Average Tibial Plateau Angle of 3,922 Stifles Undergoing Surgical Stabilization for Cranial Cruciate Ligament Rupture

2020 ◽  
Vol 33 (03) ◽  
pp. 167-173 ◽  
Author(s):  
Elisabeth A. Fox ◽  
David L. Dycus ◽  
Christopher S. Leasure ◽  
Herbert A. Fox ◽  
Sherman O. Canapp
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Cranial Cruciate Ligament ◽  
Large Sample ◽  
Significant Difference ◽  
Retrospective Case Study ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective The aim of this study was to report the average tibial plateau angle (TPA) from a large sample of dogs and to determine if breed or gonadectomy had a significant association with abnormal TPA. Study Design This was a retrospective case study. Materials and Methods Medical records from 2006 to 2015 were reviewed for dogs that were diagnosed with cranial cruciate ligament (CrCL) rupture and underwent dynamic surgical stabilization. Signalment, examination findings, preoperative TPA and surgical report were reviewed. Results A total of 3,249 dogs underwent CrCL stabilization surgery from 2006 to 2015. Of the 3,249 dogs, 3,054 dogs met the inclusion criteria for a total of 3,922 stifles to be evaluated. The average preoperative TPA was 29° ± 3.7°. Average breed-specific preoperative TPA ranged from 27° to 35.1°, with four breeds having significantly lesser TPA and four breeds significantly greater TPA than the overall mean of dogs. Neutered dogs had a higher TPA of 28.87° ± 3.8° than non-neutered dogs with an average TPA of 26.88° ± 4.0°, p < 0.001. There was not a significant difference in average TPA between females and males, regardless of the neuter status. Conclusion and Clinical Relevance Our reported preoperative TPA in a large sample of dogs is higher than what has been previously published. In reviewing 3,922 stifles, the average preoperative TPA was 29°. We report the average preoperative TPA in specific breeds and report that neutered dogs have a significantly higher TPA than intact dogs. This updated information may guide clinicians in management decisions regarding treatment for CrCL rupture.

Outcome after Tibial Plateau Levelling Osteotomy and Modified Maquet Procedure in Dogs with Cranial Cruciate Ligament Rupture

2020 ◽  
Vol 33 (03) ◽  
pp. 189-197
Author(s):  
Julia Knebel ◽  
Daniela Eberle ◽  
Stephanie Steigmeier-Raith ◽  
Sven Reese ◽  
Andrea Meyer-Lindenberg
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Radiographic Evaluation ◽  
Control Group ◽  
Cranial Cruciate Ligament ◽  
Surgical Methods ◽  
Significant Difference ◽  
Reaction Forces ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective The aim of this study was to compare outcomes after tibial plateau levelling osteotomy (TPLO) and modified Maquet procedure (MMP) for the treatment of cranial cruciate ligament rupture (CCLR) in dogs using clinical and radiographic evaluation and treadmill-based force plate gait analysis. Study Design This study was a prospective, randomized, controlled study. Materials and Methods Sixty-one dogs (76 joints) with CCLR were treated with TPLO (n = 30 dogs, 41 joints) or MMP (n = 31 dogs, 35 joints) and compared with a control group of 16 healthy Labrador Retrievers. Outcomes after surgery were compared by clinical orthopaedic assessment, radiographic evaluation and force plate gait analysis performed preoperatively, and then at 6 weeks, 3 and 6 months postoperatively. For objective comparison of ground reaction forces, the data were compared with the control group. Major complications were reported. Results A significant improvement in ground reaction forces was reached in all surgically treated dogs. No significant difference was found between the surgical methods at any postoperative re-examination. With regard to peak vertical force (PVF), there were significantly more patients with TPLO within the reference range of healthy dogs at the 3 months re-examination than dogs with MMP. There was no significant difference in mean value comparisons between TPLO and control groups 6 months postoperatively. Compared with the control group, mean values of 93.9% (PVF) and 85.9% (vertical impulse [VI]) were reached by the TPLO group and 89.4% (PVF) and 79.9% (VI) by the MMP group, 6 months postoperatively.No significant differences were found regarding major complications or progression of osteoarthritis. Conclusions Although no significant differences were found between the surgical methods, TPLO patients showed superiority with regard to clinical outcome.

