scholarly journals Does traditional tibial tuberosity advancement yield similar postoperative outcomes as tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease?

2020 ◽  
Vol 187 (2) ◽  
pp. 69-71
Author(s):  
Constance White ◽  
Lisa Morrow
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Postoperative Outcomes ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

Conformation of the proximal tibia and cranial cruciate ligament disease in small breed dogs

2017 ◽  
Vol 30 (03) ◽  
pp. 178-183 ◽  
Author(s):  
Michal Kyllar ◽  
Duncan Midgley ◽  
Martin Owen ◽  
Jan Janovec
Keyword(s):  
Body Weight ◽  
Clinical Significance ◽  
Tibial Plateau ◽  
Proximal Tibia ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Relative Body Weight ◽  
Cranial Cruciate Ligament Disease ◽  
Small Breed

SummaryObjectives: To investigate the conformation of the proximal tibia in small breed dogs with and without cranial cruciate ligament disease (CCLD) and to identify morphologic abnormalities that may predispose to development of CCLD.Methods: Mediolateral radiographs of the entire tibia of dogs <15 kg with surgically confirmed CCLD were retrospectively evaluated. Proximal tibial width (PTW), tibial plateau length (TPL), tibial plateau angle as described by Slocum and Slocum (sTPA), proximal tibial tuberosity angle (PTTA), tibial plateau angle as described by Inauen and colleagues (nTPA), and diaphyseal tibial width (DTW) were measured. The same variables were obtained from mediolateral radiographs of the entire tibia of dogs <15 kg without CCLD. In addition, a quotient nTPA/ PTW, relative tibial tuberosity width (rTTW), and relative body weight (rBW) were calculated for each dog. Independent two-sample t-test (p = 0.05) was used to compare mean ± SD of all measured variables between the two groups.Results: Gender, age, and weight mean ± SD were not significantly different between the two groups of dogs (p <0.05). Dogs with CCLD had significantly greater sTPA (p = 0.015) and rBW (p = 0.016).Clinical significance: In dogs of small breeds, a combination of an excessively steep tibial plateau and an increased relative body weight may predispose to early CCLD development. The slope of the tibial plateau was found to be caused by an abnormal caudal angulation of the proximal tibia, a phenomenon previously associated with CCLD development in small breed dogs in individual cases.

Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight

2017 ◽  
Vol 30 (04) ◽  
pp. 299-305 ◽  
Author(s):  
Matthew Barnhart ◽  
Shawn Kennedy ◽  
Steven Naber ◽  
Eric Hans
Keyword(s):  
Antibiotic Therapy ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Major Complication ◽  
Surgical Revision ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Major Complications ◽  
One Year ◽  
Cranial Cruciate Ligament Disease

SummaryObjectives: To analyse and compare major complications in dogs ≥50 kg undergoing tibial tuberosity advancement (TTA) or tibial plateau levelling osteotomy (TPLO) for treatment of cranial cruciate ligament disease.Methods: Medical records and radiographs of client-owned dogs (≥50 kg) treated for cranial cruciate ligament disease with either TTA or TPLO between January 2011 and November 2015 were reviewed. Ninety-one TTA cases and 54 TPLO cases met the study inclusion criteria. All complications within one year of surgery were recorded. Major complications were those requiring surgical revision or intervening medical therapy to resolve. Logistic regression analysis evaluated for associations with major complication occurrence. Major complications were statistically compared between TTA and TPLO treatment groups.Results: Incidence of major complications following TTA and TPLO surgery were 19.8% and 27.8%, respectively. Surgical site infection (SSI) was the single most common major complication following both TTA (15.4%) and TPLO (25.9%) surgery. There were no significant differences between TTA and TPLO treatment regarding the rate of SSI, surgical revision, or overall occurrence of major complications. Postoperative antibiotic therapy significantly reduced the risk of a major complication in all dogs ≥50 kg (p = 0.015; OR: 0.201: 95%CI: 0.055–0.737).Clinical significance: Major complications occurred frequently following TTA and TPLO treatment of cranial cruciate ligament disease in dogs ≥50 kg. The increased chance for SSI should be considered and postoperative antibiotic therapy is recommended.

Short-term comparison of tibial tuberosity advancement and tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease using kinetic analysis

2016 ◽  
Vol 29 (03) ◽  
pp. 209-213 ◽  
Author(s):  
Cássio Ferrigno ◽  
Alexandre de Souza ◽  
Daniela Caquias ◽  
Adriana de Figueiredo ◽  
Márcio Ferreira
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Tibial Tuberosity ◽  
Short Term ◽  
Cranial Cruciate Ligament ◽  
Time Points ◽  
Patient Allocation ◽  
Postoperative Time ◽  
Cranial Cruciate Ligament Disease

SummaryObjectives: This study set out to compare the outcomes of tibial tuberosity advancement (TTA) and tibial plateau levelling osteotomy (TPLO) procedures in the treatment of dogs affected with unilateral cranial cruciate ligament disease (CCLD) based on subjective parameters and objective pressure platform analysis (baropodometry).Methods: Twenty-seven adult dogs weighing over 20 kg that were presented with unilateral CCLD and were treated by the TTA (12 dogs) or TPLO (15 dogs) surgical procedure. Patient allocation to either group was based on tibial plateau angle (TPA), according to clinical guidelines (indication for TTA for dogs was a TPA up to 25°, and indication for TPLO was any TPA). Pressure platform analysis was performed prior to surgery and at four different postoperative time points (14, 30, 60 and 90 days).Results: Limb function significantly improved following TTA and TPLO, with no significant differences between groups.Conclusion: The TTA and TPLO surgical procedures were considered to be equally effective in promoting weight bearing capacity recovery in dogs affected with unilateral CCLD under the conditions of this trial.

scholarly journals In dogs weighing under 15 Kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tafara Mapuvire
Keyword(s):  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Research Question ◽  
Tibial Tuberosity ◽  
Clinical Expertise ◽  
Best Interest ◽  
Bottom Line ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

PICO question In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed There were no papers that answered the PICO question Strength of evidence Zero Outcomes reported Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg Conclusion Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

Extracapsular articulating implant to treat cranial cruciate ligament disease in a dog with multiple myeloma

2019 ◽  
Vol 7 (2) ◽  
pp. e000767
Author(s):  
Eloise Elisabeth Lhuillery ◽  
Philip Georg Witte
Keyword(s):  
Multiple Myeloma ◽  
Medical Treatment ◽  
Range Of Motion ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Mild Reduction ◽  
Cranial Cruciate Ligament Disease ◽  
Hindlimb Lameness ◽  
Malignant Neoplasia

An 11-year-old Border collie was presented for left hindlimb lameness associated with cranial cruciate ligament disease. The history included right tibial plateau levelling osteotomy performed approximately two years previously, with a subjectively good outcome. Multiple myeloma had been diagnosed approximately two months before presentation of the left hindlimb lameness. Medical treatment of multiple myeloma included glucocorticoids (prednisolone) and melphalan. Stabilisation of the left stifle was performed with the Simitri Stable in Stride extracapsular articulating implant. The dog demonstrated weightbearing on the operated limb within 24 hours following surgery. Re-examination six weeks following surgery revealed mild left hindlimb lameness, no resentment to manipulation of the left stifle, no cranial tibial thrust and a mild reduction in the range of motion. Hindlimb function was affected by various neurological events considered secondary to the malignant neoplasia; however, left stifle function was good until euthanasia 11 months following surgery.

Short-Term Complications following Single-Session versus Staged Bilateral Tibial Plateau Levelling Osteotomies Stabilized with Locking Plates for Treatment of Bilateral Cranial Cruciate Ligament Disease: A Retrospective Study

2019 ◽  
Vol 32 (06) ◽  
pp. 460-466 ◽  
Author(s):  
Kelsey K. Cappelle ◽  
Matthew D. Barnhart
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Significant Risk ◽  
Study Groups ◽  
Complication Rates ◽  
Locking Plates ◽  
Single Session ◽  
Cranial Cruciate Ligament ◽  
Major Complications ◽  
Cranial Cruciate Ligament Disease

Objective The aim of this study was to compare complications between dogs with bilateral cranial cruciate ligament disease treated with single-session bilateral tibial plateau levelling osteotomies (BSSTPLO) versus staged bilateral TPLO (STPLO) procedures stabilized with locking plates. Study Design Medical records of client-owned dogs treated with BSSTPLO or STPLO stabilized with locking plates between March 2017 and July 2018 at two associated institutions were reviewed. Patient data and complications from 37 dogs with BSSTPLO and 18 with STPLO were compared between groups. Major complications were defined as any complication that required further surgical or medical treatment whereas minor complications did not. Results Incidence for major complications for BSSTPLO and STPLO was 7/37 and 6/18 respectively. Incidence for minor complications for BSSTPLO and STPLO was 3/37 and 2/18 respectively. No significant differences in minor or major complication rates existed between study groups (p = 0.2). Mean body weight was significantly higher in the STPLO group (p = 0.001); however, no correlation between weight or BCS and complication rate existed within either group. Increasing age was the only significant risk factor for major complications (p = 0.01) in either group. Conclusion Our findings support the claim that BSSTPLO and STPLO performed with locking implants have similar complication rates. The decision to perform BSSTPLO or STPLO in dogs with bilateral cranial cruciate ligament disease should be based on other considerations rather than just complication rates.

