Comparison of three methods for the management of fragmented medial coronoid process in the dog

 

 Buy Article Permissions and Reprints

Summary

The objective of this review and analysis was to compare arthroscopy, medial arthrotomy and medical management for treating fragmented coronoid process in the dog. The data come from manuscripts published in peer-reviewed veterinary journals, and the study design is a systematic review followed by meta-analysis. The meta-analysis combines data from a set of studies so that surgical techniques and medial management can be compared in a single analysis. Several literature databases and veterinary texts were thoroughly searched to provide a list of over 400 candidate manuscripts. Inclusion criteria were used to filter the candidate manuscripts to a final set of fourmanuscripts that directly pertained to the clinical question. They were scored for their evidentiary value using a semi-objective measure. The results were that arthroscopy was superior to medial arthrotomy and medical management, but medial arthrotomy was not superior to medical management. Only one manuscript was a randomized controlled trial, hence the results must be tempered by the evidentiary value of the data.

• References

• 1 Bouck GR, Miller CW, Taves CL. A Comparison of Surgical and Medical Treatment of Fragmented medial coronoid process and Osteochondritis Dissecans of the canine elbow. Vet Comp Orthop Traumatol 1995; 8: 177-183.
  Article in Thieme ConnectPubMedGoogle Scholar
• 2 Trostel CT, McLaughlin RM, Pool RR. Canine elbow dysplasia: Incidence, diagnosis, treatment, and prognosis. Compendium 2003; 25: 763-772
  PubMedGoogle Scholar
• 3 Grondalen J. Arthrosis in the elbow joint of young rapidly growing dogs. III. Nord Vet Med 1979; 31: 520-527.
  PubMedGoogle Scholar
• 4 Ness MG. Treatment of fragmented coronoid process in young dogs by proximal ulnar osteotomy. J Small Anim Pract 1998; 39: 15-18.
  CrossrefPubMedGoogle Scholar
• 5 Cockcroft Cockcroft, Holmes M. Handbook of evidence-based veterinary medicine. Oxford: Blackwell Publishing; 2003
  Google Scholar
• 6 Aragon Aragon, Budsberg SC. Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog. Vet Surg 2005; 3: 93-98.
  PubMedGoogle Scholar
• 7 Slatter D. Textbook of small animal surgery. Philadelphia: WB. Saunders; 2003
  Google Scholar
• 8 American Dietetic Association. ADA Evidence Analysis Manual. American Dietetic Association; Chicago: 2003
  Google Scholar
• 9 Schultz KF, Chalmers I, Hayes RJ. et al. Empirical evidence of bias: Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273: 408-412.
  CrossrefPubMedGoogle Scholar
• 10 Eddy DM, Hasselblad V, Shachter R. Meta-analysis by the confidence profile method: the statistical synthesis of evidence. Boston Academic Press; 1992
  PubMedGoogle Scholar
• 11 Lunn DJ, Thomas A, Best N. et al. (2000) Win- BUGS -- a Bayesian modelling framework: concepts, structure, and extensibility. Statistics and Computing 10: 325-337
  PubMedGoogle Scholar
• 12 Meyer-Lindenberg A, Longhann A, Fehr M. et al. Arthrotomy Versus Arthroscopy in the Treatment of the Fragmented Medial Coronoid Process of the Ulna (FMCP) in 421 Dogs. Vet Comp Orthop Traumatol 2003; 16: 204-210.
  Article in Thieme ConnectPubMedGoogle Scholar
• 13 Brown DC. Control of selection bias in parallel-group controlled clinical trials in dogs and cats: 97 trials (2000-2005). J Am Vet Med Assoc 2006; 229: 990-993.
  CrossrefPubMedGoogle Scholar
• 14 Huibregtse BA, Johnson AL, Muhlbauer MC. et al. The effect of treatment of fragmented coronoid process of the development of osteoarthritis of the elbow. J Am Anim Hosp 1994; 30: 177-195.
  PubMedGoogle Scholar
• 15 Read RA, Armstrong SJ, O'Keefe JD. et al. Fragmentation of the medial coronoid process of the ulna in dogs: A study of 109 cases. J Small Anim Pract 1990; 31: 330-334.
  CrossrefPubMedGoogle Scholar