• Title/Summary/Keyword: Tibial plateau leveling osteotomy

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Influence of Plate Design on the Accuracy of Tibial Alignment after Center of Rotation of Angulation-Based Leveling Osteotomy in Toy-Breed Dogs

  • Han, Jae-Hong;Lee, Hae-Beom;Jeong, Jae-Min;Jeon, Young-Jin;Roh, Yoon-Ho
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.100-106
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    • 2022
  • The center of rotation of angulation-based leveling osteotomy (CBLO) has been introduced for the stabilization of cranial cruciate ligament rupture (CCLR) in small-breed dogs. This technique can be applied to the tibia without damaging its tuberosity. Although different designs of CBLO plates are available, tibial plateau leveling osteotomy (TPLO) plates have been still used for stabilization during CBLO. To the best of our knowledge, no studies have reported the effects of TPLO plates on the postoperative limb alignment after CBLO. Therefore, the present study (January 2020 to February 2021) aimed to compare the postoperative outcomes (postoperative tibial plateau angle [TPA] and tibial alignment) in patients receiving CBLO and TPLO plates during CBLO. Paired stifle joints (n = 16) were obtained from eight toy-breed cadaver dogs (mean weight, 4.4 kg) that underwent CBLO. The joints were randomly assigned to receive the CBLO (CBLO group) or TPLO plates (TPLO group). Pre-and postoperative radiographs were obtained, and the dissected tibiae were evaluated. The following postoperative parameters were compared to evaluate the surgical outcome: TPA, osteotomy location, mechanical medial proximal tibia angle, inter-segment gap, and tibial plateau translation. No significant differences were found in the postoperative alignment between the two groups. Therefore, TPLO plates may be considered as a viable alternative in toy-breed dogs undergoing CBLO.

Tibial Plateau Leveling Osteotomy Combined with Tibial Tuberosity Transposition in a Dog with Medial Patellar Luxation and Cranial Cruciate Ligament Rupture

  • Kim, Ji-hye;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.366-369
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    • 2017
  • A 30 kg, 6-year-old spayed female Samoyed dog was referred with a history of intermittent weight-bearing lameness in her right hindlimb for 3 weeks. The patient hadsurgery to correct a medial patellar luxation in the same limb 3 years prior. Based on the physical examination and radiographic findings, MPL and CCLR of the right hindlimb were diagnosed. Pre-surgical arthroscopy examination was performed, revealing a complete rupture of the cranial cruciate ligament, medial caudal meniscal tears and fibrotic cartilagechanges on the trochlear groove. An arthroscopy-assisted partial meniscectomy was used to repair themedial caudal meniscus. To correct the tibial plateau angle and medial patellar luxation, a tibial plateau leveling osteotomy (TPLO) was performed. A tibial tuberosity transposition (TTT) was performed to realignthe quadriceps mechanism with the trochlear block recession followed by soft tissue reconstruction. The post-surgical recovery was uneventful, and the patient was weight-bearing with normal ambulation on the repaired limb. There were no complications, and the implants were well positioned at the last follow-up. The clinical outcome of the caseindicates that combining TPLO with TTTis a good surgical option for treatingconcurrent CCLR and MPL.

Radiographic Comparison of Cranial Tibial Wedge Osteotomy versus Tibial Plateau Leveling Osteotomy: A Cadaveric Study

  • Lee, Jiyoon;Kim, Dongwook;Oh, Hyejong;Lee, Sungin;Choi, Seok Hwa;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.93-99
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    • 2022
  • The present study was performed to compare cranial tibial wedge osteotomy (CTWO) and tibial plateau leveling osteotomy (TPLO) through radiographic evaluation. The experiment was conducted with five cadaver dogs [mean (± SD) weight, 32.9 ± 4.1 kg; mean (± SD) age, 6 ± 2 years; three males and two females] euthanized for reasons unrelated to this study. The cadaver dogs consisted of German Shepherd (n = 3), Belgian Malinois (n = 1), and mixed breed (n = 1). CTWO and TPLO were carried out by the standard surgical method. Radiographic evaluation was performed by comparing several factors, including the flexion and extension angles, the anatomical mechanical axis angle (AMA-angle), tibial length, patellar height measurement using the Labelle-Laurin method, mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), and frontal plane alignment (FPA). Both the CTWO and the TPLO groups showed significantly increased flexion angles after surgery. Only the CTWO group had significantly increased extension angle. Although both groups showed significant decreases in the AMA-angle, the mechanical axis moved cranially against the anatomical axis only in the CTWO group. The patellar height was significantly lowered in the CTWO group. No significant differences were found in mMPTA, mMDTA, or FPA. In conclusion, radiographic comparison revealed more changes in CTWO group than in TPLO group.