A comparison of outcomes following tibial plateau levelling osteotomy and cranial tibial wedge osteotomy procedures

2007 ◽  
Vol 20 (04) ◽  
pp. 312-319 ◽  
Author(s):  
C. Brown ◽  
S. A. Corr
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Small Sample ◽  
Wedge Osteotomy ◽  
Complication Rates ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Rupture

SummaryThe objective of this study was to determine whether clinical outcomes were superior and complication rates were lower in dogs that had had a cranial cruciate ligament rupture treated by tibial plateau levelling osteotomy (TPLO), compared to those dogs that had been treated using the original cranial tibial wedge osteotomy (CTWO) procedure. Thirty-seven client-owned dogs with cranial cruciate ligament rupture were included in the study: 19 dogs underwent a TPLO procedure, and 18 dogs underwent a CTWO procedure. The study was retrospective, with the data being obtained from medical records and a review of radiographs. The long-term outcome was assessed by means of an owner questionnaire using a visual analogue scale. For the majority of factors that were reviewed, there was not a significant difference in outcome between the dogs that had a TPLO or those that had undergone a CTWO. All of the dogs showed a rapid return to weight bearing after surgery, and at the six week re-examination, the majority of the dogs did not have any pain on stifle palpation. They displayed a good stifle range of motion and significantly lower lameness scores than those prior to surgery. The complication rates did not differ between the procedures, however, within this small sample of dogs, complications following a CTWO were more likely to require revision surgery.

scholarly journals Radiographic changes of the patellar ligament in dogs after tibial tuberosity advancement

2013 ◽  
Vol 82 (2) ◽  
pp. 215-218
Author(s):  
Ladislav Stehlík ◽  
Pavel Proks ◽  
Petra Fedorová ◽  
Alois Nečas
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Radiographic Examination ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Rupture

Patellar desmopathy in dogs after tibial plateau levelling osteotomy has been described in many studies. Tibial tuberosity advancement is a biomechanically different technique. It is assumed that the patellar ligament is loaded with little force similarly as after tibial plateau levelling osteotomy. Various aspects related to secondary patellar desmopathy are not completely understood. This study deals with computed radiography measurement of patellar ligament thickness after tibial tuberosity advancement in dogs with cranial cruciate ligament rupture. The thickness of the patellar ligament in exactly predetermined locations was measured from mediolateral radiographs of stifle joints. A total of 18 dogs (20 knee joints) with cranial cruciate ligament (ligamentum cruciatum craniale) rupture underwent three radiographic examinations of the knee (preoperative examination and control examination 7 and 15 weeks after the surgery). Significant difference was found between the thickness of the patellar ligament in the first and second examinations. Some of the demographic factors possibly related to patellar ligament thickness (age, sex, body weight, type of cranial cruciate ligament rupture, arthrotomy, cage size, meniscal injury, time between surgery and radiographic examination) were analyzed. However, statistical analyses did not show any effect of these factors on the thickness of the patellar ligament, except for the time between surgery and radiographic examination. These findings can extend the surgeons’ knowledge of biomechanical aspects of tibial tuberosity advancement.

scholarly journals Comparison of the Tibial Anatomical-Mechanical Axis Angle and Patellar Positions between Labrador Retrievers and Golden Retrievers with and without Cranial Cruciate Ligament Rupture

2020 ◽  
Vol 5 (2) ◽  
pp. 1-9
Author(s):  
Guenego L
Keyword(s):  
Tibial Plateau ◽  
Mechanical Axis ◽  
Cruciate Ligament ◽  
Control Group ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Labrador Retrievers ◽  
Cranial Cruciate Ligament Rupture

