Extracorporeal shock wave therapy improves short-term limb use after canine TPLO

Authors: 
Barnes K, Faludi A, Takawira C, Aulakh K, Rademacher N, Liu CC1, Lopez MJ.
Vet Surg. 2019 Aug 30. doi: 10.1111/vsu.13320.

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 years old weighing 18 to 75 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 mJ/mm2 immediately and 2 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 weeks after surgery. Measures were compared between treatments at each time point and among time points for each treatment (P < .05).

RESULTS: The PVF (5.5 ± 1.0 N/kg, mean ± SD) and VI (0.67 ± 0.14 N-s/kg) of surgically treated limbs in the ESWT cohort were higher 8 weeks after surgery compared with preoperative (3.8 ± 1.1 N/kg, P < .0001 and 0.47 ± 0.21 N-s/kg, P = .0012, respectively) values. In the control cohort, PVF (2.9 ± 1.3 N/kg, P = .0001) and VI (0.33 ± 0.20 N-s/kg, P = .0003) 2 weeks after surgery and VI (0.42 ± 0.2 N-s/kg, P = .0012) 8 weeks after surgery were lower (4.59 ± 2.33 N/kg and 0.592 ± 0.35 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.