title: Conservative versus arthroscopic management for medial coronoid process disease in dogs: a prospective gait evaluation.
abstract: OBJECTIVE
  To investigate, using objective gait analysis, the long-term outcome of dogs with medial coronoid process disease (MCPD) treated with conservative management (CM) versus arthroscopic treatment (AT).
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Dogs (n = 20) with unilaterally confirmed MCPD.
  
  
  METHODS
  Eleven dogs were treated arthroscopically with removal of coronoid fragments and burring of any associated chondromalacic cartridge and 9 dogs were managed conservatively. All dogs were administered a 6-week course of oral tepoxalin on enrollment. Inverse dynamics gait analysis was performed at initial presentation and at 4, 8, 26, and 52 weeks. The gait variables analyzed were elbow moment (EM), elbow power (EP), total support moment (TSM), and total support moment ratio (TSMR) as a measure of forelimb asymmetry.
  
  
  RESULTS
  Affected peak EM increased from 0.58 to 0.76 Nm/kg in the AT dogs, and from 0.66 to 0.81 Nm/kg in the CM dogs and there was no significant difference between groups. Affected peak EP increased marginally in the AT dogs, but was unchanged in the CM dogs and there was no significant difference between groups. TSM increased from 1.49 to 1.92 Nm/kg in the AT dogs and from 1.52 to 2.06 Nm/kg in the CM dogs and there was no significant difference between groups. TSMR was statistically different between treatment groups at 1 (P = .003) and 2 months (P = .048) with the AT group more asymmetric and hence more lame. TSMR at 12 months was 0.83 (AT) and 0.86 (CM) implying a failure of return to soundness by either group.
  
  
  CONCLUSIONS
  AT dogs had increased mechanical asymmetry at 4 and 8 weeks compared to the CM group revealing surgery worsened limb function. There was no significant difference in mechanical symmetry between groups at 26 and 52 weeks.
authors.affiliation: Langford Veterinary Services, University of Bristol, Langford, North Somerset, UK. neil.burton@bristol.ac.uk
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Burton
authors.forename: Martin R
authors.initials: MR
authors.lastname: Owen
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Kirk
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Toscano
authors.forename: G Robert
authors.initials: GR
authors.lastname: Colborne
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001182:Arthroscopy / Q000662:veterinary*; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D005081:Exercise Therapy / Q000662:veterinary*; D005260:Female; D005552:Forelimb / Q000601:surgery; D005684:Gait; D007592:Joint Diseases / Q000628:therapy / Q000662:veterinary*; D007794:Lameness, Animal / Q000628:therapy*; D008297:Male; D015233:Models, Statistical; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal