Prophylactic Efficacy of Tibial Plateau Levelling Osteotomy for a Canine Model with Experimentally Induced Degeneration of the Cranial Cruciate Ligament

Author(s):  
Masakazu Shimada ◽  
Nobuo Kanno ◽  
Tom Ichinohe ◽  
Shuji Suzuki ◽  
Yasuji Harada ◽  
...  

Abstract Objective The aim of this study was to clarify the histological effects of tibial plateau levelling osteotomy on cranial cruciate ligament degeneration induced by excessive tibial plateau angle. Study Design Five female Beagles were used to bilaterally create excessive tibial plateau angle models surgically. A second tibial plateau levelling osteotomy was performed 11 months after the first surgery on the right stifle (tibial plateau levelling osteotomy group), and a sham operation that did not change the tibial plateau angle was performed on the left stifle (excessive tibial plateau angle group). At 6 months after the second surgery, the dogs were euthanatized. The cranial cruciate ligament was stained with haematoxylin–eosin to assess the cell density, Alcian-Blue to assess proteoglycans and Elastica-Eosin to assess elastic fibres, and immunohistochemically stained to assess type I (COL1) and type II collagen and SRY-type HMG box 9 (SOX9) expression. Results In each group, the cranial cruciate ligament degeneration, especially on the tibial side, including the presence of Alcian-Blue- and Elastica-Eosin-positive regions, decreased in COL1-positive regions, and enhancement of SOX9 expression was observed. Besides, compared with the tibial plateau levelling osteotomy group, the excessive tibial plateau angle group showed increases in Alcian-Blue- and Elastica-Eosin-positive regions and a decrease in the COL1-positive regions. Conclusion The results suggested that excessive tibial plateau angle-induced cranial cruciate ligament degeneration can be suppressed by reducing the biomechanical load on the cranial cruciate ligament by performing tibial plateau levelling osteotomy.

2015 ◽  
Vol 28 (04) ◽  
pp. 240-249
Author(s):  
N. Kanno ◽  
Y. Harada ◽  
T. Yogo ◽  
M. Tagawa ◽  
Y. Hara ◽  
...  

Summary Objective: To create a canine model of excessive tibial plateau angle (eTPA) and assess the chondroid metaplasia and extracellular matrix alteration in the cranial cruciate ligament. Methods: Seven mature female Beagles were included. Cylindrical osteotomy was performed bilaterally in the proximal tibia. The TPA was increased to approximately 40° in the left tibia (eTPA stifle) and left unchanged in the right tibia (control stifle). Exercise stress was started at three months postoperatively, and at 12 months postoperatively the dogs were euthanatized and the cranial cruciate ligaments were collected. The specimens were subjected to haematoxylin and eosin staining to assess the ligamentocyte morphology and immunostaining to assess the type I (COLI), type II (COLII), and type III (COLIII) collagen, and the sry-type HMG box 9 (SOX9) staining. Results: Macroscopic cranial cruciate ligament injury was absent in six dogs but present in the eTPA stifle of one dog, which was excluded from the analysis. The ligamentocyte density decreased and the percentage of round ligamentocytes increased in the eTPA stifles. The COLII, COLIII, and SOX9 staining increased significantly and COLI deposition decreased in the eTPA stifles compared to the control stifle. Clinical significance: The extracellular matrix changed, COLI deposition decreased, and COLIII and SOX9 staining increased in the cranial cruciate ligament of the eTPA stifles. SOX9 may contribute to COLII synthesis in the extracellular matrix of the cranial cruciate ligament in eTPA stifles, and eTPA may promote chondroid metaplasia and extra -cellular matrix alteration.


2008 ◽  
Vol 21 (04) ◽  
pp. 375-377 ◽  
Author(s):  
E. Simko ◽  
G. Harasen

SummaryA 10-year-old spayed female Golden Retriever was admitted with chronic lameness of the right hind limb. A tibial plateau leveling osteotomy (TPLO) had been performed on this leg approximately three years previously. A progressively growing soft tissue mass, affecting the right stifle, previously treated with TPLO was biopsied and found to be a histiocytic sarcoma. Previously proposed links between the development of neoplasia in the stifle region and the presence of chronic synovitis, osteotomy, orthopaedic implants, and specifically the Slocum TPLO plate, are briefly discussed.


2009 ◽  
Vol 22 (04) ◽  
pp. 332-335 ◽  
Author(s):  
N. M. Girard ◽  
J. O’Riordan ◽  
N. Fitzpatrick ◽  
T. J. Smith

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.


VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e146-e152
Author(s):  
Massimo Petazzoni ◽  
Melania Dallago ◽  
Antonio Ferretti

AbstractThe aim of this study was to report a case of caudal cruciate ligament rupture in a 9-year-old dog who underwent juvenile tibial plateau cranial hemiepiphysiodesis that was performed to treat a partial cranial cruciate ligament rupture and excessive tibial plateau angle. A 9-year-old, 45 kg, male Bernese Mountain dog was referred for a non-traumatic acute right pelvic-limb lameness. At the age of 5 months, the dog underwent bilateral tibial plateau cranial hemiepiphysiodesis to treat a bilateral partial cranial cruciate ligament rupture and excessive tibial plateau angles. At clinical examination, a caudal tibial subluxation of the right stifle was detected. The right tibial plateau angle was 3 degree. Arthroscopy confirmed a complete caudal cruciate ligament rupture. The cranial cruciate ligament was partially torn. A diagnosis of caudal cruciate ligament rupture 8.5 years post juvenile tibial plateau hemiepiphysiodesis was made. A tibial plateau overcorrection might have contributed to caudal cruciate ligament rupture in this dog.


2017 ◽  
Vol 30 (03) ◽  
pp. 178-183 ◽  
Author(s):  
Michal Kyllar ◽  
Duncan Midgley ◽  
Martin Owen ◽  
Jan Janovec

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.


2012 ◽  
Vol 25 (06) ◽  
pp. 488-497 ◽  
Author(s):  
J. Grierson ◽  
C. R. Lamb ◽  
F. H. David

SummaryBackground: Magnetic resonance (MR) images of the postoperative canine stifle are adversely affected by susceptibility artefacts associated with metallic implants.Objectives: To determine empirically to what extent susceptibility artefacts could be reduced by modifications to MR technique.Methods: Three cadaveric limbs with a tibial plateau levelling osteotomy (TPLO), tibial tuberosity advancement (TTA), or extra-capsular stabilization (ECS) implant, respectively, were imaged at 1.5T. Series of proton density and T2-weighted images were acquired with different combinations of frequency-encoding gradient (FEG) direction and polarity, stifle flexion or extension, echo spacing (ES), and readout bandwidth (ROBW), and ranked. The highest rank (a rank of 1) corresponded to the smallest artefact.Results: Image ranking was affected by FEG polarity (p = 0.005), stifle flexion (p = 0.01), and ROBW (p = 0.0001). For TPLO and TTA implants, the highest ranked images were obtained with the stifle flexed, lateromedial FEG, and medial polarity for dorsal images, and craniocaudal FEG and caudal polarity for sagittal images. For the ECS implant, the highest ranked images were obtained with the stifle extended, a proximodistal FEG and proximal polarity for dorsal images, and craniocaudal FEG and cranial polarity for sagittal images.Clinical significance: Susceptibility artefacts in MR images of postoperative canine stifles do not preclude clinical evaluation of joints with ECS or TTA implants.Part of this study was presented at the Annual Meeting of the American College of Veterinary Radiology, Albuquerque, NM, October 2011.


2009 ◽  
Vol 22 (02) ◽  
pp. 83-86 ◽  
Author(s):  
S. Reese ◽  
K. Lorinson ◽  
D. Lorinson ◽  
E. Schnabl

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.


2019 ◽  
Vol 7 (2) ◽  
pp. e000767
Author(s):  
Eloise Elisabeth Lhuillery ◽  
Philip Georg Witte

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.


2020 ◽  
Vol 33 (05) ◽  
pp. 301-307
Author(s):  
Masakazu Shimada ◽  
Tetsuya Takagi ◽  
Nobuo Kanno ◽  
Satoshi Yamakawa ◽  
Hiromichi Fujie ◽  
...  

Abstract Objective The aim of the study was to determine the changes in biomechanical characteristics following tibial plateau levelling osteotomy (TPLO) using simulated manual tests. Study Design Twenty-one stifles from healthy Beagle dogs that had undergone TPLO or had not (control) were first tested in the intact form, and then the cranial cruciate ligament (CrCL) was transected in each to provide four test situations: control-intact, control-CrCL-transected, TPLO-intact and TPLO-CrCL-transected. The stifles were then analysed using a robotic joint biomechanical testing system. The craniocaudal drawer, axial rotation and proximal compression tests were applied. Results The craniocaudal displacement during the drawer test was not significantly different between the control-intact and TPLO-intact. However, the displacement was significantly greater in the TPLO-CrCL-transected than in the control-intact. In the axial rotation test, the internal–external (IE) rotation was significantly greater in the TPLO-intact than in the control-intact. Similarly, the IE rotation was significantly greater in the TPLO-CrCL-transected than in the control-CrCL-transected. In the proximal compression test, craniocaudal displacement was not significantly different among the control-intact, TPLO-intact and TPLO-CrCL-transected. Conclusion These findings suggest that TPLO influences the tension of the collateral ligaments and might generate laxity of the tibiofemoral joint. Instability after the osteotomy might be associated with the progression of osteoarthritis.


Sign in / Sign up

Export Citation Format

Share Document