Surgery and Conservative Managment, how does bracing fit in between?
Optimist:
Surgery is 92.6% effective at 24 weeks, case closed
Pessimist:
Conservative Management is only 33.3% at 24 weeks
Realist:
ALL cruciate treatment protocols have room for improvement. Conservative management early on and surgery at a year and beyond. Would you be happy with a 75% on your final exam? That was the best outcome at 1 year
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The first In Vivo kinematic study of cruciate braces, what do we know?
Optimist:
There is a phase shift at midstance when the brace would need to support the cruciate.
Pessimist:
The waves do not follow "Normal" gait pattern. Plus this study was done on healthy dogs.
Realist:
An effective brace that would limit cranial drawer would need a wave form differing from "Normal" to prevent that cranial drawer. This study was the first step and intended to ensure we could actually measure brace kinematics. Turns out we can. Next step, cruciate deficient dogs.
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How does bracing compare to a TPLO?
Optimist:
Pretty good, 88%
Pessimist:
They did not use force plates to measure. This was a subjective study where they asked the owners
Realist:
Though not conclusive, this is a high enough number to merit looking closer at bracing. As we've seen before, conservative management has a much lower outcome. In reality, not all dogs can have surgery. Is 88% acceptable for those dogs?
Read The Study
Can computer aided models help us?
Optimist:
Of course they can, this study used a CT scan of a healthy dog to make a great computer model
Pessimist:
It is really tough to emulate soft tissue movement in a computer model.
Realist:
The body is tough to model. The nice thing about modeling is it helps understand nuances of brace design. It was thought that flexible joints emulated the body motion best but this model showed us that using a bit stiffer joint actually helps limit the cranial drawer better.
Read The Study
Add bracing to your clinic's toolbox!
"Bracing has dramatically made a difference in a pet's life"-Dr. Michelle Beck, Backlund Animal Clinic, Omaha, Nebraska
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