This study investigated proximodistal and craniocaudal patellar positions and assessed these positions with the tibial anatomical-mechanical axis angle (AMA-angle), tibial plateau angle (TPA), relative tibial tuberosity width (rTTW), and Z-angle in Labrador Retrievers (LR) and Golden Retrievers (GR) with and without cranial cruciate ligament rupture (CCLR). Mediolateral radiographs were obtained from 2 groups. The affected group had a normal contralateral stifle measured at the time of unilateral surgically confirmed CCLR, which developed a subsequent contralateral CCLR (SC-CCLR; 40 dogs), and the control group (60 dogs aged >11 years) had normal stifles. In the SC-CCLR group, 95% of the tibial anatomical axes (AAs) were cranial (CR) to the patella, with a median (range) AMA-angle of 2.92° (1.65°-4.92°), while in the control group, 93% of the stifles had AAs caudal (CA) to or in the middle (M) of the patella, with a median (range) AMA-angle of 1.03° (0°-3.52°). The craniocaudal position of the patella was correlated statistically with the AMA-angles (median (range), 0.86° (0-1.61°), 1.87° (1.22-2.7°), and 2.97° (1.72-4.92°) in the CA, M, and CR positions, respectively, but not with other tibial measurements (p<0.0001). The patellar height did not differ between the groups (p<0.0001). The highly significant difference found in the AMA-angle and the craniocaudal patellar position between LR and GR with or without CCL injury suggest that craniocaudal angulation of the proximal tibia could influence the development of canine CCLR.

scholarly journals Use of the modified Insall Salvati method for determination of vertical patellar position in dogs with and without cranial cruciate ligament rupture considering the morphology of the cranio-proximal tibia

2012 ◽  
Vol 81 (4) ◽  
pp. 403-407 ◽  
Author(s):  
Dávid Kňazovický ◽  
Valent Ledecký ◽  
Marián Hluchý ◽  
Marek Ďurej
Keyword(s):  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Insertion Point ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Healthy Dogs ◽  
Cranial Cruciate Ligament Rupture

The aim of this study was to evaluate if the modified Insall Salvati (IS) method can be applied for the canine patient despite differences of proximal tibial morphology, and if such potential differences are also seen in dogs with cranial cruciate ligament rupture. Insall Salvati method is a simple and convenient method for determination of the vertical position of patella, by dividing the length of patella by length of the patellar ligament. The influence of the variable proximal tibial morphology on the modified (IS) index was measured and the value of modified IS index in healthy dogs (n = 25) was compared with dogs with cranial cruciate ligament rupture (n = 26). Medio-lateral radiographs of 102 stifles were evaluated. Patellar ligament length (PLL), patellar length (PL), modified IS ratio and the height of insertion point of patellar ligament on tibial tuberosity were measured. Data of the IS ratio were compared with the value of the height of the insertion point with no significant difference (P = 0.36). There was no significant difference (P = 0.07) in the PLL:PL ratio between dogs affected or unaffected with cranial cruciate ligament rupture. Based on the results of this study we can conclude that the morphology of the cranio-proximal tibia and the height of insertion point of the patellar ligament do not have an influence on the value of the modified IS index both in healthy dogs and in dogs with cranial cruciate ligament rupture.

Measurement of the tibial plateau angle in cats with and without cranial cruciate ligament rupture

2009 ◽  
Vol 22 (02) ◽  
pp. 83-86 ◽  
Author(s):  
S. Reese ◽  
K. Lorinson ◽  
D. Lorinson ◽  
E. Schnabl
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Inter Observer Variability ◽  
Measurement Results ◽  
Cranial Cruciate Ligament Rupture

SummaryThe objective of the present study was to determine the tibial plateau angle (TPA) in cats without stifle pathology and to compare it with cats suffering from an isolated cranial cruciate ligament rupture. Mediolateral radiographs of the stifle were taken and the tibial plateau angle was measured based on the method previously described by Slocum and Devine (1983) for dogs. Three observers with different levels of experience evaluated the radiographs of all of the cats in this study. The mean tibial plateau angle measured by all three observers in the cats with a rupture of the cranial cruciate ligament (CCL) was 3.1° greater than in cats without stifle pathology. Neither gender, age, body weight nor degenerative joint disease had an influence on measurement results. The authors found an inter-observer variability of ± 5.3°. Hence it can be concluded that cats with cranial cruciate ligament rupture have a greater TPA, and this at least lends some credence to the possibility of higher TPA being a predis-posing factor for cruciate injury in this species.

