Tibial plateau angle in four common canine breeds with cranial cruciate ligament rupture, and its relationship to meniscal tears

Summary Objectives: To compare tibial plateau angle (TPA) among Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs that had undergone tibial plateau leveling osteotomies (TPLO) for cranial cruciate ligament disease, and to determine if higher TPAs are associated with increased risk for concurrent meniscal injury. Methods: This was a retrospective study including 275 client-owned dogs of one of the four aforementioned breeds that received TPLO radiographs between 1999 and 2005 prior to undergoing the TPLO procedure. The TPA measured by the original surgeon was compared among four breeds and analyzed with respect to presence or absence of meniscal injury diagnosed via arthroscopy or arthrotomy at the time of surgery. Results: Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs had mean TPAs of 25.9°, 26.2°, 25.9°, and 28.2°, respectively. The TPA of German Shepherd Dogs was significantly higher than that of the other breeds of dogs examined. TPA higher than the mean for dogs in this study did not significantly increase the risk for concurrent meniscal injury. Clinical significance: German Shepherd Dogs with cranial cruciate ligament disease had a significantly higher TPA compared to the other breeds examined. Higher TPA did not increase the likelihood of meniscal tears in this study. However, several variables that were not assessed, including the degree of cranial cruciate ligament integrity at the time of surgery and the time between original CrCL deficiency and surgical assessment, could have affected this analysis.

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

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-07-0115 ◽

2017 ◽

Vol 30 (03) ◽

pp. 178-183 ◽

Cited By ~ 2

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.

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Does meniscal release confer similar clinical benefits to meniscal tear treatment when compared to meniscectomy?

Veterinary Evidence ◽

10.18849/ve.v5i4.339 ◽

2020 ◽

Vol 5 (4) ◽

Author(s):

Ben Garland

Keyword(s):

Cruciate Ligament ◽

Research Question ◽

Meniscal Tear ◽

Clinical Expertise ◽

Meniscal Tears ◽

Bottom Line ◽

Cranial Cruciate Ligament ◽

Long Term Outcome ◽

Time Of Surgery ◽

Naturally Occurring

PICO question In adult dogs with naturally occurring medial meniscal tears concurrent to cranial cruciate ligament disease does meniscal release confer the same benefits in lameness resolution as meniscectomy? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed A single prospective cross-sectional study was reviewed, that fulfilled the criteria Strength of evidence None Outcomes reported Meniscal release, meniscectomy (partial, hemi- or complete), or the two combined performed for concurrent medial meniscal pathology at time of surgery for naturally occurring cranial cruciate ligament (CCL) rupture resulted in an acceptable long-term outcome. Difference in outcome between the techniques was not reported Conclusion There is no evidence that meniscal release provides an equal or superior treatment option for medial meniscal injury treated at the time of surgery for CCL rupture when compared to meniscectomy. The study critically reviewed performed meniscal release via radial transection through the meniscotibial ligament, and therefore does not represent mid-body abaxial radial release. Neither is this summary appropriate for considering prophylactic meniscal release of the normal meniscus. In addition, the surgical treatments for cranial cruciate ligament rupture were either ‘Tightrope’ or tibial plateau levelling osteotomy (TPLO) procedures. Further studies are required to compare clinical outcome between meniscal release or meniscectomy for treatment of concurrent meniscal tears How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

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

Veterinary Record Case Reports ◽

10.1136/vetreccr-2018-000767 ◽

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.

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Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament

Journal of the American Veterinary Medical Association ◽

10.2460/javma.2002.221.1426 ◽

2002 ◽

Vol 221 (10) ◽

pp. 1426-1429 ◽

Cited By ~ 71

Author(s):

Vicki L. Wilke ◽

Michael G. Conzemius ◽

Michael F. Besancon ◽

Richard B. Evans ◽

Matt Ritter

Keyword(s):

Tibial Plateau ◽

Cruciate Ligament ◽

Cranial Cruciate Ligament ◽

Clinically Normal ◽

Labrador Retrievers

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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

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0039-1693153 ◽

2019 ◽

Vol 32 (06) ◽

pp. 460-466 ◽

Cited By ~ 1

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.

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Complications of tibial plateau levelling osteotomy in dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-09-0122 ◽

2012 ◽

Vol 25 (05) ◽

pp. 349-358 ◽

Cited By ~ 34

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.

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

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-4162-8070 ◽

2015 ◽

Vol 67 (5) ◽

pp. 1254-1262 ◽

Cited By ~ 2

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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