scholarly journals Innovative triangular cutting guide in cranial tibial wedge osteotomy in dogs with a cranial cruciate ligament rupture

2020 ◽  
Vol 76 (06) ◽  
pp. 6414-2020
Author(s):  
ROMAN ALEKSIEWICZ ◽  
KRZYSZTOF LUTNICKI ◽  
JERZY KIRSTEIN ◽  
MACIEJ KIEŁBOWICZ ◽  
MARCIN PSZCZOŁA
Keyword(s):  
Callus Formation ◽  
Cruciate Ligament ◽  
Statistical Significance ◽  
Correlation Coefficients ◽  
Brief Pain Inventory ◽  
Wedge Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Oscillating Saw ◽  
Kendall Correlation ◽  
Saw Blade

Damage of the cranial cruciate ligament is a frequent cause of limb lameness in dogs. The aim of the study was to present the usefulness of a new guide for the blade of the oscillating saw in the Cranial Tibial Wedge Osteotomy (CTWO) technique. CTWO procedures using a proprietary triangular guide were performed on 62 dogs of both sexes. Radiological evaluation of the formation of bone scars in the Hammer scale showed that 3 months after the surgery most patients had a solid 2nd or 3rd degree of osteotomy consolidation. Lameness rating by the Functional Stifle Scale showed an improvement in the clinical condition of the dogs. This was reflected in the opinions of the owners expressed in Canine Brief Pain Inventory questionnaires, as presented in the chart. Values of the Pearson and Kendall correlation coefficients and statistical significance coefficients confirmed the relationship between the owners’ satisfaction and the results of the therapy and improvement in clinical trials. The triangular guide of the oscillating saw blade facilitates the transfer of the osteotomy angle determined on a digital radiogram onto the operating field, ensures precise orthogonal osteotomy incisions in the course of CTWO, significantly affects the time of callus formation, and accelerates the recovery of limb function.

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.

A Comparative Study of the Length Patterns of Anterior Cruciate Ligament Reconstructions in the Dog and Man

2000 ◽  
Vol 13 (02) ◽  
pp. 73-77 ◽  
Author(s):  
J. T. Andrish ◽  
M. L. Olmstead ◽  
Helen Kambic ◽  
A. Shah ◽  
M. P. Palmisano
Keyword(s):  
Anterior Cruciate Ligament ◽  
Soft Tissues ◽  
Cruciate Ligament ◽  
Statistical Significance ◽  
Full Extension ◽  
Cranial Cruciate Ligament ◽  
Custom Made ◽  
Fresh Frozen ◽  
Anterior Cruciate ◽  
Over The Top

SummaryTo measure the change of length patterns of nine different simulated anterior cruciate ligament (ACL) reconstructions in the canine and human knee.Six fresh-frozen canine cadaver knees and six fresh-frozen human cadaver knees were used in this study. All of the soft tissues were removed from each cadaver knee, leaving the menisci, collateral ligaments and cruciate ligaments intact. After fixation of the femur to a custom-made frame, the ACL was excised. Three tunnels were made each at the ACL origin and insertion, making possible nine reconstruction combinations. A modified intra-articular technique was used to measure change of length, in mm, of each ACL reconstruction through a range of motion of 0 degrees (full extension) to 135 degrees of flexion. A rankorder list of reconstruction combinations was determined. The most isometric combination was determined for the canine and human knees, and trends in length patterns were also evaluated in both species relative to femoral and tibial position. Statistical significance was determined by ANOVA.A combination joining a point caudal to the ACL origin (over-the-top) and anterior on the tibial insertion was found to be the most isometric combination in both the canine and human. The trends in change of length patterns across all reconstruction combinations were similar in the dog and man. Isometry was improved as the reconstruction was placed further posterior on the femur and anterior on the tibia. Conclusions: The canine knee is an appropriate animal model for the study of isometry of the human ACL and its reconstructions.The length patterns of nine simulated Anterior Cruciate Ligament (ACL) reconstructions were determined in the dog and man. In both species, the most isometric reconstruction was one joining points corresponding to a position at the posterior edge of the intercondylar roof of the femur (over-thetop) with a position anterior on the ACL insertion. For the sake of clarity the term anterior cruciate ligament has been used, throughout, for both species, instead of the cranial cruciate ligament (CCL) in the dog. Also knee has been used in place of stifle for the dog.

scholarly journals Use of a Modified Tibial Plateau Levelling Osteotomy with Double Cut and Medial Crescentic Closing Wedge Osteotomy to Treat Dogs with Cranial Cruciate Ligament Rupture and Tibial Valgus Deformity

