Extracorporeal shock wave therapy improves short-term limb use after canine tibial plateau leveling osteotomy.

Abstract

OBJECTIVE: To determine the influence of postoperative extracorporeal shock wave therapy (ESWT) on hind limb use after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Randomized, prospective clinical trial. ANIMALS: Sixteen client-owned dogs, 2 to 10&#x2009;years old weighing 18 to 75&#x2009;kg. METHODS: Dogs were randomly assigned to treatment cohorts, TPLO with ESWT (ESWT, n = 9) or TPLO without ESWT (control, n = 7). Treatment consisted of 1000 pulses at 0.15&#x2009;mJ/mmimmediately and 2&#x2009;weeks after surgery. Subjective pain, stifle goniometry, stifle circumference, peak vertical force (PVF) and vertical impulse (VI) were measured before surgery, prior to ESWT, and 2 and 8&#x2009;weeks after surgery. Measures were compared between treatments at each time point and among time points for each treatment (P&#x2009;<&#x2009;.05). RESULTS: The PVF (5.5&#x2009;&#xb1;&#x2009;1.0&#x2009;N/kg, mean&#x2009;&#xb1;&#x2009;SD) and VI (0.67&#x2009;&#xb1;&#x2009;0.14&#x2009;N-s/kg) of surgically treated limbs in the ESWT cohort were higher 8&#x2009;weeks after surgery compared with preoperative (3.8&#x2009;&#xb1;&#x2009;1.1&#x2009;N/kg, P&#x2009;<&#x2009;.0001 and 0.47&#x2009;&#xb1;&#x2009;0.21&#x2009;N-s/kg, P = .0012, respectively) values. In the control cohort, PVF (2.9&#x2009;&#xb1;&#x2009;1.3&#x2009;N/kg, P = .0001) and VI (0.33&#x2009;&#xb1;&#x2009;0.20&#x2009;N-s/kg, P = .0003) 2&#x2009;weeks after surgery and VI (0.42&#x2009;&#xb1;&#x2009;0.2&#x2009;N-s/kg, P = .0012) 8&#x2009;weeks after surgery were lower (4.59 &#xb1;&#x2009;2.33&#x2009;N/kg and 0.592&#x2009;&#xb1;&#x2009;0.35&#x2009;N-s/kg, respectively) than before surgery. Other parameters did not differ between groups. CONCLUSION: Weight bearing increased faster after TPLO in dogs treated with postoperative ESWT. CLINICAL SIGNIFICANCE: This study provides evidence to consider adjunct ESWT after TPLO.