Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy

2005 ◽  
Vol 18 (04) ◽  
pp. 235-242 ◽  
Author(s):  
S. W. Aiken ◽  
G. R. DiResta ◽  
L. G. Herr ◽  
S. Monette ◽  
K. Carey
Keyword(s):  
Risk Factors ◽  
Patellar Tendon ◽  
Medical Records ◽  
Tibial Plateau ◽  
Conservative Therapy ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Cranial Cruciate Ligament ◽  
Tibial Tuberosity Fracture ◽  
Clinical Changes

SummaryPatellar tendon thickening (PTT) and patellar tendinosis (PTS) have been discussed in the veterinary literature as a post-operative complication of tibial plateau leveling osteotomy (TPLO). The purpose of this study was to define radiographic PTT, determine the frequency of and risk factors for PTT and PTS, and describe the clinical and histopathological findings of PTS after TPLO. We hypothesized that the location of the osteotomy alters forces placed on the patellar tendon resulting in PTT or PTS. Radiographs and medical records from 83 dogs undergoing 94 TPLO procedures were retrospectively evaluated. Two months post-operatively, 19 dogs (20.2%) had a normal patellar tendon or mild PTT, 51 (54.3%) had moderate PTT, and 24 (25.5%) had severe PTT. Seven of the 24 dogs (7.4%) with severe PTT had clinical signs consistent with PTS. Only dogs with severe PTT developed PTS (p < 0.0001). The risk factors for the development of PTT include: a cranial osteotomy, a partially intact cranial cruciate ligament (CCL) in conjunction with a cranial osteotomy, and post-operative tibial tuberosity fracture. The only risk factor identified for the development of PTS was a partially intact CCL. Four dogs with PTS improved with conservative therapy and one improved with surgical treatment. Two dogs had tendon biopsies with histopathological review that showed tendon degeneration with lack of inflammation. As only the dogs with severe PTT develop PTS, a caudal osteotomy for the prevention of PTT and subsequent PTS is recommended.

Tibial plateau levelling osteotomy in 69 small breed dogs using conically coupled 1.9/2.5 mm locking plates

2015 ◽  
Vol 28 (05) ◽  
pp. 347-354 ◽  
Author(s):  
U. Reif ◽  
F. M. Martini ◽  
G. Cosenza
Keyword(s):  
Medical Records ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Locking Plates ◽  
Clinical Experiences ◽  
Short Term ◽  
Radiographic Images ◽  
Cranial Cruciate Ligament ◽  
Tibial Tuberosity Fracture ◽  
Small Breed

SummaryObjective: To report clinical experiences with the tibial plateau levelling osteotomy (TPLO) procedure in small breed dogs with cranial cruciate ligament (CCL) disease using specific, conically coupled, 1.9/2.5 mm locking plates and evaluating short-term complications and outcome.Methods: Medical records of small breed dogs (<15 kg) that underwent TPLO using 1.9/2.5 mm locking plates were reviewed retrospectively. The preoperative, postoperative and six to eight weeks postoperative tibial plateau angle (TPA) measurements were determined from the radiographic images. Lameness evaluation was assessed subjectively preoperatively and six to eight weeks postoperatively.Results: Sixty-nine small breed dogs (n = 79 stifles) were included in the study. Mean (± SD) preoperative TPA was 29.0 ± 3.4°, postoperative TPA was 5.8 ± 2.5°, and six to eight weeks postoperative TPA was 7.3 ± 4.1°. Sixteen complications occurred in 12 out of 79 TPLO procedures: three were intra-operative (intra-articular screw placement) and 13 were postoperative complications, of which nine were identified as minor complications not requiring surgical reintervention, and four as major complications requiring additional surgical intervention, including tibial tuberosity fracture (n = 1), osteomyelitis (n = 1), screw failure (n = 1), and plate breakage (n = 1). Lameness scores by clinical assessment reduced from a median value of 3/4 preoperatively to 1/4 at six to eight weeks postoperatively.Clinical significance: 1.9/2.5 mm locking plates appear to be a valid choice of implant for the stabilization of unilateral TPLO in small breed dogs.

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.

Tibial plateau levelling osteotomy in an alpaca

2009 ◽  
Vol 22 (04) ◽  
pp. 332-335 ◽  
Author(s):  
N. M. Girard ◽  
J. O’Riordan ◽  
N. Fitzpatrick ◽  
T. J. Smith
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Acute Onset ◽  
Radiographic Examination ◽  
Tibial Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Pelvic Limb ◽  
The Right

SummaryIn this report, a case of cranial cruciate ligament (CrCL) rupture treated by tibial plateau levelling osteotomy (TPLO), in a 36-month-old male breeding alpaca, is described. The alpaca was presented with the complaint of acute onset of right pelvic limb lameness. The findings of our clinical and radiographic examinations were consistent with CrCL insufficiency of the right stifle joint. The right tibial plateau angle measured prior to surgery was 19°. A TPLO was performed and this eliminated cranial tibial thrust. Culture of a swab taken from the surgical site prior to wound closure was positive for Pseudomonas aeruginosa. Enrofloxacin was administered parenterally for two weeks postoperatively. There were not any clinical signs of infection noted. Outcome assessments included veterinary examination (two and six weeks) and owner assessment (28 months). At two weeks the animal walked with a grade 2/5 lameness, and at six weeks radiographic examination showed progression of bone healing at the site of tibial osteotomy. A return to full breeding fitness occurred by eight weeks after the surgery. The alpaca remained free from lameness 28 months later, according to the owner.

scholarly journals Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: A retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247555
Author(s):  
Karen Marin ◽  
Marcos D. Unis ◽  
Jason E. Horgan ◽  
James K. Roush
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Complication Rate ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Short Term ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cranial Cruciate Ligament Rupture

The purpose of this retrospective study was to evaluate the risk factors for short-term postoperative complications in the 8 weeks after unilateral tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament rupture in small dogs weighing less than 15 kg. Medical records were retrospectively reviewed for 90 dogs weighing <15 kg that underwent medial parapatellar arthrotomy with inspection of the meniscus and TPLO performed by the same surgeon between January 2012 and December 2017. The overall complication rate was 4.44% (4/90 dogs). There were four cases of partial incisional dehiscence, none of which required surgical revision. Complications were significantly more likely in dogs that had undergone placement of a 2.4-mm TPLO plate. Overall, the complication rate was less than that in previous studies of dogs weighing > 15kg. In this study, patients in which 2.4-mm TPLO plates were used were more likely to develop postoperative complications. Dogs weighing <15 kg that underwent TPLO had good short-term outcomes with minimal complications. In our study, the overall complication rate after TPLO in dogs weighing <15 kg is less than that historically reported in heavier dogs. Our data suggests that TPLO is a safe treatment option in small dogs with cranial cruciate ligament rupture.

Prevalence and Risk Factors for Bilateral Meniscal Tears Identified during Treatment for Cranial Cruciate Ligament Disease Via Tibial Plateau Levelling Osteotomy in Dogs

2020 ◽  
Author(s):  
Rebecca L. Laube ◽  
Kyle K. Kerstetter
Keyword(s):  
Risk Factors ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Significant Risk ◽  
Kappa Coefficient ◽  
Meniscal Tears ◽  
Cohen’S Kappa ◽  
Cranial Cruciate Ligament ◽  
Cohen's Kappa ◽  
Cohen’S Kappa Coefficient

Abstract Objective The aim of this study was to report the prevalence and risk factors of bilateral meniscal tears during a tibial plateau levelling osteotomy (TPLO). Methods Data from 362 dogs that underwent staged or simultaneous TPLO between January 2006 and April 2019 were retrospectively collected. Variables such as breed, sex, weight change and intervals between surgeries were analysed with logistic regression. Preoperative tibial plateau angle, age, cranial cruciate ligament status and body weight were analysed with a generalized linear mixed model. All analyses were performed to assess the likelihood of bilateral meniscal tears versus unilateral tears and no tears. Correlation of meniscal tears between stifles was assessed with Cohen's kappa coefficient. Results Prevalence of bilateral meniscal tears was 48.0% (95% confidence interval [CI]: 43.0–53.0%). There was moderate agreement of the presence of meniscal tears between stifles (Cohen's kappa coefficient = 0.41, 95% CI: 0.31–0.51).The odds for bilateral meniscal tears were higher for Rottweilers (odds ratio [OR:] 4.5 [95% CI 1.1–30.3], p = 0.033), older dogs (OR: 1.2 [95% CI: 1.1–1.4 per year], p < 0.0001), smaller dogs (OR: 0.98 [95% CI: 0.97–0.99 per 0.45-kg], p = 0.001), stifles with complete cranial cruciate ligament tears (OR: 21.1 [95% CI: 7.1–62.4], p < 0.0001). Conclusion Contralateral meniscal tears, breed, older age, lower patient weight and complete cranial cruciate ligament tear were significant risk factors for bilateral meniscal tears. Surgeons can use these results to determine prognoses and propensities for meniscal tears in at-risk dogs.

Risk factors for excessive tibial plateau angle in large-breed dogs with cranial cruciate ligament disease

2007 ◽  
Vol 231 (11) ◽  
pp. 1688-1691 ◽  
Author(s):  
Felix M. Duerr ◽  
Colleen G. Duncan ◽  
Roman S. Savicky ◽  
Richard D. Park ◽  
Erick L. Egger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

Long-term complications following tibial plateau levelling osteotomy in small dogs with tibial plateau angles > 30°

2018 ◽  
Vol 182 (16) ◽  
pp. 461-461 ◽  
Author(s):  
Rebekah Knight ◽  
Alan Danielski
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Complication Rate ◽  
Medical Records ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Complication Rates ◽  
Cranial Cruciate Ligament ◽  
Veterinary Surgeon

