Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs

2016 ◽  
Vol 249 (4) ◽  
pp. 391-398 ◽  
Author(s):  
Juliette L. Hart ◽  
Kimberly D. May ◽  
Nina R. Kieves ◽  
Patrice M. Mich ◽  
Clara S. S. Goh ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Owner Satisfaction ◽  
Cranial Cruciate Ligament Disease

scholarly journals Tibial plateau angle: methods of measurement, value, applicability

2017 ◽  
Vol 73 (9) ◽  
pp. 532-537
Author(s):  
Adam Przeworski ◽  
Joanna Głodek ◽  
Zbigniew Adamiak
Keyword(s):  
Measurement Errors ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Clinical Importance ◽  
Angle Measurement ◽  
Radiographic Examination ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Maximum Tolerance ◽  
Cranial Cruciate Ligament Disease

The tibial plateau angle measurement and its applicability have been reviewed based on the literature. The measurement was made on radiographs of the stifle joint with superimposition of the femoral condyles (with maximum tolerance of 2.0-4.0mm). Due to great variation among dog populations (size, breed), mean tibial plateau angles were found to be between 16.9° and 34°, but an excessive angle was described as >35°. An appropriate measurement of the tibial plateau angle can be made at about 108 days of age. The influence on the magnitude of the measured tibial plateau angle were the limb position during radiographic examination, the measurement technique (with modifications) and the experience level of the observer. Differences in magnitudes of the tibial plateau angles in dogs with and without cranial cruciate ligament rupture were not observed. The tibial plateau angle is commonly used in osteotomy of the tibia and its magnitude in order to select the proper surgical technique. The significance of the tibial plateau angle on the aetiopathogenesis of cranial cruciate ligament disease is questionable. Other measurements of the proximal tibia were attained to determine the risk factor of cranial cruciate ligament insufficiency. Knowledge of the tibial plateau angle and factors influencing measurement errors have great clinical importance.

Conformation of the proximal tibia and cranial cruciate ligament disease in small breed dogs

2017 ◽  
Vol 30 (03) ◽  
pp. 178-183 ◽  
Author(s):  
Michal Kyllar ◽  
Duncan Midgley ◽  
Martin Owen ◽  
Jan Janovec
Keyword(s):  
Body Weight ◽  
Clinical Significance ◽  
Tibial Plateau ◽  
Proximal Tibia ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Relative Body Weight ◽  
Cranial Cruciate Ligament Disease ◽  
Small Breed

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.

Extracapsular articulating implant to treat cranial cruciate ligament disease in a dog with multiple myeloma

2019 ◽  
Vol 7 (2) ◽  
pp. e000767
Author(s):  
Eloise Elisabeth Lhuillery ◽  
Philip Georg Witte
Keyword(s):  
Multiple Myeloma ◽  
Medical Treatment ◽  
Range Of Motion ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Mild Reduction ◽  
Cranial Cruciate Ligament Disease ◽  
Hindlimb Lameness ◽  
Malignant Neoplasia

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.

Effect of Tibial Plateau Levelling Osteotomy on Cranial Tibial Subluxation in the Feline Cranial Cruciate Deficient Stifle Joint: An Ex Vivo Experimental Study

2018 ◽  
Vol 31 (04) ◽  
pp. 273-278
Author(s):  
A. Bilmont ◽  
M. Retournard ◽  
E. Asimus ◽  
S. Palierne ◽  
A. Autefage
Keyword(s):  
Tibial Plateau ◽  
Rotation Angle ◽  
Ex Vivo ◽  
Cruciate Ligament ◽  
Tibial Rotation ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Before And After ◽  
Osteotomy Technique ◽  
Gastrocnemius Muscles

Objectives This study evaluated the effects of tibial plateau levelling osteotomy on cranial tibial subluxation and tibial rotation angle in a model of feline cranial cruciate ligament deficient stifle joint. Methods Quadriceps and gastrocnemius muscles were simulated with cables, turnbuckles and a spring in an ex vivo limb model. Cranial tibial subluxation and tibial rotation angle were measured radiographically before and after cranial cruciate ligament section, and after tibial plateau levelling osteotomy, at postoperative tibial plateau angles of +5°, 0° and –5°. Results Cranial tibial subluxation and tibial rotation angle were not significantly altered after tibial plateau levelling osteotomy with a tibial plateau angle of +5°. Additional rotation of the tibial plateau to a tibial plateau angle of 0° and –5° had no significant effect on cranial tibial subluxation and tibial rotation angle, although 2 out of 10 specimens were stabilized by a postoperative tibial plateau angle of –5°. No stabilization of the cranial cruciate ligament deficient stifle was observed in this model of the feline stifle, after tibial plateau levelling osteotomy. Clinical Significance Given that stabilization of the cranial cruciate ligament deficient stifle was not obtained in this model, simple transposition of the tibial plateau levelling osteotomy technique from the dog to the cat may not be appropriate.

