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.

Risk factors for excessive tibial plateau angle in large-breed dogs with cranial cruciate ligament disease

2007 ◽  
Vol 231 (11) ◽  
pp. 1688-1691 ◽  
Author(s):  
Felix M. Duerr ◽  
Colleen G. Duncan ◽  
Roman S. Savicky ◽  
Richard D. Park ◽  
Erick L. Egger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

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.

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.

Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy

2005 ◽  
Vol 18 (04) ◽  
pp. 235-242 ◽  
Author(s):  
S. W. Aiken ◽  
G. R. DiResta ◽  
L. G. Herr ◽  
S. Monette ◽  
K. Carey
Keyword(s):  
Risk Factors ◽  
Patellar Tendon ◽  
Medical Records ◽  
Tibial Plateau ◽  
Conservative Therapy ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Cranial Cruciate Ligament ◽  
Tibial Tuberosity Fracture ◽  
Clinical Changes

SummaryPatellar tendon thickening (PTT) and patellar tendinosis (PTS) have been discussed in the veterinary literature as a post-operative complication of tibial plateau leveling osteotomy (TPLO). The purpose of this study was to define radiographic PTT, determine the frequency of and risk factors for PTT and PTS, and describe the clinical and histopathological findings of PTS after TPLO. We hypothesized that the location of the osteotomy alters forces placed on the patellar tendon resulting in PTT or PTS. Radiographs and medical records from 83 dogs undergoing 94 TPLO procedures were retrospectively evaluated. Two months post-operatively, 19 dogs (20.2%) had a normal patellar tendon or mild PTT, 51 (54.3%) had moderate PTT, and 24 (25.5%) had severe PTT. Seven of the 24 dogs (7.4%) with severe PTT had clinical signs consistent with PTS. Only dogs with severe PTT developed PTS (p < 0.0001). The risk factors for the development of PTT include: a cranial osteotomy, a partially intact cranial cruciate ligament (CCL) in conjunction with a cranial osteotomy, and post-operative tibial tuberosity fracture. The only risk factor identified for the development of PTS was a partially intact CCL. Four dogs with PTS improved with conservative therapy and one improved with surgical treatment. Two dogs had tendon biopsies with histopathological review that showed tendon degeneration with lack of inflammation. As only the dogs with severe PTT develop PTS, a caudal osteotomy for the prevention of PTT and subsequent PTS is recommended.

Comparison of Surgical Treatment Options for Cranial Cruciate Ligament Disease in Large-Breed Dogs with Excessive Tibial Plateau Angle

2008 ◽  
Vol 37 (1) ◽  
pp. 49-62 ◽  
Author(s):  
FELIX M. DUERR ◽  
COLLEEN G. DUNCAN ◽  
ROMAN S. SAVICKY ◽  
RICHARD D. PARK ◽  
ERICK L. EGGER ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

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

2008 ◽  
Vol 21 (02) ◽  
pp. 125-128 ◽  
Author(s):  
D. B. Fox ◽  
J. L. Cook ◽  
D. B. Guastella
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
The Other ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
German Shepherd ◽  
Cranial Cruciate Ligament ◽  
Time Of Surgery ◽  
Cranial Cruciate Ligament Disease ◽  
Labrador Retrievers

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.

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.

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