2019 ◽  
Vol 33 (01) ◽  
pp. 059-065
Author(s):  
Luca Vezzoni ◽  
Sara Bazzo ◽  
Silvia Boiocchi ◽  
Aldo Vezzoni
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Closing Wedge Osteotomy ◽  
Ligament Rupture ◽  
Closing Wedge ◽  
Cruciate Ligament Rupture ◽  
Tibial Valgus ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective The aim of this study was to report efficacy of a modified tibial plateau levelling osteotomy (TPLO) with double cut and medial crescentic closing wedge osteotomy (TPLO/MCCWO) to treat dogs with cranial cruciate ligament rupture and concurrent tibial valgus. Study Design This study was a cases series. Materials and Methods Medical records of dogs that had TPLO with medial crescentic closing wedge osteotomy were reviewed. Data collected included signalment, body weight, pre- and postoperative tibial valgus angle, tibial plateau angle (TPA), surgical planning, corrective osteotomy technique, method of fixation, complications, and length of time to radiographic healing. Results Fifty-two surgical procedures performed in 45 dogs (7 bilateral) were included in the study. Mean age at surgery was 54 months, and body weight ranged from 5 to 63 kg (mean: 36.5 kg). Mean pre- and postoperative mechanical medial proximal tibial angle were 101° (98°–107°) and 92.80° (88°–97°) respectively. The mean pre- and postoperative TPA were 27.80° (16–35°) and 6.50° (3–11°) respectively. Intraoperative complications occurred in two stifles: in one stifle over-rotation of the proximal tibial segment resulted in a TPA of –8°, with immediate revision to a 5° TPA; in the second stifle a fissure of the lateral tibial cortex developed during insertion of a screw and required adjunctive fixation. No postoperative complications were recorded and all osteotomies healed uneventfully. Conclusions Tibial plateau levelling osteotomy/medial crescentic closing wedge osteotomy is an effective treatment for dogs with cranial cruciate ligament rupture and tibial valgus allowing accurate correction of the tibial deformity with a low complication rate.

Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs

2017 ◽  
Vol 30 (01) ◽  
pp. 20-27 ◽  
Author(s):  
Barry Brower ◽  
Ann Peruski ◽  
Antonio Pozzi ◽  
Jonathan Dyce ◽  
Kenneth Johnson ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Comprehensive Treatment ◽  
Angular Deformity ◽  
Cranial Cruciate Ligament ◽  
Closing Wedge ◽  
The Mean ◽  
Cranial Cruciate Ligament Disease

SummaryObjective: To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique.Methods: Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner.Results: A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51).Clinical significance: In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by fe-moral varus, and supports an association between stifle instability and medial patellar luxation.

Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs

2007 ◽  
Vol 20 (03) ◽  
pp. 169-174 ◽  
Author(s):  
B. A. Smith ◽  
A. P. Black ◽  
C. J. Bailey
Keyword(s):  
Surgical Technique ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Ligament Injuries ◽  
Cranial Cruciate Ligament ◽  
Tibial Plateau Slope ◽  
Cranial Cruciate Ligament Disease ◽  
Preoperative Radiograph

SummaryThe tibial wedge osteotomy (TWO), a procedure that reduces the tibial plateau slope, has become an established surgical technique for the treatment of cranial cruciate ligament injuries in dogs, yet variation from the desired postoperative tibial plateau slope of 6° has been noted. The objectives of this study were to investigate the geometric implications of this procedure and to identify factors that affect the postoperative angles. The records of 35 consecutive cases that had a TWO performed were reviewed and comparisons were made between the alignment of the cortices and level of the osteotomy using duplicated tracings of a preoperative radiograph. The existing method for calculating the size of wedge to be removed was found to result in a postoperative slope greater than the expected 6°. Our results indicate that the desired postoperative angle is more likely to be achieved if the cranial cortices are aligned and the osteotomy is performed proximally.

Sagittal joint instability in the cranial cruciate ligament insufficient canine stifle

2014 ◽  
Vol 42 (03) ◽  
pp. 151-156 ◽  
Author(s):  
J. Rey ◽  
M. S. Fischer ◽  
P. Böttcher
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Motion Pattern ◽  
Cranial Cruciate Ligament ◽  
Sound Control ◽  
In Vitro Simulation ◽  
Canine Stifle

Summary Objective: This in vivo study qualitatively describes the sagittal motion pattern of the cranial cruciate ligament (CrCL) insufficient canine stifle in operated and unoperated joints with cranio-caudal laxity on palpation. Material and methods: Sagittal stifle kinematics were recorded in vivo in dogs (> 15 kg BW) with unilateral (n = 7) or bilateral (n = 6) complete CrCL rupture and positive cranial drawer test as well as two sound control dogs using uniplanar fluoroscopic kinematography with the dogs walking on a treadmill. Stifle stability and sagittal motion pattern of the femur and the tibia were determined by visual inspection of the fluoroscopic video sequences. Results: Control dogs showed no cranio-caudal instability, identical to the contralateral stifles of the dogs with unilateral rupture. All unoperated stifles with CrCL rupture (n = 6) showed caudal slippage of the femur at the beginning of the stance phase. Of the 13 operated stifles (TightRope: n = 1, tibial tuberosity advancement, TTA: n = 6, tibial plateau leveling osteotomy, TPLO: n = 5, cranial closing wedge osteotomy, CCWO: n = 1) nine were unstable, showing the same motion pattern as the unoperated stifles. Conclusion: In the CrCL insufficient stifle with in vivo cranio-caudal instability caudal slippage of the distal femur at tow touch is the predominant motion pattern. Clinical significance: The discrepancy between in vivo motion pattern and in vitro simulation of CrCL insufficiency in which cranial tibial subluxation is the predominant sagittal motion pattern warrants further studies.

Tibial plateau levelling osteotomy using a dome‐shaped saw blade for canine cranial cruciate ligament insufficiency

2021 ◽  
Author(s):  
Petar Polajnar ◽  
Zsigmond Szanto ◽  
Sanja Gruborovic ◽  
Florian Willmitzer ◽  
Nikola Medl
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Saw Blade
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