Extended Long-Term Radiographic Comparison of Tibial Plateau Leveling Osteotomy versus Tibial Tuberosity Advancement for Cranial Cruciate Ligament Rupture in the Dog

Introduction: Our objective was to evaluate extended long-term (≥ 36 months) outcomes of patients who had stifle stabilization surgery by tibial plateau leveling osteotomy (TPLO) or tibial tuberosity advancement (TTA).

Materials and Methods: Medical records were reviewed retrospectively for patients that were > 15 kg and ≥ 3 years postop TPLO or TTA. Follow-up exam and radiographs were performed on dogs meeting the inclusion criteria: 166 stifles (118 dogs), 133 stifles (94 dogs) in the TPLO group and 33 stifles (24 dogs) in the TTA group. Outcomes were assessed by evaluating radiographic OA at 3-time points (0, 8 weeks, and ≥ 3 years) and client questionnaires (canine brief pain inventory [CBPI] and canine orthopedic index [COI]) completed at final follow-up.

Results: Radiographic OA progressed after both procedures over time; however, OA was seen to progress more post-TTA (p = 0.0054) and if bilateral procedures were performed (p = 0.0265). Owner assessment using the CBPI to rate the severity of their dog’s pain and the degree to which that pain interferes with function indicated a better outcome for dogs that had a TPLO. Owner assessment of using the COI to rate their dog’s degree of joint stiffness, function, gait, and overall quality of life indicated a better outcome for dogs those had a TPLO.

Discussion/Conclusion: Osteoarthritis progresses over time after TPLO and TTA but progresses less after a TPLO. Client based outcomes indicate that patients have better function, less pain, and overall better quality of life after TPLO.

Acknowledgment: There was no proprietary interest or funding for this project.