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.

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.

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.

Force Plate Gait Analysis and Clinical Results after Tibial Plateau Levelling Osteotomy for Cranial Cruciate Ligament Rupture in Small Breed Dogs

2020 ◽  
Vol 33 (03) ◽  
pp. 183-188 ◽  
Author(s):  
Hirokazu Amimoto ◽  
Tetsuaki Koreeda ◽  
Yoshiyuki Ochi ◽  
Ryota Kimura ◽  
Hideo Akiyoshi ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Limb Function ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Cranial Cruciate Ligament Rupture ◽  
Small Breed

Abstract Objective The aim of this study was to evaluate objective limb function using force plate gait analysis after tibial plateau levelling osteotomy (TPLO) in small breed dogs with cranial cruciate ligament rupture (CCLR). Materials and Methods Small breed dogs (15 kg or less) with unilateral CCLR treated with TPLO were evaluated using symmetry index (SI) of peak vertical force (PVF), vertical impulse and vector magnitude at PVF performed preoperatively and at 1, 2, 4 and 6 months postoperatively after routine TPLO surgery. Results Twelve dogs met the inclusion criteria. Hindlimb function was markedly improved after TPLO, with all three postoperative SI significantly higher after a month than preoperative values (p < 0.01). At 2 months after surgery, the SI was nearly normalized to 1.0 (preoperative SI: 0.50 ± 0.20, 0.44 ± 0.19 and 0.51 ± 0.19, and 2 months postoperative SI: 0.92 ± 0.16, 0.90 ± 0.18 and 0.92 ± 0.16 respectively). Complications were noted in two dogs (fibular fracture and a partial implant failure), neither of which required a revision surgery for acceptable functional recovery. Conclusion The objective limb function of the affected hindlimb improved continuously after surgery and reached a near normal value at 6 months after surgery. It was suggested that TPLO for small breed dogs had good outcomes based on force plate gait analysis.

scholarly journals Outcome after Modified Maquet Procedure in dogs with unilateral cranial cruciate ligament rupture: Evaluation of recovery limb function by use of force plate gait analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256011
Author(s):  
Giovanni Della Valle ◽  
Chiara Caterino ◽  
Federica Aragosa ◽  
Fabiana Micieli ◽  
Dario Costanza ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Ground Reaction Forces ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Reaction Forces ◽  
Plate Analysis ◽  
Cranial Cruciate Ligament Rupture

Introduction Cranial cruciate ligament failure is one of the principal causes of canine lameness. Several surgical procedures were proposed to achieve joint stabilisation; among these, the Modified Maquet Procedure involves using a titanium foam wedge to achieve and maintain the tibial tuberosity advancement. The force-plate analysis provides to objectively assess normal and abnormal gait and the outcome of different surgical techniques. The study evaluates the outcome of limbs that underwent Modified Maquet Procedure using land-force plate analysis comparing the operated limb with its healthy contralateral one as a control. Materials and methods Thirty-five dogs with unilateral cranial cruciate ligament rupture were evaluated. Outcome after surgery was assessed by orthopaedic and radiographic evaluations and force plate gait analysis performed before surgery, at 15, 30 and 90 days after surgery. For objective comparison of ground reaction forces, data of operated limb were compared to contralateral limb on each time control and Symmetry Index at 90 days was determined. Healing radiographic signs, minor and major complication were reported. Results A significant improvement in ground reaction forces was reached in all the treated limbs between set time intervals. The median percentage increase in ground reaction forces was constant from 15 to 90 days, with a Symmetry Index >9 in 54.2% of patients suggesting a normal gait symmetry. A complete bone healing was noticed at 90 days follow-up radiographic assessment. We experienced three major (8.5%) and one minor (2.8%) complications. Conclusions To the Authors’ knowledge, this is the first study in the veterinary literature that assessed outcomes of dogs undergoing Modified Maquet Procedure for the treatment of cranial cruciate ligament rupture using force plate gait analysis and healthy contralateral limb as a control group. Our results confirm that Modified Maquet Procedure is an effective method to stabilise the stifle joint.

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.

Intra-articular injections of autologous platelet concentrates in dogs with surgical reparation of cranial cruciate ligament rupture

2013 ◽  
Vol 26 (04) ◽  
pp. 285-290 ◽  
Author(s):  
J. U. Carmona ◽  
C. M. F. Rezende ◽  
R. F. Silva
Keyword(s):  
Cruciate Ligament ◽  
Reaction Force ◽  
Force Plate ◽  
Treated Group ◽  
Radiographic Evaluation ◽  
Control Group ◽  
Platelet Concentrates ◽  
Cranial Cruciate Ligament ◽  
Replacement Surgery ◽  
Autologous Platelet

Summary Objective The objective of this study was to evaluate by clinical, radiographic, and force plate gait analyses the effect of postsurgical intra-articular injections of autologous platelet concentrates (PC) in a small group of dogs with cranial cruciate ligament (CCL) rupture. Methods The ten dogs used in this study were initially presented with CCL rupture and underwent ligament replacement surgery by fascia lata autograft guided by arthroscopy. Six dogs received three intra-articular injections of PC (PC group); one dose was injected immediately after surgery, and two additional doses were injected at two-week intervals. The remaining four dogs received only nutraceuticals (control group). All dogs were evaluated by clinical examination, serial radiography, and force plate gait analyses at monthly intervals up to 90 days. Results The clinical follow-up of the PC-treated group indicated a better outcome than the control group. Radiographic evaluation was not conclusive. Values of peak vertical reaction force and vertical impulse of the affected limbs were only significantly larger on the 90th postoperative day in the PC group compared to the control group. Clinical significance Our results indicate that autologous PC might improve functional outcome after intra-articular cranial cruciate ligament repair. The effect of PC when using other repair procedures warrants additional studies.

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.

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