CORA Based Leveling Osteotomy with Tibial Tuberosity Transposition for Cranial Cruciate Ligament Rupture with Concurrent Medial Patellar Luxation in Two Small Breed Dogs

SummaryThe effect of two suture types, monofilament polybutester and braided polyester, on stifle joint biomechanics after extra-articular repair of cranial cruciate ligament rupture was evaluated by analysis of the instant centre of motion. The instant centres of motion and resulting velocity vectors were determined radiographically on both stifles of eight fresh canine cadavers before and after cranial cruciate ligament transection. After ligament transection, all 16 stifles were repaired with an extra-articular technique utilizing a double strand of suture placed between the lateral fabella and the tibial tuberosity. One stifle on each cadaver was repaired with each suture type. The instant centres of motion and resulting velocity vectors were re-evaluated post repair. All stifles had normal instant centres of motion prior to transection of the cranial cruciate ligament. Neither ligament transection nor extra-articular repair with either suture type resulted in an abnormal change in the instant centre of motion.

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Evaluation, Description of the Technique, and Clinical Outcomes After Tibial Tuberosity Advancement With Cranial Fixation (TTA CF) for Cranial Cruciate Ligament Rupture in 22 Dogs

Topics in Companion Animal Medicine ◽

10.1053/j.tcam.2018.07.003 ◽

2018 ◽

Vol 33 (3) ◽

pp. 65-72 ◽

Cited By ~ 3

Author(s):

Yauheni Zhalniarovich ◽

Andrzej Sobolewski ◽

Grzegorz Waluś ◽

Zbigniew Adamiak

Keyword(s):

Clinical Outcomes ◽

Cruciate Ligament ◽

Tibial Tuberosity ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Cranial Cruciate Ligament Rupture

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Risk factors and long-term surgical outcome of patellar luxation and concomitant cranial cruciate ligament rupture in small breed dogs

Veterinární Medicína ◽

10.17221/155/2019-vetmed ◽

2020 ◽

Vol 65 (No. 4) ◽

pp. 159-167

Author(s):

M Candela Andrade ◽

P Slunsky ◽

LG Klass ◽

L Brunnberg

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Cruciate Ligament ◽

Surgical Equipment ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

The Mean ◽

Cranial Cruciate Ligament Rupture ◽

Small Breed

Concomitant cranial cruciate ligament rupture (CCLR) is a common complication in small breed dogs with patellar luxation (PL) with an elusive pathogenesis. Surgical treatment is available and commonly includes remodelling osteotomies. While these modern techniques have shown good functional results, access is limited due to the high costs for owners and the need for special surgical equipment. The objectives of the study were to evaluate the frequency and risk factors for concomitant CCLR in small breed dogs with PL. To study the outcome and complications of the combination of the Wedge recession osteotomy (WR) and Tibial tuberosity transposition (TT) with a Fascia over-the-top (OT) or a Capsular and fascial imbrication technique (CFI) for the simultaneous treatment of PL and concomitant CCLR. A retrospective study is presented here. The signalment, body weight, luxation grade and direction, affected side, bilateral or unilateral PL, CCLR and meniscal status were analysed. The surgical treatment for PL and concomitant CCLR, outcome and complications were investigated. Of 233 small breed dogs with PL, 52 (22.31%) had a concomitant CCLR. Maltese dogs were more likely to have concomitant CCLR. The mean age for the dogs with PL only was 5.32 years, which was significantly younger than the mean age of dogs with PL and concomitant CCLR (7.39 years). Overweight dogs with PL were prone to develop concomitant CCLR. Surgical stabilisation with a combination of WR, TT and OT or CFI had excellent or good results in 86.63% of the cases, while 16.67% of the cases developed complications. In conclusion, PL and concomitant CCL ruptures can be managed successfully by performing a combination of WR, TT and OT or CFI. The outcomes and complication rates are comparable to remodelling osteotomies. Moreover, these techniques are less expensive and can be performed with standard surgical equipment. These findings should be beneficial for clinical diagnosis, client education and treatment.