Tibial Plateau Symmetry and the Effect of Osteophytosis on Tibial Plateau Angle Measurements

2007 ◽  
Vol 43 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Matthew John Ritter ◽  
Ruby L. Perry ◽  
N. Bari Olivier ◽  
Sun Young Kim ◽  
Loic M. Dejardin
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Medial Tibial Plateau ◽  
Cranial Cruciate Ligament ◽  
Novel Technique ◽  
Angle Measurements ◽  
Significant Difference ◽  
Improve Accuracy ◽  
The Face

A novel technique was developed to estimate the caudal medial tibial plateau landmark in the face of osteophytosis to improve accuracy in tibial plateau angle measurements. Using this technique, tibial plateau angles were evaluated in 31 normal dogs before and 8 months after right cranial cruciate ligament transection. There was no significant difference in mean tibial plateau angle before or after induction of osteophytosis. Additionally, it was determined that 90% of dogs had a difference of =2° between right and left tibial plateau angles, which was considered symmetrical.

scholarly journals Radiographic assessment of the proximal tibial angles in dogs and cats with and without cranial cruciate ligament rupture

2018 ◽  
Vol 38 (6) ◽  
pp. 1190-1195 ◽  
Author(s):  
Ana Flávia D.P. Arruda ◽  
Leonardo A.L. Muzzi ◽  
Antonio C.C. Lacreta Junior ◽  
Ruthnéa A.L. Muzzi ◽  
Gabriela R. Sampaio ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Common Tangent ◽  
Cranial Cruciate Ligament ◽  
Mean Values ◽  
Stifle Joint ◽  
Significant Difference ◽  
Tangent Method ◽  
Healthy Dogs

ABSTRACT: The influence of the proximal tibial angles in the cranial cruciate ligament (CCL) rupture in dogs is still controversial, and little is known regarding this topic in cats. The aim of this study was to evaluate and compare the angles of the proximal portion of the tibia in dogs and cats with and without CCL rupture. Retrospective and prospective radiographs of the stifle joints were obtained and divided into four groups. Group 1 was composed of 70 stifle joint images of dogs without orthopedic disorders (healthy dogs), group 2 had 70 stifle joint images of dogs with CCL rupture, group 3 had 50 stifle joint images of cats without orthopedic disorders (healthy cats) and group 4 had 25 stifle joint images of cats with CCL rupture. Radiographs were taken with the stifle joint in the mediolateral projection, positioned at the angle of hind limb support. Between the two groups of dogs evaluated, the dogs with CCL rupture had statistically greater tibial plateau angle (TPA) compared with healthy dogs. No difference was shown in relation to the TPA between healthy cats and cats with CCL rupture. In relation to the patellar ligament angle by tibial plateau method the values for the healthy dogs were significantly higher than those for the CCL ruptured dogs. Similarly, healthy cats had significantly higher mean values than cats with CCL rupture. In the patellar ligament angle by common tangent method there was no significantly difference between the two groups of dogs. Between the two groups of cats, animals with CCL rupture had statistically higher mean values than healthy cats. In general, the groups of dogs showed higher mean values than the groups of cats. For the patellar ligament insertion angle (PLIA) healthy dogs showed a significantly higher mean than dogs with CCL rupture. There was no significant difference between the groups of cats. In conclusion, the TPA and the PLIA possibly influence the etiology of CCL rupture in dogs but not in cats. The low patellar ligament angle measured by common tangent method may favorably influence the reduced incidence of CCL rupture in cats.

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