Short-term comparison of tibial tuberosity advancement and tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease using kinetic analysis

2016 ◽  
Vol 29 (03) ◽  
pp. 209-213 ◽  
Author(s):  
Cássio Ferrigno ◽  
Alexandre de Souza ◽  
Daniela Caquias ◽  
Adriana de Figueiredo ◽  
Márcio Ferreira
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Tibial Tuberosity ◽  
Short Term ◽  
Cranial Cruciate Ligament ◽  
Time Points ◽  
Patient Allocation ◽  
Postoperative Time ◽  
Cranial Cruciate Ligament Disease

SummaryObjectives: This study set out to compare the outcomes of tibial tuberosity advancement (TTA) and tibial plateau levelling osteotomy (TPLO) procedures in the treatment of dogs affected with unilateral cranial cruciate ligament disease (CCLD) based on subjective parameters and objective pressure platform analysis (baropodometry).Methods: Twenty-seven adult dogs weighing over 20 kg that were presented with unilateral CCLD and were treated by the TTA (12 dogs) or TPLO (15 dogs) surgical procedure. Patient allocation to either group was based on tibial plateau angle (TPA), according to clinical guidelines (indication for TTA for dogs was a TPA up to 25°, and indication for TPLO was any TPA). Pressure platform analysis was performed prior to surgery and at four different postoperative time points (14, 30, 60 and 90 days).Results: Limb function significantly improved following TTA and TPLO, with no significant differences between groups.Conclusion: The TTA and TPLO surgical procedures were considered to be equally effective in promoting weight bearing capacity recovery in dogs affected with unilateral CCLD under the conditions of this trial.

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.

Comparison of the Effect of Dog, Surgeon and Surgical Procedure Variables on Improvement in Eight-Week Static Weight-Bearing following Tibial Plateau Levelling Osteotomy

2018 ◽  
Vol 31 (06) ◽  
pp. 396-404
Author(s):  
Megan Wilson ◽  
Walter Renberg ◽  
James Roush
Keyword(s):  
Surgical Procedure ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Primary Outcome Measure ◽  
Surgical Experience ◽  
Cranial Cruciate Ligament ◽  
Naturally Occurring ◽  
Cranial Cruciate Ligament Disease ◽  
Meniscal Damage

Objective The purpose of this article was to compare the effect of surgeon and tibial plateau levelling osteotomy (TPLO) procedure variations on the outcome of TPLO in naturally occurring cranial cruciate ligament disease. Materials and Methods Records from 142 dogs that had a TPLO procedure were reviewed for information regarding surgical procedure, status of meniscus at the time of surgery, surgeon identity, ACVS diplomate or resident, meniscal release, progression of healing at the progress evaluation based on radiographic interpretation and complications encountered. The primary outcome measure was static force on the affected limb at re-evaluation (42–84 days postoperatively) on a PetSafe Stance Analyzer. Results Re-evaluation tibial plateau angle (TPA) was negatively and significantly correlated with improvement (r = −0.2132, p = 0.013). Postoperative and re-evaluation TPA were all significantly correlated with one another. The amount of TPA change from initial to immediate postoperative values was significantly correlated with the preoperative TPA (r = 0.628, p < 0.001). Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and preoperative TPA had no significant effect on weight-bearing at recheck. Clinical Significance TPLO show improvement of 4.58% body weight on the affected limb at 6 to 12 weeks rechecks on a Stance Analyzer. Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and initial TPA have no effect on this measurement of surgical outcome.

Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight

2017 ◽  
Vol 30 (04) ◽  
pp. 299-305 ◽  
Author(s):  
Matthew Barnhart ◽  
Shawn Kennedy ◽  
Steven Naber ◽  
Eric Hans
Keyword(s):  
Antibiotic Therapy ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Major Complication ◽  
Surgical Revision ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Major Complications ◽  
One Year ◽  
Cranial Cruciate Ligament Disease

SummaryObjectives: To analyse and compare major complications in dogs ≥50 kg undergoing tibial tuberosity advancement (TTA) or tibial plateau levelling osteotomy (TPLO) for treatment of cranial cruciate ligament disease.Methods: Medical records and radiographs of client-owned dogs (≥50 kg) treated for cranial cruciate ligament disease with either TTA or TPLO between January 2011 and November 2015 were reviewed. Ninety-one TTA cases and 54 TPLO cases met the study inclusion criteria. All complications within one year of surgery were recorded. Major complications were those requiring surgical revision or intervening medical therapy to resolve. Logistic regression analysis evaluated for associations with major complication occurrence. Major complications were statistically compared between TTA and TPLO treatment groups.Results: Incidence of major complications following TTA and TPLO surgery were 19.8% and 27.8%, respectively. Surgical site infection (SSI) was the single most common major complication following both TTA (15.4%) and TPLO (25.9%) surgery. There were no significant differences between TTA and TPLO treatment regarding the rate of SSI, surgical revision, or overall occurrence of major complications. Postoperative antibiotic therapy significantly reduced the risk of a major complication in all dogs ≥50 kg (p = 0.015; OR: 0.201: 95%CI: 0.055–0.737).Clinical significance: Major complications occurred frequently following TTA and TPLO treatment of cranial cruciate ligament disease in dogs ≥50 kg. The increased chance for SSI should be considered and postoperative antibiotic therapy is recommended.