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Tibial Plateau Leveling Osteotomy Combined with Tibial Tuberosity Transposition in a Dog with Medial Patellar Luxation and Cranial Cruciate Ligament Rupture

Journal of Veterinary Clinics ◽

10.17555/jvc.2017.10.34.5.366 ◽

2017 ◽

Vol 34 (5) ◽

pp. 366-369

Author(s):

Ji-hye Kim ◽

Jiyoung Park ◽

Seong Mok Jeong ◽

Haebeom Lee

Keyword(s):

Tibial Plateau ◽

Cruciate Ligament ◽

Tibial Tuberosity ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Cranial Cruciate Ligament Rupture

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Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007–2009)

Journal of the American Veterinary Medical Association ◽

10.2460/javma.240.12.1481 ◽

2012 ◽

Vol 240 (12) ◽

pp. 1481-1487 ◽

Cited By ~ 59

Author(s):

Rebecca E. Wolf ◽

Thomas D. Scavelli ◽

Michael G. Hoelzler ◽

Ryan P. Fulcher ◽

Richard P. Bastian

Keyword(s):

Postoperative Complications ◽

Cruciate Ligament ◽

Tibial Tuberosity ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Cranial Cruciate Ligament Rupture

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

Acta Veterinaria Brno ◽

10.2754/avb201382020215 ◽

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.

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Preliminary experience of a modified Maquet technique for repair of cranial cruciate ligament rupture in dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-10-01-0012 ◽

2011 ◽

Vol 24 (03) ◽

pp. 223-227 ◽

Cited By ~ 29

Author(s):

L. Brunel ◽

G. Bollen ◽

M. Balligand ◽

S. Etchepareborde

Keyword(s):

Cruciate Ligament ◽

Force Plate ◽

Primary Treatment ◽

Healing Time ◽

Tibial Tuberosity ◽

Cranial Cruciate Ligament ◽

Clinical Communication ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Cranial Cruciate Ligament Rupture

SummaryThe modified Maquet technique (MMT) uses the same principle as the tibial tuberosity advancement (TTA) for stabilization of the cranial cruciate ligament-deficient stifle in the dog. In the MMT, the tibial tuberosity is advanced in a similar manner to that used in the TTA, however the means by which the tibial crest is stabilized differs. The plate and fork originally described by Montavon et al. are not used (7). The MMT was first described by Maquet for use on humans it leaves intact a distal bony attachment to the tibial shaft, and the tuberosity is either reinforced or not by a figure-of-eight wire. In this paper, we describe the MMT, and we report the results of our first 20 canine patients with cranial cruciate ligament rupture that were treated by the MMT. Mean clinical bone healing time was 6.8 weeks (range 4 to 12 weeks).The evidence provided by this Clinical Communication suggests that it is technically possible to achieve an advancement of the tibial tuberosity without the need for a plate. The MMT deserves consideration as a primary treatment option for cranial cruciate ligament rupture in dogs, and further evaluation in large clinical studies. Long-term follow-up and force plate analysis would be necessary to compare the MMT to both the TTA and the tibial plateau levelling osteotomy.

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Biceps femoris muscle transposition for treatment of cranial cruciate ligament rupture in small breed dogs

Journal of Veterinary Science ◽

10.4142/jvs.2012.13.1.93 ◽

2012 ◽

Vol 13 (1) ◽

pp. 93 ◽

Cited By ~ 4

Author(s):

Roberto Tamburro ◽

Stefania Pinna ◽

Anna Maria Tribuiani ◽

Alessandra Panacea ◽

Fabio Carli ◽

...

Keyword(s):

Cruciate Ligament ◽

Biceps Femoris ◽

Muscle Transposition ◽

Cranial Cruciate Ligament ◽

Biceps Femoris Muscle ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Femoris Muscle ◽

Cranial Cruciate Ligament Rupture ◽

Small Breed

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

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0039-1700990 ◽

2020 ◽

Vol 33 (03) ◽

pp. 183-188 ◽

Cited By ~ 1

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.

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