Effect of tibial plateau levelling osteotomy and rehabilitation on muscle function in cruciate-deficient dogs evaluated with acoustic myography

2021 ◽  
pp. 1-12
Author(s):  
G.M. Varcoe ◽  
J.M. Manfredi ◽  
A. Jackson ◽  
J.E. Tomlinson
Keyword(s):  
Repeated Measures ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Spatial Summation ◽  
Biceps Femoris ◽  
Rehabilitation Program ◽  
Thigh Circumference ◽  
Cranial Cruciate Ligament ◽  
Time Points ◽  
Acoustic Myography

The objective of the study was to determine the function of the biceps femoris, quadriceps, gastrocnemius and semitendinosus muscles at the walk in dogs with unilateral clinical cruciate disease and palpable joint instability. To compare function before and after a tibial plateau levelling osteotomy (TPLO) procedure, and after six weeks of subsequent rehabilitation therapy. Fourteen adult client-owned dogs with cranial cruciate ligament deficiency (CCLD). Orthopaedic examination, temporospatial gait analysis and acoustic myography (AMG) recordings were made at three time points: before TPLO, and post-operatively at two and eight weeks. A rehabilitation program started 2 weeks after surgery and was either in-clinic along with in-home rehabilitation or in-home only. Statistics included: repeated measures ANOVA and paired t-tests. Significance was set at P<0.05. When comparing the affected versus the unaffected limb in the CCLD dogs, there were no significant differences found in AMG values between baseline and other time points for the quadriceps and semitendinosus muscles. The gastrocnemius and biceps femoris muscles had a significant change in spatial summation (S) score over time. The gastrocnemius (S) score was not significantly different to the unaffected limb by 8 weeks post TPLO. There was no significant effect of rehabilitation method on S score. Dogs with in-clinic rehabilitation regained more symmetry in thigh circumference versus in-home only. Lameness parameters improved but did not completely resolve in all dogs by week 8 post TPLO. The function of the gastrocnemius muscles in affected limbs was significantly different to normal limbs at baseline and 2 weeks post TPLO but not at 8 weeks. Thigh symmetry, but no other parameters, was improved with the addition of in-clinic rehabilitation.

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.

Reducing susceptibility artefacts in magnetic resonance images of the canine stifle following surgery for cranial cruciate ligament deficiency

2012 ◽  
Vol 25 (06) ◽  
pp. 488-497 ◽  
Author(s):  
J. Grierson ◽  
C. R. Lamb ◽  
F. H. David
Keyword(s):  
Magnetic Resonance ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Magnetic Resonance Images ◽  
Proton Density ◽  
Mr Images ◽  
Cranial Cruciate Ligament ◽  
Metallic Implants ◽  
Image Ranking ◽  
Canine Stifle

SummaryBackground: Magnetic resonance (MR) images of the postoperative canine stifle are adversely affected by susceptibility artefacts associated with metallic implants.Objectives: To determine empirically to what extent susceptibility artefacts could be reduced by modifications to MR technique.Methods: Three cadaveric limbs with a tibial plateau levelling osteotomy (TPLO), tibial tuberosity advancement (TTA), or extra-capsular stabilization (ECS) implant, respectively, were imaged at 1.5T. Series of proton density and T2-weighted images were acquired with different combinations of frequency-encoding gradient (FEG) direction and polarity, stifle flexion or extension, echo spacing (ES), and readout bandwidth (ROBW), and ranked. The highest rank (a rank of 1) corresponded to the smallest artefact.Results: Image ranking was affected by FEG polarity (p = 0.005), stifle flexion (p = 0.01), and ROBW (p = 0.0001). For TPLO and TTA implants, the highest ranked images were obtained with the stifle flexed, lateromedial FEG, and medial polarity for dorsal images, and craniocaudal FEG and caudal polarity for sagittal images. For the ECS implant, the highest ranked images were obtained with the stifle extended, a proximodistal FEG and proximal polarity for dorsal images, and craniocaudal FEG and cranial polarity for sagittal images.Clinical significance: Susceptibility artefacts in MR images of postoperative canine stifles do not preclude clinical evaluation of joints with ECS or TTA implants.Part of this study was presented at the Annual Meeting of the American College of Veterinary Radiology, Albuquerque, NM, October 2011.

