 72.1 ± 8.2 N) and two-strand repairs (24.7 ± 8.3 N, 36.5 ± 6.0 N and 36.1 ± 6.3 N) respectively (p < 0.001). Occurrence of 3 mm gap formation was significantly less using six-strand repairs (p < 0.001). Mode of failure did not differ between groups with all repairs (36/36; 100%) failing by suture pull-through.
          Conclusion Pattern modification by increasing the number of suture strands crossing the repair site, increasing points of suture purchase from the transection site and depth of suture penetrance is positively correlated with repair site strength while significantly reducing the occurrence of gap formation in a canine cadaveric model. Additional studies in vivo are recommended to evaluate their effect on tendinous healing, blood supply and glide resistance prior to clinical implementation.}, journal={VETERINARY AND COMPARATIVE ORTHOPAEDICS AND TRAUMATOLOGY}, author={Curcillo, Chiara P. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2021}, month={Mar} }
 @article{duffy_curcillo_chang_gaffney_fisher_moore_2020, title={Biomechanical evaluation of an autologous flexor digitorum lateralis graft to augment the surgical repair of gastrocnemius tendon laceration in a canine ex vivo model}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13453}, abstractNote={AbstractObjectiveTo evaluate the effect of an autologous flexor digitorum lateralis (FDL) graft to augment a three‐loop pulley (3LP) core repair in a canine cadaveric gastrocnemius tendon (GT) laceration model.Study designEx vivo, biomechanical study.Sample populationTwenty‐six canine cadaveric hind limbs.MethodsTendons were divided into two groups (n = 13). After sharp transection, paired GT were repaired with 3LP or 3LP + FDL tendon augmentation. Yield, peak and failure loads, tensile loads required to create 1 and 3‐mm gapping, and failure modes were analyzed. Significance was set at P < .05.ResultsYield and failure force (mean ± SD) for 3LP + FDL were 134.9 ± 44.1 N and 205.4 ± 46.4 N, respectively, which were greater than for 3LP alone (67.9 ± 12.2 N and 91.8 ± 9.9 N, respectively, P < .0001). No constructs (0%) formed 1 or 3‐mm gaps in the 3LP + FDL graft group compared with 84% and 39% for 3LP, respectively (P < .0001). Failure modes were different between groups (P < .001), with 85% of 3LP + FDL constructs failing by tissue rupture at the myotendinous junction, distant to the repair site.ConclusionAddition of an autologous FDL graft to a core 3LP tendon repair increased yield, peak, and failure forces by twofold, 2.3‐fold, and 2.2‐fold, respectively, compared with core 3LP alone while preventing the occurrence of gap formation.Clinical significanceUse of FDL tendon augmentation for GT laceration may increase repair site strength and resist gap formation better than 3LP core suture use alone. Additional studies are required in vivo to determine the effect of FDL graft augmentation on clinical function.}, number={8}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Curcillo, Chiara P. and Chang, Yi-Jen and Gaffney, Lewis and Fisher, Matthew B. and Moore, George E.}, year={2020}, month={Dec}, pages={1545–1554} }