Evaluation of Surgical Technique and Clinical Results of a Procedure-Specific Fixation Method for Tibial Tuberosity Transposition in Dogs: 37 Cases

Abstract

Objective The aim of this study was to describe the use of a procedure-specific fixation method for tibial tuberosity transposition and report clinical outcome.

Study Design This is a multi-institutional case series, evaluating 37 cases that were treated surgically for medial patellar luxation (MPL) and in which the tibial tuberosity transposition (TTT) was performed using the Rapid Luxation Plating System (RLPS). Surgical technique, implants, clinical outcome, and complications are reported.

Results Surgery was successfully performed in dogs weighing 2.5 to 36.2 kg. Postoperative minor complications occurred in 13 cases (35%) and major complications occurred in 3 cases (8%). No implant-related complications or tibial tuberosity avulsions or fractures were seen. Outcome related to surgery was good or excellent in all cases.

Conclusion The RLPS for TTT provides a feasible technique in a large range of patients with MPL and lowers the occurrence of implant-related complications and tibial tuberosity avulsion or fracture.

Keywords

rapid luxation plating system - tibial tuberosity transposition - medial patellar luxation - dog - implant

Authors' Contribution

D.O., J.E., E.W. and D.S. contributed to the conception, study design, acquisition of data, data analysis and interpretation. K.B-S. contributed to acquisition of data, data analysis and interpretation. J.C.M.V. contributed to study design, data analysis and interpretation. B.P.M. contributed to conception, study design, data analysis and interpretation. All authors drafted, revised, and approved the submitted manuscript and are publicly responsible for the relevant content.