Complications of tibial plateau levelling osteotomy in dogs

2012 ◽  
Vol 25 (05) ◽  
pp. 349-358 ◽  
Author(s):  
B. Peirone ◽  
M. S. Bergh
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Tibial Plateau ◽  
Postoperative Morbidity ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Technical Errors ◽  
Surgeon Experience ◽  
Incidence Risk ◽  
Cranial Cruciate Ligament Disease

SummaryThe tibial plateau levelling osteotomy (TPLO) is one of the most common surgical procedures used to treat cranial cruciate ligament disease in dogs. Complications occurring during or after TPLO can range in severity from swelling and bruising to fracture and osteomyelitis. Ten to 34% of TPLO surgical procedures are reported to experience a complication and approximately two to four percent require revision surgery to address a complication. Although the risk factors for many complications have not been fully assessed, the best available evidence suggests that complications of TPLO can be reduced with increased surgeon experience, careful surgical planning, and accurate execution of the surgical procedure. Identification of known or suspected risk factors and intraoperative technical errors allow subsequent action to be taken that is aimed at decreasing postoperative morbidity. There is a need for prospective studies with consistent data reporting in order to fully reveal the incidence risk factors for complications associated with TPLO.

Incidence of complications associated with tibial tuberosity advancement in Boxer dogs

2016 ◽  
Vol 29 (01) ◽  
pp. 39-45 ◽  
Author(s):  
Rui Sul ◽  
Tim Parkin ◽  
Ignacio Calvo ◽  
Brigite de Lima Dantas
Keyword(s):  
Revision Surgery ◽  
Medical Records ◽  
Odds Ratio ◽  
Surgical Repair ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
P Value ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease ◽  
Boxer Dogs

SummaryObjective: To retrospectively review and describe the incidence of complications associated with tibial tuberosity advancement (TTA) surgical procedures in a group of Boxer dogs (n = 36 stifles) and compare the data with a non-Boxer control population (n = 271 stifles).Methods: Retrospective analysis of medical records to identify all dogs that underwent TTA surgery due to cranial cruciate ligament disease. These records were categorized into two groups: Boxer dogs and non-Boxer dogs (controls – all other breeds).Results: Of the 307 stifles included, 69 complications were reported in 58 joints. The complication rate differed significantly for Boxer dogs (16/36 stifles) and non-Boxer dogs (42/271 stifles), corresponding to an odds ratio of 5.8 (confidence interval: 1.96–17.02; p-value <0.001). Boxer dogs were more likely to undergo revision surgery and to develop multiple complications. The incidence of tibial tuberosity fractures requiring surgical repair (2/36 versus 1/271) and incisional infections requiring antibiotic treatment (three in each group) was significantly higher in the Boxer group.Clinical significance: Boxer dogs had more major and multiple complications after TTA surgery than the control non-Boxer group; these complications included higher rates of revision surgery, tibial tuberosity fractures requiring stabilization, and infection related complications. The pertinence and value of breed-specific recommendations for cranial cruciate ligament disease appears to be a subject worthy of further investigation.

Theoretical discrepancy between cage size and efficient tibial tuberosity advancement in dogs treated for cranial cruciate ligament rupture

2011 ◽  
Vol 24 (01) ◽  
pp. 27-31 ◽  
Author(s):  
J. Mills ◽  
V. Busoni ◽  
L. Brunel ◽  
M. Balligand ◽  
S. Etchepareborde
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Direction Parallel ◽  
Cage Size ◽  
Osteotomy Plane ◽  
The Difference ◽  
Clinically Significant ◽  
Cranial Cruciate Ligament Rupture

Summary Objectives: To calculate the difference between the desired tibial tuberosity advancement (TTA) along the tibial plateau axis and the advancement truly achieved in that direction when cage size has been determined using the method of Montavon and colleagues. To measure the effect of this difference on the final patellar tendon-tibial plateau angle (PTA) in relation to the ideal 90°. Methods: Trigonometry was used to calculate the theoretical actual advancement of the tibial tuberosity in a direction parallel to the tibial plateau that would be achieved by the placement of a cage at the level of the tibial tuberosity in the osteotomy plane of the tibial crest. The same principle was used to calculate the size of the cage that would have been required to achieve the desired advancement. The effect of the difference between the desired advancement and the actual advancement achieved on the final PTA was calculated. Results: For a given desired advancement, the greater the tibial plateau angle (TPA), the greater the difference between the desired advancement and the actual advancement achieved. The maximum discrepancy calculated was 5.8 mm for a 12 mm advancement in a case of extreme TPA (59°). When the TPA was less than 31°, the PTA was in the range of 90° to 95°. Clinical significance: A discrepancy does exist between the desired tibial tuberosity advancement and the actual advancement in a direction parallel to the TPA, when the tibial tuberosity is not translated proximally. Although this has an influence on the final PTA, further studies are warranted to evaluate whether this is clinically significant.

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