• Journal of Veterinary Clinics
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• v.18 no.2
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• pp.160-163
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• 2001

A 8 months old female dog with the combination of a fracture of the proximal tibia (Salter-Harris type I) with an avulsion of the tibial tuberosity was repaired with cross intramedullary pin for proximal tibial physeal fracture, and intramedullary pin combined with tension band wire for avulsion fracture of tibial tuberosity, resulted in complete healing. At 45 days after operation, on the radiological views, there was premature closure of growth plate of proximal tibia and tibial tuberosity, but at 7 months no developing growing deformities.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.420-426
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• 2018

Background: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. Methods: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. Results: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, $7.9^{\circ}$ vs. $-0.81^{\circ}$). Conclusions: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.

• Journal of Veterinary Science
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• v.21 no.4
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• pp.67.1-67.11
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• 2020

Background: Tibial tuberosity transposition (TTT) causes caudalization of the patellar ligament insertion in canine medial patellar luxation, which can lead to increases in patellofemoral contact pressure. Objectives: The purpose of this study is to confirm the effect of patellofemoral contact mechanics after craniolateral and caudolateral transposition of tibial tuberosity in normal canine hindlimbs. Methods: Craniolateral and caudolateral transposition of tibial tuberosity was performed in 5 specimens, respectively. The pressure was measured in the specimen before TTT, and then in the same specimen after TTT. In this process, data was obtained in 10 specimens. The measurement results were output as visualization data through the manufacturer's software and numerical data through spreadsheet. Based on these 2 data and the anatomical structure of the patellofemoral joint (PFJ) surface, whole measurement area was analysed by dividing into medial, lateral and central area. Results: In craniolateralization of tibial tuberosity, total, medial, central contact pressure was decreased and lateral contact pressure was not statistically changed lateral contact pressure than normal PFJ. In caudolateralization of tibial tuberosity, total, lateral contact pressure was increased and medial contact pressure was not statistically changed than normal PFJ. Although not statistically significant changed, central contact pressure in caudolateralization of tibial tuberosity was increased in all 5 specimens. Conclusions: These results imply that traditional TTT, prone to caudal shift of patellar tendon, can increase retropatellar pressure may lead to various complications and diseases of the stifle joint.

• Korean Journal of Veterinary Research
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• v.63 no.3
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• pp.24.1-24.6
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• 2023

This study compared the biomechanical properties of bone-stapling techniques with those of other fixation methods used for stabilizing tibial tuberosity fractures using 3-dimensionally (3D)-printed canine bone models. Twenty-eight 3D-printed bone models made from computed tomography scan files were used. Tibial tuberosity fractures were simulated using osteotomy. All samples were divided into 4 groups. Group 1 was stabilized with a pin and tension-band wire; group 2, with a pin and an 8 mm-wide bone staple; group 3, with 2 horizontally aligned pins and an 8 mm-wide bone staple; and group 4 with a 10 mm-wide bone staple. Tensile force was applied with vertical distraction until failure occurred. The load and displacement were recorded during the tests. The groups were compared based on the load required to cause displacements of 1, 2, and 3 mm. The maximum failure loads and modes were recorded. The loads at all displacements in group 4 were greater than those in groups 1, 2, and 3. The loads at 1, 2, and 3 mm displacements were similar in groups 1 and 3. There was no significant difference between groups 1 and 3. Groups 1 and 4 provided greater maximum failure loads than groups 2 and 3. Failure occurred because of tearing of the nylon rope, tibial fracture, wire breakage, pin bending, and fracture around the bone staple insertion. In conclusion, these results demonstrate that the bone-stapling technique is an acceptable alternative to tension-band wire fixation for the stabilization of tibial tuberosity fractures in canine bone models.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.11-14
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• 2014

This is a retrospective study describing postoperative complication encountered with surgery performed in dogs with medial patellar luxation (MPL). During the 4-year period, 77 operations had been performed in 66 dogs for correction of MPL. The patients were surgically treated with medial soft tissue release, lateral soft tissue tightening, trochlear block recession, and/or tibial tuberosity transposition (TTT). Their prognoses were periodically evaluated for 6 months postoperatively. The failure rate was higher in revision surgery than in the first surgery, and the most common postoperative complication was migration of the tibial tuberosity fragment. The causes for the migration of the tibial tuberosity fragment were identified as the downward insertion of a surgical pin, the eccentric position of an inserted pin in the tibial tuberosity fragment, and blunt angle formation of the tibial tuberosity. It is suggested that the appropriate methods for TTT could minimize complications and lead to a good prognosis.

• 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.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.133-136
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• 2014

An 8 kg, 9-month-old castrated male Shiba Inu presented with a history of intermittent bilateral hind limb lameness. On examination, grade III medial patellar luxation of the bilateral hind limbs was diagnosed. A novel surgical method involving relatively noninvasive tibial tuberosity transposition was used to restore normal alignment of the quadriceps mechanism. The procedure involved an incision on the medial cortical bone of the tibial tuberosity along the tibial crest and placement of a cortical screw on the medial side of the tibial crest to laterally transpose the tibial tuberosity. Lameness and patellar luxation of bilateral hind limbs were improved at a 3-month postoperative examination. This technique could be considered an effective treatment for medial patellar luxation in skeletal immature patients.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.11a
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• pp.83-83
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• 2006

• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.282-284
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• 2019

A 8-year-old, intact female, 2.1 kg, yorkshire terrier dog was referred to Animal Medical Center, Chonbuk National University due to right hindlimb lameness. Orthopedic examinations revealed pain during extension and flexion on stifle joint, positive cranial drawer sign, positive tibial compression test and patella luxation. Radiography showed the cranial displacement of right tibia with mildly increasing the synovial volume. The surgical procedure involved radial osteotomy of the proximal tibia and fixation by 1.2 T-locking plate. At two weeks after surgery, the patient was able to weight-bearing and gait gradually improved. This case report describes circular Tibial Tuberosity Advancement (cTTA) surgical technique and the successful surgical repair of cranial cruciate ligament rupture a dog.

• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.285-288
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• 2019

A 5-year-old 6 kg male mongrel (case 1) and a 7-year-old 4.3 kg male yorkshire terrier (case 2) were presented to Chonbuk animal medical center (CAMC). Both animals had non-weight bearing hind limb lameness. Case 1 had complete rupture of cranial cruciate ligament with grade 3 medial patellar luxation. Case 2 had complete cranial cruciate ligament rupture with grade 4 medial patellar luxation. During surgery, in both cases, trochlear block recession was performed followed by CORA based leveling osteotomy (CBLO) and tibial tuberosity transposition (TTT). General soft tissue reconstructions for medial patellar luxation including medial releasing and lateral imbrication were also performed. Postoperatively, both animals demonstrated excellent recovery and regained normal weight bearing of the affected hind limb without any recognizable complication. CBLO followed by TTT can be a curative surgical option without complications in cases of cranial cruciate ligament rupture with high-grade medial patellar luxation in small breed dogs.