Publikationsverlauf

Eingereicht: 10. Juni 2022

Angenommen: 15. Mai 2023

Artikel online veröffentlicht:
19. Juni 2023

• References

• 1 Ness MG, Abercromby RH, May C, Turner BM, Carmichael S. A survey of orthopaedic conditions in small animal veterinary practice in Britain. Vet Comp Orthop Traumatol 1996; 09 (02) 43-52
• 2 Johnson JA, Austin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994; 07 (02) 56-69
• 3 Perry KL, Déjardin LM. Canine medial patellar luxation. J Small Anim Pract 2021; 62 (05) 315-335
• 4 Kowaleski MP, Boudrieau RJ, Pozzi A. Stifle joint. In: Johnston Spencer A, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd ed.. Philadelphia, PA: Elsevier Saunders; 2017: 1141-1159
• 5 Arthurs GI, Langley-Hobbs SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 2006; 35 (06) 559-566
• 6 Rossanese M, German AJ, Comerford E, Pettitt R, Tomlinson A, de Vicente F. Complications following surgical correction of medial patellar luxation in small-to-medium-size dogs. Vet Comp Orthop Traumatol 2019; 32 (04) 332-340
• 7 Dokic Z, Lorinson D, Weigel JP, Vezzoni A. Patellar groove replacement in patellar luxation with severe femoro-patellar osteoarthritis. Vet Comp Orthop Traumatol 2015; 28 (02) 124-130
• 8 Brower BE, Kowaleski MP, Peruski AM. et al. Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2017; 30 (01) 20-27
• 9 Swiderski JK, Palmer RH. Long-term outcome of distal femoral osteotomy for treatment of combined distal femoral varus and medial patellar luxation: 12 cases (1999-2004). J Am Vet Med Assoc 2007; 231 (07) 1070-1075
• 10 Fullagar BA, Rajala-Schultz P, Hettlich BF. Comparison of complication rates of unilateral, staged bilateral, and single-session bilateral surgery for the treatment of bilateral medial patellar luxation in dogs. Can Vet J 2017; 58 (01) 39-44
• 11 Gallegos J, Unis M, Roush JK, Agulian L. Postoperative complications and short-term outcome following single-session bilateral corrective surgery for medial patellar luxation in dogs weighing <15 kg: 50 cases (2009-2014). Vet Surg 2016; 45 (07) 887-892
• 12 Sanders LB, Bevan JM. Comparison of short-term complications between unilateral and single-session bilateral surgery for medial patellar luxation in small/medium breed dogs. J Small Anim Pract 2019; 60 (01) 51-57
• 13 Cashmore RG, Havlicek M, Perkins NR. et al. Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. Vet Comp Orthop Traumatol 2014; 27 (04) 263-270
• 14 Linney WR, Hammer DL, Shott S. Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998-2009). J Am Vet Med Assoc 2011; 238 (09) 1168-1172
• 15 Roush JK. Canine patellar luxation. Vet Clin North Am Small Anim Pract 1993; 23 (04) 855-868
• 16 Wangdee C, Theyse LFH, Techakumphu M, Soontornvipart K, Hazewinkel HA. Evaluation of surgical treatment of medial patellar luxation in Pomeranian dogs. Vet Comp Orthop Traumatol 2013; 26 (06) 435-439
• 17 Towle HA, Griffon DJ, Thomas MW, Siegel AM, Dunning D, Johnson A. Pre- and postoperative radiographic and computed tomographic evaluation of dogs with medial patellar luxation. Vet Surg 2005; 34 (03) 265-272
• 18 Talcott KW, Goring R, de Haan J. Rectangular recession trochleoplasty tor treatment of patellar luxation in dogs and cats. Vet Comp Orthop Traumatol 2000; 13: 39-43
• 19 Rita Leibinger GmbH & Co. KG. Muhlheim an der Donau. Rapid Luxation Technique. Accessed May 30, 2023 at: https://leibinger.vet/patella-luxation/rapid-luxation-technique/
• 20 Hercock CA, Pinchbeck G, Giejda A, Clegg PD, Innes JF. Validation of a client-based clinical metrology instrument for the evaluation of canine elbow osteoarthritis. J Small Anim Pract 2009; 50 (06) 266-271
• 21 R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/. Published online 2021. Accessed May 30, 2023
• 22 Wickham H, Bryan J. readxl: Read Excel Files. R readxl: Read Excel Files. R package version 1.3.1. https://CRAN.R-project.org/package=readxl. Published online 2019. Accessed May 30, 2023
• 23 Stanke NJ, Stephenson N, Hayashi K. Retrospective risk factor assessment for complication following tibial tuberosity transposition in 137 canine stifles with medial patellar luxation. Can Vet J 2014; 55 (04) 349-356
• 24 Filliquist B, Viskjer S, Stover SM. Tibial tuberosity transposition stabilization using a cortical screw placed adjacent to the tuberosity in dogs with patellar luxation. VCOT Open. 2019; 2 (01) e43-e49
• 25 Pugliese LC, Pike FS, Aiken SW. Distal tibial tuberosity translation using TTA implants for the treatment of patella alta in large breed dogs. Surgical technique and clinical outcome. Vet Comp Orthop Traumatol 2015; 28 (04) 274-281
• 26 Yeadon R, Fitzpatrick N, Kowaleski MP. Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog. Surgical technique, radiographic and clinical outcomes. Vet Comp Orthop Traumatol 2011; 24 (01) 18-26
• 27 Eskelinen EV, Suhonen AP, Virolainen JV, Liska WD. Tibial tuberosity transposition fixation with a locking plate during medial patellar luxation surgery: an ex vivo mechanical study. Vet Comp Orthop Traumatol 2022; 35 (02) 96-104
• 28 Nutt AE, Garcia-Fernandez P, San Roman F, Parkin T, Calvo I. Risk factors for tibial tuberosity fracture after tibial tuberosity advancement in dogs. Vet Comp Orthop Traumatol 2015; 28 (02) 116-123
• 29 Perry KL, Adams RJ, Andrews SJ, Tewson C, Bruce M. Impact of femoral varus on complications and outcome associated with corrective surgery for medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30 (04) 288-298
• 30 Soparat C, Wangdee C, Chuthatep S, Kalpravidh M. Radiographic measurement for femoral varus in Pomeranian dogs with and without medial patellar luxation. Vet Comp Orthop Traumatol 2012; 25 (03) 197-201
• 31 Longo F, Nicetto T, Pozzi A, Contiero B, Isola M. A three-dimensional computed tomographic volume rendering methodology to measure the tibial torsion angle in dogs. Vet Surg 2021; 50 (02) 353-364
• 32 Longo F, Nicetto T, Knell SC, Evans RB, Isola M, Pozzi A. Three-dimensional volume rendering planning, surgical treatment, and clinical outcomes for femoral and tibial detorsional osteotomies in dogs. Vet Surg 2022; 51 (07) 1126-1141
• 33 DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. The stifle joint. In: DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. eds. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed.. Philadelphia, PA: W.B. Saunders; 2016: 597-669