Tibial plateau levelling osteotomy (TPLO) is commonly performed for surgical management of cranial cruciate ligament (CCL) disease. It has been suggested that small dogs may have steeper tibial plateau angles (TPAs) than large dogs, which has been associated with increased complication rates after TPLO. A retrospective study was performed to assess the rate and nature of long-term complications following TPLO in small dogs with TPAs>30°. Medical records were reviewed for dogs with TPAs>30° treated for CCL rupture by TPLO with a 2.0 mm plate over a five-year period. Radiographs were assessed to determine TPA, postoperative tibial tuberosity width and to identify any complication. Up-to-date medical records were obtained from the referring veterinary surgeon and any complications in the year after surgery were recorded. The effects of different variables on complication rate were assessed using logistic regression analysis. Minor complications were reported in 22.7 per cent of cases. This is similar to or lower than previously reported complication rates for osteotomy techniques in small dogs and dogs with steep TPAs. A smaller postoperative TPA was the only variable significantly associated with an increased complication rate. No major complications were identified.

Effect of tibial plateau levelling osteotomy on patellar tendon angle: A prospective clinical study

2014 ◽  
Vol 27 (05) ◽  
pp. 346-350 ◽  
Author(s):  
P. Gilbert ◽  
A. Sharma ◽  
S. Hendrick ◽  
S. Sathya
Keyword(s):  
Regression Analysis ◽  
Clinical Study ◽  
Patellar Tendon ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Naturally Occurring ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Cranial Cruciate Ligament Rupture

SummaryObjective: To evaluate the effect of the tibial plateau levelling osteotomy (TPLO) procedure on the patellar tendon angle (PTA) in dogs with naturally occurring cranial cruciate ligament rupture.Study design: Prospective observational clinical study.Animals: Dogs with naturally occurring CrCL rupture that had a TPLO performed (n = 40).Methods: Preoperative tibial plateau angle (TPA) and PTA were measured on radiographic images of affected stifle joints at 90° and standing angle (135°) respectively. The TPA and PTA were measured after TPLO was performed. Regression analysis was performed to evaluate the effect of preoperative TPA and PTA and postoperative TPA on postoperative PTA. Linear regression analysis was performed to evaluate the correlation between postoperative TPA and PTA.Results: The mean (± SD) preoperative TPA and PTA were 26.5 ± 3.8° and 105.7 ± 3.8° respectively. The postoperative TPA and PTA values were 7.6 ± 3.3° and 91.4 ± 5.5°, respectively. Regression analysis showed that higher preoperative PTA and postoperative TPA are associated with a larger difference between the postoperative PTA and 90°. There was a positive correlation between postoperative TPA and PTA.Conclusion: The TPLO procedure alters the PTA to 90° in dogs with cranial cruciate ligament rupture similar to tibial tuberosity advancement (TTA).Clinical significance: The TPLO may provide dynamic stability to the cranial cruciate deficient stifle by altering the TPA relative to the patellar tendon and creating a PTA of 90°. The biomechanical principle and mechanism of action of TPLO may be similar to TTA.

Measurement of the patellar tendon-tibial plateau angle and tuberosity advancement in dogs with cranial cruciate ligament rupture

2013 ◽  
Vol 26 (06) ◽  
pp. 469-478 ◽  
Author(s):  
C. Bismuth ◽  
A. Labrunie ◽  
B. Marin ◽  
A. Filleur ◽  
P. Pillard ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Tibial Plateau ◽  
Interobserver Reliability ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Observer Reliability ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Level Of Experience ◽  
Cranial Cruciate Ligament Rupture

SummaryObjectives: To (i) compare agreement of the common tangent (CT) and tibial plateau angle (TP) methods in terms of measuring the patellar tendon angle (PTA) and required advancement and (ii) determine the intraand inter-observer reliability of observers who measured PTA and the advancement.Methods: Six observers were divided into three groups based on their level of experience. They measured the PTA and the required advancement on 43 radiographic images of the tibiae of dogs affected by cranial cruciate ligament rupture. Each observer repeated the measurements three times with each method. The inter-technique (interT), intra-observer (intraO), and interobserver (interO) reliabilities were evaluated, assessed by calculating the intraclass correlation coefficient (ICC), and represented by Jones plots.Results: The agreement between PTA-CT and PTA-TP was low (the ICC interT values ranged from 0.11 to 0.4). The PTA-CT was associated with moderate intra-observer reliability (ICC intraO, CT = 0.61) and poor interobserver reliability (ICC interO, CT = 0.33). The PTA-TP was associated with good intra-observer reliability (ICC intraO, TP = 0.75) and moderate interobserver reliability (ICC interO, TP = 0.59). Interobserver reliability did not depend on the level of experience. The advancement measurements were associated with reliability results similar to those obtained for PTA. Jones’ plots showed that the CT method consistently yielded lower PTA and advancement values than the TP method.Conclusion: Given its poor reliability, the CT method is not recommended.

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