Measurement of the tibial plateau angle in cats with and without cranial cruciate ligament rupture

2009 ◽  
Vol 22 (02) ◽  
pp. 83-86 ◽  
Author(s):  
S. Reese ◽  
K. Lorinson ◽  
D. Lorinson ◽  
E. Schnabl
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Inter Observer Variability ◽  
Measurement Results ◽  
Cranial Cruciate Ligament Rupture

SummaryThe objective of the present study was to determine the tibial plateau angle (TPA) in cats without stifle pathology and to compare it with cats suffering from an isolated cranial cruciate ligament rupture. Mediolateral radiographs of the stifle were taken and the tibial plateau angle was measured based on the method previously described by Slocum and Devine (1983) for dogs. Three observers with different levels of experience evaluated the radiographs of all of the cats in this study. The mean tibial plateau angle measured by all three observers in the cats with a rupture of the cranial cruciate ligament (CCL) was 3.1° greater than in cats without stifle pathology. Neither gender, age, body weight nor degenerative joint disease had an influence on measurement results. The authors found an inter-observer variability of ± 5.3°. Hence it can be concluded that cats with cranial cruciate ligament rupture have a greater TPA, and this at least lends some credence to the possibility of higher TPA being a predis-posing factor for cruciate injury in this species.

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.

scholarly journals Biomechanical Effects of Tibial Plateau Levelling Osteotomy on Joint Instability in Normal Canine Stifles: An In Vitro Study

2020 ◽  
Vol 33 (05) ◽  
pp. 301-307
Author(s):  
Masakazu Shimada ◽  
Tetsuya Takagi ◽  
Nobuo Kanno ◽  
Satoshi Yamakawa ◽  
Hiromichi Fujie ◽  
...  
Keyword(s):  
Joint Instability ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Biomechanical Testing ◽  
In Vitro Study ◽  
Axial Rotation ◽  
Testing System ◽  
Compression Tests ◽  
Cranial Cruciate Ligament

Abstract Objective The aim of the study was to determine the changes in biomechanical characteristics following tibial plateau levelling osteotomy (TPLO) using simulated manual tests. Study Design Twenty-one stifles from healthy Beagle dogs that had undergone TPLO or had not (control) were first tested in the intact form, and then the cranial cruciate ligament (CrCL) was transected in each to provide four test situations: control-intact, control-CrCL-transected, TPLO-intact and TPLO-CrCL-transected. The stifles were then analysed using a robotic joint biomechanical testing system. The craniocaudal drawer, axial rotation and proximal compression tests were applied. Results The craniocaudal displacement during the drawer test was not significantly different between the control-intact and TPLO-intact. However, the displacement was significantly greater in the TPLO-CrCL-transected than in the control-intact. In the axial rotation test, the internal–external (IE) rotation was significantly greater in the TPLO-intact than in the control-intact. Similarly, the IE rotation was significantly greater in the TPLO-CrCL-transected than in the control-CrCL-transected. In the proximal compression test, craniocaudal displacement was not significantly different among the control-intact, TPLO-intact and TPLO-CrCL-transected. Conclusion These findings suggest that TPLO influences the tension of the collateral ligaments and might generate laxity of the tibiofemoral joint. Instability after the osteotomy might be associated with the progression of osteoarthritis.

Histiocytic sarcoma of the stifle in a dog with cranial cruciate ligament failure and TPLO treatment

2008 ◽  
Vol 21 (04) ◽  
pp. 375-377 ◽  
Author(s):  
E. Simko ◽  
G. Harasen
Keyword(s):  
Tibial Plateau ◽  
Soft Tissue Mass ◽  
Cruciate Ligament ◽  
Histiocytic Sarcoma ◽  
Tissue Mass ◽  
Cranial Cruciate Ligament ◽  
Chronic Synovitis ◽  
Previously Treated ◽  
Ligament Failure ◽  
The Right

SummaryA 10-year-old spayed female Golden Retriever was admitted with chronic lameness of the right hind limb. A tibial plateau leveling osteotomy (TPLO) had been performed on this leg approximately three years previously. A progressively growing soft tissue mass, affecting the right stifle, previously treated with TPLO was biopsied and found to be a histiocytic sarcoma. Previously proposed links between the development of neoplasia in the stifle region and the presence of chronic synovitis, osteotomy, orthopaedic implants, and specifically the Slocum TPLO plate, are briefly discussed.

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