Effects of Osteotomy Angle on Tibial Angulation and Torsion During CORA-Based Leveling Osteotomy in Toy Breed Dogs: A Computer Modeling-Based Study

  • Jeong, Youngeun;Jeong, Jaemin;Cho, Cheongwoon;Jeong, SeongMok;Lee, Hae Beom
    • Journal of Veterinary Clinics
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    • v.37 no.4
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    • pp.175-179
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    • 2020
  • The objective of this study was to determine the effect of osteotomy angle and tibial proximal segment rotation angle on angular and torsional tibial deformities and to assess the trends of these deformities during the rotation of the tibial proximal segment in a center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) by performing computer modeling of the tibia. Four tibias of toy breed dogs with no history of lameness were used in this study. Osteotomies were performed in the proximal tibias at angles of 0°, 10°, 20°, -10°, and -20°, perpendicular to either the proximodistal or craniocaudal tibial axes. The mechanical medial proximal tibial angle (mMPTA) and transcondylar (TC) and distal cranial tibial (CnT) axes were used to measure angular and torsional deformities, respectively. All tibias showed an increase in angular and rotational deformities with an increase in the tibial plateau rotation angle. The tibia with osteotomies performed in the proximodistal and craniocaudal directions showed the highest magnitude of torsional and angular deformities, respectively. The results of this study revealed a tendency of occurrence of angular and torsional deformities with osteotomy performed along the proximodistal and craniocaudal directions in the CBLO.

Tibial Plateau Leveling Osteotomy for Treatment of Naturally Occurring Cranial Cruciate Ligament Rupture in Small Breed Dogs - Case Series (소형견에서 전 십자인대 단열의 치료를 위한 경골 고평부 평탄 골절단술의 평가)

  • Kim, Choong-Sup;Heo, Su-Young;Kim, Min-Su;Kim, Nam-Soo;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.483-489
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    • 2014
  • This study describes a surgical technique and evaluates the clinical outcomes in small breed dogs with cranial cruciate ligament rupture (CCLR) treated with tibial plateau leveling osteotomy (TPLO). Seven skeletally mature dogs weighing less than 15 kg underwent unilateral TPLO to stabilize the stifle joint with CCLR. Clinical evaluation was performed via visual lameness score, range of motion (ROM), and thigh girth circumference (TC). Postoperative complications were recorded. All patients reached a grade 1 score at 1 week and grade 0 at 8 weeks postoperatively. The mean operated limb extension angle was 98.11%, 99.07%, and 98.73% of the mean extension angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean operated limb flexion angle was 98.07%, 95.88%, and 96.35% of the mean flexion angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean TC of the operated limb was 92.95%, 93.68%, and 95.44% of the mean TC of the normal limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. Our outcomes for TPLO in small breed dogs are not worse than those previously reported for large breed dogs. Based on the result in the present study, CCLR in small dogs can be successfully managed with TPLO, as done in large breed dogs.

Scintigraphic Evaluation of Dogs with Experimentally Transected Cranial Cruciate Ligaments Treated Using Tibial Plateau Leveling Osteotomy (실험적으로 전십자 인대를 단열한 개에서 TPLO의 핵의학적 평가)

  • Lee Jae yeong;Kim Joong-hyun;Lee Won guk;Kang Seong soo;Bae Chun sik;Choi Seok hwa
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.21-25
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    • 2005
  • This study was performed to assess therapeutic effect of the tibial plateau leveling osteotomy (TPLO) in dogs with experimentally transected cranial cruciate ligaments (CrCL). Nine healthy adult Beagle dogs were transected left CrCL under general anesthesia. The dogs were assigned to TPLO and non-TPLO control groups. The TPLO procedures for correcting the CrCL rupture in the left stifle of dogs were performed under sterile conditions. Before TPLO procedures, all dogs were screened by orthopedic and radiographic examinations. Dogs were lameness free for the previous three months, and when examined at the walk and trot on a hard surface, in a straight line and on a circle. Lateral and craniocaudal radiographs were done to confirm the soundness of the both knee joint in dogs and not detectable lesions were diagnosed. The dogs were intravenously injected with a 10 mci/kg of 99mTechnetium-methylene diphosphonate (99mTc-MDP) under general anesthesia. Scintigraphs were obtained using a large field of view gamma camera equipped a parallel-hole, low-energy about 3 hours after intravenous injection of 99mTc-MDP. Before CrCL transection and 4, 8, and 12 weeks after the procedures, scintigraphy were conducted. Bone uptake of the left stifle joint increased after the procedures in all dogs. When the bone uptake from the TPLO procedure was compared with that of the control, there was a significant difference (p < 0.05). At 12 weeks after the TPLO procedure, the dogs showed normal anatomical posture and gait. It is concluded that TPLO procedure was effective in reconstruct of the stifle joint in dogs with CrCL rupture.