• Title/Summary/Keyword: tibial plateau angle

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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.

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.

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.

Measurement of the Tibial Plateau Angle in Normal Small Breed Dogs (정상 소형 견에서 경골 고평부각의 측정)

  • Kim, Choong-sup;Heo, Su-Young;Seol, Jae-Won;Kim, Min-Su;Lee, Sang-Hoon;Kim, Nam-Soo;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.231-234
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    • 2015
  • This study measured the tibial plateau angle (TPA), a value that predicts cranial cruciate ligament rupture (CCLR) and a prerequisite for dynamic stabilization, in small breed dogs. The cadavers of 32 skeletally mature small breed dogs without CCLR were used to measure TPA. Differences were evaluated between males and females, left and right limbs, and among breeds. The mean TPA of all dogs was $26.13^{\circ}{\pm}2.33^{\circ}$. The mean TPAs of left and right limbs were $26.00^{\circ}{\pm}2.23^{\circ}$ and $26.26^{\circ}{\pm}2.45^{\circ}$, respectively, which was not a significant difference. The mean TPAs of male and female dogs were $26.01^{\circ}{\pm}1.57^{\circ}$ and $26^{\circ}.22{\pm}2.80^{\circ}$, respectively, which was also not significant difference. The mean TPAs in Maltese, Poodle, Shih Tzu, and Yorkshire terrier were $26.06^{\circ}{\pm}2.96^{\circ}$, $25.21^{\circ}{\pm}1.38^{\circ}$, $26.65^{\circ}{\pm}2.96^{\circ}$, and $26.27^{\circ}{\pm}1.61^{\circ}$, respectively. Differences in these means were not statistically significant. The TPA measured from this study could provide important information for further investigation of the pathogenesis of and surgical techniques for CCLR in small breed dogs.

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.

A Deep Neural Network Technique for Automatic Measurement of Tibial Plateau Angle from Animal X-ray Images (동물 X-ray 영상에서 경골고원각도 자동 검출을 위한 심층신경망 기법 )

  • Jimin Kim;Hyungkyu Kim;Jeonghyeon Ryu;Sunju Lee;Hojoon Kim
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.11a
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    • pp.579-580
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    • 2023
  • 본 논문에서는 동물의 십자인대 질환의 진단지표인 경골고원각도(TPA)를 자동으로 측정하는 딥러닝 소프트웨어 기법을 제안한다. 동물 X-ray 영상에서 나타나는 피사체의 위치와 형태에 대한 다양한 변이는 TPA(Tibial Plateau Angle) 지표 산출에 필요한 특징점 검출과정에서 학습 효율을 현저하게 저하시킨다. 이에 본 연구에서는 YOLO(You Only Look Once) 기반 모델을 사용하여 일차적으로 경골영역의 분할 단계를 수행하고, 이어서 경골 상단부의 과간융기와 복사뼈의 중심점을 찾는 과정을 Resnet 기반의 특징점 추출 모듈로서 구현함으로써 학습의 효율과 지표 검출의 정확도를 향상시켰다. 총 201 개의 실제 X-ray 영상을 사용하여 학습 속도와 영역 분할 및 특징점 추출의 정확도 측면을 고려함으로 제안된 이론의 타당성을 실험적으로 평가하였다.

Does Coronal Knee and Ankle Alignment Affect Recurrence of the Varus Deformity after High Tibial Osteotomy?

  • Lee, O-Sung;Lee, Seung Hoon;Lee, Yong Seuk
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.311-318
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    • 2018
  • Purpose: The purpose of this study was to evaluate changes in the coronal alignment of the knee and ankle joints after open wedge high tibial osteotomy (OWHTO) to determine factors related to the recurrence (R) of the varus deformity by serial analysis. Materials and Methods: Sixty-four OWHTOs were enrolled in this study. The weight bearing line (WBL) ratio, joint line convergence angle (JLCA), knee joint inclination, mechanical axis-tibial plateau angle, talar inclination (TI), and distal tibia articular angle (DTAA) were serially assessed. Serial correlation analysis between all parameters was performed. Patients were divided into R group and no recurrence (NR) group according to the WBL ratio (55%) at postoperative one year. Results: The preoperative WBL ratio showed significantly negative correlation with serial changes of JLCA, TI, and DTAA (p<0.05). The JLCA, TI, and DTAA as well as WBL ratio showed a significantly larger degree of varus alignment in the R group than in NR group at postoperative 6 weeks and 1 year after OWHTO (p<0.05). Conclusions: Sufficient correction of the WBL and restoration of the JLCA during OWHTO are essential to prevention of the R of varus deformity after the surgery because they are the only modifiable factors during surgery. Level of Evidence: IV, Case series.

Triple Tibial Osteotomy (TTO) for Treatment of Cranial Cruciate Ligament Rupture in Small Breed Dogs

  • Kim, Tae-Hwan;Hong, Subin;Moon, Heesup;Shin, Jeong-In;Jang, Yun-Sul;Choi, Hyeonjong;Kim, In-Geun;Lee, Jae-hoon
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.7-12
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    • 2017
  • Twelve dogs weighing less than 10 kg underwent unilateral TTO to stabilize the stifle joint with cranial cruciate ligament rupture. Surgical findings, intra-operative and post-operative complications were recorded. Radiographic examinations were performed for 8 weeks following surgery. Postoperative outcome was evaluated using a visual analogue lameness scoring system. Mean preoperative PTA (the angle created by the intersection of the tibial plateau extrapolation line and the patellar tendon) was 103.8 degrees. Mean tibial wedge angle was 16.6 degrees. Mean postoperative PTA was 92.1 degrees. Intraoperatively, fracture through the caudal tibial cortex occurred in all dogs, through the distal tibial crest cortex in 2 dogs, through the lateral tibial cortex in 2 dogs and through the fibula in 1 dog. Four-week postoperative radiographs demonstrated evidence of progressive bone union at osteotomy site and complete unions were identified at 8 week in 10 dogs. All dogs were healed in 11 weeks. Most of dogs revealed weak lameness in 4 weeks and normal ambulation in 8 weeks postoperatively except for only one dog returned in 11 weeks. Despite frequent minor complication, it appears that the TTO is an alternative procedure for management of cranial cruciate ligament rupture in small breed dogs.

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.