Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017–2019)

Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy.Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by phone or email for a follow-up questionnaire.Results: Twenty-four horses underwent unilateral EVC, performed transendoscopically under sedated restraint, using monopolar electrosurgical instrumentation successfully. One horse experienced excessive intraoperative hemorrhage. No horses demonstrated postoperative complications. Twenty cases had a history of increased airway noise prior to surgery. In 15 of these cases (15/20, 75%), the airway noise was reported as fully improved post-surgery. Eighteen cases had a history of exercise intolerance prior to surgery. In 15 of these cases (15/18; 83%), the exercise intolerance was reported as resolved.Conclusion: EVC, in conjunction with prosthetic laryngoplasty, can contribute to improvement of RLN symptoms and aid in the effective return to athletic work. Performing transendoscopic ventriculocordectomy with monopolar electrosurgical instrumentation provides comparable clinical outcomes to traditional techniques using a diode laser or direct excision via laryngotomy.

An Analysis of Contractor Satisfaction on Owner Team Performance in Construction Projects (Case Study: Construction Projects in ITS)

Subjective performance measurements have been developed on construction projects of various key stakeholders such as contractors, designers and consultants. These approaches are usually related to owner satisfaction, customer satisfaction, occupant satisfaction but very rarely consider contractor satisfaction. The performance of the contractor and owner are interdependent, and their interactions fundamentally determine the overall project performance. This research aims to analyze the level of contractor satisfaction with the team owner’s performance which in the end to improve the improvement (Continuous Improvement) where there are indicators of team’ owner performance that needs attention to be improved and improved and those that need to be maintained. Owner performance indicators include the owner’s understanding of project needs, finances, decision-making, management, adequate support for contractors, client attitudes, clarity of client/owner commitment goals, and the working relationship of the owner and contractor. These indicators were obtained from literature and interviews with practitioners. These indicators are then developed to improve the existing conceptual framework. The satisfaction is measured using the Customer Satisfaction Index (CSI) and priority variables that need to be improved are analyzed by the Importance Performance Analysis (IPA) method. The results of this study indicate the level of contractor satisfaction with the performance of the team owner from CSI calculations at the level of satisfaction. Meanwhile the results of the IPA show that financial indicators, one sub-indicator of support for contractors and one sub-indicator of the attitude of the owner must be improved. Keywords: Contractor satisfaction, Owner performance, Customer Satisfaction Index (CSI), Importance Performance Analysis (IPA).

Prospective Evaluation of a Citrate-Based Biomaterial Wedge for a Modified Maquet Procedure in the Treatment of Cranial Cruciate Ligament Rupture in Dogs

Objective The aim of this study was to describe short- and mid-term outcomes, complications, implant bioabsorption and owner satisfaction for a modified Maquet procedure (MMP) in which a novel bioabsorbable citrate-based implant is used as the wedge component to treat cranial cruciate ligament rupture in client-owned dogs. Study Design Prospective clinical study of dogs (n = 13) undergoing MMP (n = 15). Intraoperative complications, postoperative complications, clinical follow-up using a 5-point lameness score and radiographs at 8 weeks and 6 months postoperatively were obtained. Mid-term outcome was assessed via physical examination, radiographs, canine orthopaedic index and owner satisfaction questionnaires. Results No catastrophic complications occurred. Major complications occurred in 3/15 stifles. All were surgical site infections and one case required implant removal. Minor complications occurred in 9/15 stifles. Non-displaced cortical hinge fractures were the most common minor complication, and these occurred intraoperatively (4/15) or postoperatively (2/15). Three dogs achieved full function, eight dogs acceptable function and the outcome was unacceptable in two dogs. Most owners were satisfied with the procedure (11/13). Complete implant bioabsorption was not confirmed on mid-term radiographs. Conclusion The described MMP with a citrate-based implant can produce satisfactory mid-term results. However, the long-term outcome of this procedure must be evaluated and technical modifications need to be implemented prior to larger-scale use of this implant.

Revision of a canine Zürich cementless total hip replacement using a ‘Cupless’ system

A 6-year-old spayed female pit bull mix developed lameness secondary to aseptic loosening of the acetabular component from a total hip replacement (THR) performed at 1 year of age with the standard Zürich cementless THR (Z-THR) system. It was treated by removing the acetabular component and replacing the standard femoral head prosthesis with the larger ‘Cupless’ femoral head. The acetabulum was reamed to accommodate it. The new prosthesis articulated directly with the reamed bone. One year later, the patient had no perceptible lameness and stable implants. Subsequent follow-up found appropriate ambulation and a high degree of owner satisfaction. The Zürich ‘Cupless’ hip replacement system aims to reduce some of the challenges associated with traditional THR. Though functional outcomes have not been scientifically compared with traditional THR, this case suggests it could be considered as an alternative to traditional THR procedures or for revision in cases with aseptic cup loosening.

The correlation between score-based protocol for equine joint assessment and subsequent arthroscopic intervention outcomes

This study aimed to grade joint abnormalities in horses submitted to therapeutic arthroscopy using score-based protocols for equine joint assessment, correlated with arthroscopic treatment outcomes and owner satisfaction. In this prospective study, we evaluated 126 joints of athletic horses referred for arthroscopy. The joints were scored according to findings of medical history and physical, radiographic, ultrasonographic and arthroscopic examination. Lameness, positive response to flexion test and decreased maximum joint flexion angle were detected in more than 50% of joints. Soft tissue swelling, sclerosis, subchondral bone osteolysis and single osteochondral fragments were the most common radiographic findings. Ultrasonographic examination revealed changes in synovial fluid volume and appearance, and subchondral bone irregularities. Increased vascularity of the synovial villi, chondral fibrillation, chondral fissures and superficial cartilage erosions were the most significant arthroscopic findings. The approaches that demonstrated greater sensitivity and correlation with treatment outcome and owner satisfaction were medical history, ultrasonographic and arthroscopic examination. The scoring protocol employed to grade joint abnormalities enabled the creation of a joint score system for the objective assessment, thus determining the most frequent findings and establishing an injury severity score for each joint.

Clinical outcomes of 28 cats 12–24 months after urethrostomy

Objectives The aim of this study was to evaluate and compare the long-term clinical outcomes and quality of life of cats having undergone perineal urethrostomy (PU) or prepubic urethrostomy (PPU). Methods This clinical study followed 28 cats (PU, n = 22; PPU, n = 6) that underwent a urethrostomy, with a minimum of 1 year postoperative follow-up. Medical records, pet owner surveys and urologic laboratory tests were used for assessment. Urologic laboratory tests included serum symmetric dimethylarginine (SDMA), serum creatinine, urinalysis, urine specific gravity (USG), urine protein:creatinine (UPC) ratio and urine culture. Results The main indications for urethrostomy were multiple catheterizations and PU stricture. The overall complication rates of PU and PPU were 31.8% and 83.3%, respectively. Recurrent urinary tract infection (UTI) and urine scald dermatitis were less frequent in PU than in PPU cats (UTI 22.7% vs 66.6%; dermatitis 4.5% vs 83.3%). Bacteriuria was present in 77.2% and 100% of PU and PPU cats, respectively. Owner satisfaction rates were excellent in 81.8% of PU and 33.3% of PPU cases. Conclusions and relevance A proportion of cats that underwent urethrostomy showed bacteriuria, recurrent UTIs and increased levels of SDMA. PPU is important as a salvage procedure; however, it should be limited to cases in which standard techniques for PU cannot be performed, owing to the potential for recurrent complications and lower owner satisfaction.