Short-Term Complications following Single-Session versus Staged Bilateral Tibial Plateau Levelling Osteotomies Stabilized with Locking Plates for Treatment of Bilateral Cranial Cruciate Ligament Disease: A Retrospective Study

2019 ◽  
Vol 32 (06) ◽  
pp. 460-466 ◽  
Author(s):  
Kelsey K. Cappelle ◽  
Matthew D. Barnhart
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Significant Risk ◽  
Study Groups ◽  
Complication Rates ◽  
Locking Plates ◽  
Single Session ◽  
Cranial Cruciate Ligament ◽  
Major Complications ◽  
Cranial Cruciate Ligament Disease

Objective The aim of this study was to compare complications between dogs with bilateral cranial cruciate ligament disease treated with single-session bilateral tibial plateau levelling osteotomies (BSSTPLO) versus staged bilateral TPLO (STPLO) procedures stabilized with locking plates. Study Design Medical records of client-owned dogs treated with BSSTPLO or STPLO stabilized with locking plates between March 2017 and July 2018 at two associated institutions were reviewed. Patient data and complications from 37 dogs with BSSTPLO and 18 with STPLO were compared between groups. Major complications were defined as any complication that required further surgical or medical treatment whereas minor complications did not. Results Incidence for major complications for BSSTPLO and STPLO was 7/37 and 6/18 respectively. Incidence for minor complications for BSSTPLO and STPLO was 3/37 and 2/18 respectively. No significant differences in minor or major complication rates existed between study groups (p = 0.2). Mean body weight was significantly higher in the STPLO group (p = 0.001); however, no correlation between weight or BCS and complication rate existed within either group. Increasing age was the only significant risk factor for major complications (p = 0.01) in either group. Conclusion Our findings support the claim that BSSTPLO and STPLO performed with locking implants have similar complication rates. The decision to perform BSSTPLO or STPLO in dogs with bilateral cranial cruciate ligament disease should be based on other considerations rather than just complication rates.

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.

Complications of tibial plateau levelling osteotomy in dogs

2012 ◽  
Vol 25 (05) ◽  
pp. 349-358 ◽  
Author(s):  
B. Peirone ◽  
M. S. Bergh
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Tibial Plateau ◽  
Postoperative Morbidity ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Technical Errors ◽  
Surgeon Experience ◽  
Incidence Risk ◽  
Cranial Cruciate Ligament Disease

SummaryThe tibial plateau levelling osteotomy (TPLO) is one of the most common surgical procedures used to treat cranial cruciate ligament disease in dogs. Complications occurring during or after TPLO can range in severity from swelling and bruising to fracture and osteomyelitis. Ten to 34% of TPLO surgical procedures are reported to experience a complication and approximately two to four percent require revision surgery to address a complication. Although the risk factors for many complications have not been fully assessed, the best available evidence suggests that complications of TPLO can be reduced with increased surgeon experience, careful surgical planning, and accurate execution of the surgical procedure. Identification of known or suspected risk factors and intraoperative technical errors allow subsequent action to be taken that is aimed at decreasing postoperative morbidity. There is a need for prospective studies with consistent data reporting in order to fully reveal the incidence risk factors for complications associated with TPLO.

scholarly journals In canine cranial cruciate ligament rupture is outcome following TPLO improved compared with lateral suture?

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Catrina Pennington ◽  
Mark Morton ◽  
Ben Walton
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Complication Rates ◽  
Bottom Line ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Owner Satisfaction ◽  
Cranial Cruciate Ligament Rupture ◽  
Improved Outcome

PICO question In dogs over 15 kg, with cranial cruciate ligament rupture is there evidence of improved outcome following tibial plateau levelling osteotomy or lateral fabellotibial suture? Clinical bottom line Although the evidence is not conclusive, the literature reviewed here suggests that tibial plateau levelling osteotomy (TPLO) results in superior limb function and owner satisfaction compared to placement of a lateral fabellotibial suture (LFS). There is currently insufficient evidence to determine if there is a difference in complication rates or osteoarthritis (OA) development following TPLO or LFS.

scholarly journals Comparison of the proximal tibial angles between Labrador Retrievers and other dog breeds with and without cranial cruciate ligament rupture

2015 ◽  
Vol 67 (5) ◽  
pp. 1254-1262 ◽  
Author(s):  
A. F. D. P. Arruda ◽  
L. A. L. Muzzi ◽  
R. A. L. Muzzi ◽  
A. C. C. Lacreta Júnior ◽  
G. Oberlender ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Proximal Tibia ◽  
Cruciate Ligament ◽  
Contact Point ◽  
Patellar Ligament ◽  
Cranial Cruciate Ligament ◽  
Insertion Angle ◽  
Stifle Joint ◽  
Significant Difference ◽  
Labrador Retrievers

ABSTRACTThe influence of the proximal tibia conformation in the rupture of the cranial cruciate ligament (CCL) in dogs is still controversial, especially in Labrador Retrievers. The aim of this study was to compare the angles of the proximal tibia between Labrador Retrievers and other large breeds of dogs, both groups with and without CCL rupture. Radiographic images of 64 stifle joints were obtained and divided into four groups of 16 images. Group 1 consisted of Labrador dogs without orthopedic disorders, group 2 consisted of Labrador dogs with CCL rupture, group 3 consisted of dogs of various large breeds without orthopedic disorders, and group 4 consisted of dogs of various large breeds with CCL rupture. The radiographs were performed in mediolateral projection with the stifle joint positioned at an approximate angle of 135°. The tibial plateau angle showed an overall average of 22.17°±4.20°, and there was no statistically significant difference between the groups. The patellar ligament angle in relation to the tibial plateau had a mean of 103°±4.20°, and there was a significant difference between groups 1 and 4. The patellar ligament angle in relation to the common tangent at the tibiofemoral contact point showed an average of 99.06°±6.08°, and there was no difference between the groups. The patellar ligament insertion angle had an overall average of 51.45°±5.06°, and there was a significant difference between the two groups of normal dogs and two groups of ruptured dogs. In conclusion, the tibial plateau angle, the patellar ligament angles and the patellar ligament insertion angle do not seem to be predisposing factors for rupture of the CCL in Labrador Retriever dogs. In general, there seems to be no relationship between the angles of the proximal tibia and the CCL rupture in dogs.

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