Comparison of Outcome and Complications in Dogs Weighing Less Than 12 kg Undergoing Miniature Tibial Tuberosity Transposition and Advancement versus Extracapsular Stabilization with Tibial Tuberosity Transposition for Cranial Cruciate Ligament Disease with Concomitant Medial Patellar Luxation

2020 ◽  
Author(s):  
Morgan Hackett ◽  
Lindsay St Germaine ◽  
Margaret-Ann Carno ◽  
Daniel Hoffmann
Keyword(s):  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Short Term ◽  
Retrospective Case ◽  
Term Outcome ◽  
Cranial Cruciate Ligament ◽  
Significant Difference ◽  
Case Comparison ◽  
Secondary Objective ◽  
Cranial Cruciate Ligament Disease

Abstract Objective The aim of this study was to describe a technique for performing miniature tibial tuberosity transposition and advancement (mTTTA). The secondary objective of this study was to compare the short-term outcome and complications in small breed dogs weighing less than 12 kg undergoing surgical correction of cranial cruciate ligament disease with concurrent medial patellar luxation via either extracapsular stabilization with tibial tuberosity transposition (ECS + TTT) or mTTTA. Study Design This is a retrospective case comparison study. Results There was no significant difference in overall outcome between the ECS + TTT group and the mTTTA group when comparing 8-week postoperative radiographic healing scores as well as 2- and 8-week postoperative lameness scores. Conclusion This study concluded that the mTTTA procedure was feasible and the overall outcome and complications for the dogs that underwent ECS + TTT and those that underwent mTTTA were comparable.

scholarly journals In dogs weighing under 15 Kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tafara Mapuvire
Keyword(s):  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Research Question ◽  
Tibial Tuberosity ◽  
Clinical Expertise ◽  
Best Interest ◽  
Bottom Line ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

PICO question In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed There were no papers that answered the PICO question Strength of evidence Zero Outcomes reported Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg Conclusion Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient   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.  

scholarly journals Use of castor bean polymer in developing a new technique for tibial tuberosity advancement for cranial cruciate ligament rupture correction in dogs

2016 ◽  
Vol 61 (No. 7) ◽  
pp. 382-388 ◽  
Author(s):  
RM Medeiros ◽  
MAM Silva ◽  
PPM Teixeira ◽  
LGGG Dias ◽  
DG Chung ◽  
...  
Keyword(s):  
Ricinus Communis ◽  
Cruciate Ligament ◽  
The Body ◽  
Tibial Tuberosity ◽  
Osteotomy Site ◽  
Cranial Cruciate Ligament ◽  
Time Points ◽  
Metallic Implants ◽  
A New Technique ◽  
Distal Fixation

The purpose of the current study was to develop a new tibial tuberosity advancement (TTA) technique, by replacing the original titanium cage with a Ricinus communis polyurethane resin-made wedge polymer. The implants were manufactured using the same size and angles of the original titanium cages, though larger distally. The modified TTA technique (TTAm) was performed in 42 knees of 35 dogs diagnosed with rupture of the cranial cruciate ligament (RCCL). Animals were submitted to radiographic and gait assessments preoperatively, early postoperatively and following 30, 60, 90 and 120 days. All animals exhibited good clinical outcome. There were no cases of impaired healing or bone resorption until 120 days postoperatively and there was no patient with patellar distress after TTAm. Scores of gait evaluation revealed differences between time points. There were also differences between the evaluations of control and pre- and post-operative times. However, there was no difference among the assessment of 30 days and the following time points. The use of the polyurethane polymer for TTAm was advantageous, not only due to biocompatibility and osseointegration, but also for providing easy handling; it can be moulded intra-operatively if necessary. Moreover, it allows precise adaptation to the osteotomy site, as opposed to the original TTA metallic implants, which cannot be moulded. It is suggested that incision lengths for TTAm are slightly shorter than those required for the conventional TTA as this requires the distal fixation of the plate at the beginning of the middle third of the body of the tibia. The TTAm does not require the use of fixation plates and it is performed only at the cranial aspect of the tibia. The method of attachment of the tibial tuberosity in the craniocaudal direction was effective. The setting associated with the use of the polyurethane polymer allowed simplification of the technique for easier implementation, and the amount of implant material required to perform TTAm was reduced in comparison to the conventional TTA. This technique can be used for treating the knees of dogs with RCCL, and provides for easy execution, less invasiveness to the tissues of the knee joint and more versatility in comparison to conventional TTA.

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.

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