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.

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.

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.

Comparison of Intra- and Postoperative Complications between Bilateral Simultaneous and Staged Tibial Plateau Levelling Osteotomy with Arthroscopy in 176 Cases

2020 ◽  
Author(s):  
Raz Peress ◽  
Sebastian Mejia ◽  
Marcos Unis ◽  
Giovanni Sotgiu ◽  
Simone Dore ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Complication Rate ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Statistical Error ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Significant Difference ◽  
Client Factors

Abstract Objective The aim of this study was to compare the resulting short-term complications after simultaneous (SIM) or staged (ST) tibial plateau levelling osteotomy (TPLO) in patients that presented with bilaterally torn cranial cruciate ligaments. Study Design This was a retrospective study. Materials and Methods Medical records of dogs diagnosed with bilateral cranial cruciate ligament disease that underwent bilateral SIM or ST TPLO surgery with arthroscopy (2005–2015) were reviewed to evaluate the intra- and postoperative complications. Data were analysed and major and minor complications were compared between the two groups. Results A total of 176 client-owned dogs (352 stifles) that had TPLO performed bilaterally with SIM or ST procedures were included for analysis. The overall complication rate was 47.5% for the SIM group and 19.5% for the ST group. The incidence of major complications was 10.1 and 3.8% in the SIM and ST groups respectively. Minor complications were 38.4 and 15.6% in the SIM and ST groups respectively. Tibial tuberosity fractures requiring revision were noted in 2% of the SIM group and none of the ST group. Clinical Significance Although no significant difference was noted in major complication rate or tibial tuberosity fractures in our cohort of patients, a Type II statistical error was found. The complication rate in the SIM group is numerically greater by a factor of 2–3× or more for nearly all categories. Surgeons should consider the risks and benefits of SIM versus ST procedures as well as relevant individual patient and client factors before electing either alternative.

Single-stage bilateral tibial tuberosity advancement for treatment of bilateral canine cranial cruciate ligament deficiency

2015 ◽  
Vol 28 (03) ◽  
pp. 215-219 ◽  
Author(s):  
A. Langenbach ◽  
J. Boim ◽  
S. Gordon ◽  
D. J. Marcellin-Little ◽  
J. E. Kiefer
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Single Stage ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Major Complications ◽  
Increased Risk ◽  
Cranial Cruciate Ligament Rupture

SummaryObjective: To report complications in dogs with naturally occurring cranial cruciate ligament rupture following single-stage bilateral tibial tuberosity advancement (SS-BTTA) procedures, and to compare these complications to a population of dogs undergoing unilateral tibial tuberosity advancement (UTTA).Methods: Medical records and radiographs of client-owned dogs treated with tibial tuberosity advancement between August 2008 and December 2011 were reviewed. Forty-four client-owned dogs with bilateral cranial cruciate ligament rupture that underwent SS-BTTA procedures and 82 client-owned dogs that underwent UTTA proced -ures were randomly selected from our hospital population. Complications were recorded and analysed. Major complications were defined as fractures or any complication requiring a second surgery. Minor complications were any problem identified that did not require surgical management.Results: Incidence for major and minor complications in the UTTA group was 2.3% and 24.4%, respectively. Incidence for major and minor complications in the SS-BTTA group was 12.5% and 26.1%, respectively. Single-stage bilateral tibial tuberosity advancement procedures had a four- to five-fold increase in odds of a major complication (p <0.050) compared to UTTA.Clinical significance: The findings of our study indicate that SS-BTTA procedures are associated with an increased risk of major complications compared to UTTA procedures.

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.

The Modified Maquet Procedure (MMP) in Dogs: Technical Development and Initial Clinical Experience

2016 ◽  
Vol 52 (4) ◽  
pp. 242-250 ◽  
Author(s):  
Malcolm Graham Ness
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Radiographic Examination ◽  
Computer Assisted ◽  
Clinical Report ◽  
Modified Technique ◽  
Cranial Cruciate Ligament ◽  
Titanium Foam

ABSTRACT The literature about tibial tuberosity advancement surgery in dogs and humans informed the development of a version of the operation using a wedge-shaped implant of titanium foam. Computer-assisted drawing and stereolithography was used to create instruments and implants that were evaluated by cadaver surgery. A trial, involving 26 client-owned dogs with lameness due to cranial cruciate ligament failure, was started. Follow-up was done by clinical and radiographic examination after 4 wk and clinical examination again 6–11 mo after surgery. The titanium foam implant maintained tibial tuberosity advancement easily and effectively. The same major complication occurred in 2 of the first 6 cases before, a slightly modified technique was used to treat 20 dogs without complication. At mid-term follow-up (6–11 mo), 20/26 dogs (77%) had returned to full function, two dogs (7.7%) had acceptable function, two dogs (7.7%) could not be evaluated due to recent contra lateral modified Maquet procedure surgery, and two (7.7%) dogs had died for reasons unrelated to the study. This is the first clinical report of the use of titanium foam in veterinary orthopaedics. Modified Maquet procedure appears to be an effective treatment for lameness due to failure of the cranial cruciate ligament in dogs.

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.  

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.

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