Subscribe to RSS
DOI: 10.1055/s-0044-1795088
Effect of Cranial Cruciate Ligament Transection during TPLO on Patellar Desmitis in Dogs with Partial Cranial Cruciate Ligament Rupture
Authors
Abstract
Objective The aim of this study was to assess the protective effect of transecting a partially ruptured cranial cruciate ligament (CCL) during tibial plateau levelling osteotomy (TPLO) surgery on postoperative patellar ligament thickness (PLT) and shortening.
Study Design Dogs with partial CCL rupture that underwent a unilateral TPLO were included. The population was divided into two groups: remnant CCL transected (study group) and left in situ (control group). Preoperative and 6-week postoperative measurements of PLT, in three specific locations, and patellar ligament length (PLL) were collected. Risk factors for PLT and shortening were also included.
Results Fifty-two dogs (56 stifles) with partial CCL rupture were retrospectively included. Twenty-nine stifles (51.8%) had the remnant CCL transected (study group) and 27 stifles (48.2%) had the remnant CCL left in situ (control group). Significant differences were found on PLT measurements between pre- and 6-week post-surgery for all three ligament locations with greatest difference at the middle region. Median PLL was significantly shorter 6-week post-surgery for both groups. No significant differences in PLT nor PLL were identified between procedures where the remnant was transected or not.
Conclusion This study did not identify a protective effect of transecting the CCL remnant on PLT or patellar ligament shortening, contrary to other reports within the literature. Further investigation is needed in the form of prospective studies with higher number of cases to understand the clinical implications of patellar ligament thickening and shortening in dogs.
Keywords
partial CCL rupture - tibial plateau levelling osteotomy - TPLO - patellar desmitis - patellar ligament thickness - patellar ligament lengthAuthors' Contribution
M.A. contributed to the study concept and design, data collection, drafting, revision, and final approval. V.L. contributed to the study concept and design, revision, and final approval.
Publication History
Received: 31 December 2023
Accepted: 21 October 2024
Article published online:
21 November 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald‐Hesse‐Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Frederick SW, Cross AR. Modified cranial closing wedge osteotomy for treatment of cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angles: technique and complications in 19 cases. Vet Surg 2017; 46: 403-411
- 2 Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 39: 460-474
- 3 Pacchiana PD, Morris E, Gillings SL, Jessen CR, Lipowitz AJ. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998–2001). J Am Vet Med Assoc 2003; 222: 184-193
- 4 Vasseur PB. Clinical results following nonoperative management for rupture of the cranial cruciate ligament in dogs. Vet Surg 1984; 13: 243-246
- 5 Hayashi K, Manley P, Muir P. Cranial cruciate ligament pathophysiology in dogs with cruciate disease: a review. J Am Anim Hosp Assoc 2004; 40: 385-390
- 6 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777-795
- 7 Warzee CC, Dejardin LM, Arnoczky SP. et al. Effect of tibial plateau levelling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifle: an in vitro experimental study. Vet Surg 2001; 30: 278-286
- 8 Kowaleski MP, Boudrieau RJ, Pozzi A. Stifle joint. In: Johnston S, Tobias K. eds. Veterinary Surgery: Small Animal. 2nd ed. Missouri:: Saunders; 2018: 1071-1168
- 9 Shahar R, Milgram J. Biomechanics of tibial plateau leveling of the canine cruciate-deficient stifle joint: a theoretical model. Vet Surg 2006; 35 (02) 144-149
- 10 Gatineau M, Dupuis J, Plante J. et al. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Rate of subsequent “pivot shift”, meniscal tear and other complications. Vet Comp Orthop Traumatol 2011; 24: 333-341
- 11 Carey K, Aiken SW, Diresta GR. et al. Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy 94 cases (2001–2003). Vet Comp Orthop Traumatol 2005; 18 (04) 235-242
- 12 Mattern KL, Berry CR, Peck JN. et al. Radiographic and ultrasonographic evaluation of patellar ligament following tibial plateau leveling osteotomy. Vet Radiol Ultrasound 2006; 47: 185-191
- 13 Jay M, Mattoon J, Gilbert P. et al. Radiographic evaluation of patellar ligament length after tibial plateau leveling osteotomy in dogs. Am J Vet Res 2019; 80 (06) 607-612
- 14 Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38 (01) 1-22
- 15 Kowaleski M, McCarthy RJ. Geometric analysis evaluating the effect of tibial plateau leveling osteotomy position on postoperative tibial plateau slope. Vet Comp Orthop Traumatol 2004; 17: 30-34
- 16 Kanno N, Ochi Y, Ichinohe T. et al. Effect of the centre of rotation in tibial plateau levelling osteotomy on quadriceps tensile force: an ex vivo study in canine cadavers. Vet Comp Orthop Traumatol 2019; 32: 117-125
- 17 Johnson MD, Shmon CL, Linn KA. et al. Ex vivo evaluation of the effect of various surgical procedures on blood delivery to the patellar tendon of dogs. Am J Vet Res 2016; 77 (05) 548-555
- 18 Caylor KB, Zumpano CA, Evan LM. et al. Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. J Am Anim Hosp Assoc 2001; 37: 263-268
- 19 Koo TK, Mae YL. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 5 (02) 155-163
- 20 Gallagher A, Cross A, Sepulveda G. The effect of shock wave therapy on patellar ligament desmitis after tibial plateau leveling osteotomy. Vet Surg 2012; 41: 482-485
- 21 Weale AE, Murrary DW, Newman JH. et al. The length of the patellar tendon after unicompartmental and total knee replacement. J Bone Joint Surg Br 1999; 81: 790-795
- 22 Dandy DJ, Desai SS. Patellar ligament length after anterior cruciate ligament reconstruction. J Bone Joint Surg Br 1994; 76: 198-199
- 23 Owen D, Manley R, Casale S. Influence of methods of joint inspection during tibial plateau leveling osteotomy on the radiographic appearance of the patellar tendon. Vet Surg 2018; 47 (07) 916-922
- 24 Geier C, Frederick S, Cross A. Evaluation of the risk of patella fracture as the result of decreasing tibial plateau angle following tibial plateau leveling osteotomy. Vet Surg 2021; 50: 984-989
- 25 Slocum B, Devine T. Cranial tibial thrust: a primary force in the canine stifle. J Am Vet Med Assoc 1983; 183 (04) 456-549
- 26 Shimada M, Takagi T, Kanno N. et al. Biomechanical effects of tibial plateau levelling osteotomy on joint instability in normal canine stifles: an in vitro study. Vet Comp Orthop Traumatol 2020; 33 (05) 301-307
- 27 Arnoczky SP, Marshall JL. The cruciate ligaments of the canine stifle: an anatomical and functional analysis. Am J Vet Res 1977; 38 (11) 1807-1814
- 28 Hulse D, Beale B, Kerwin S. Second look arthroscopic findings after tibial plateau leveling osteotomy. Vet Surg 2010; 39: 350-354
- 29 Bergh M, Rajala-Schultz P, Johnson K. Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs. Vet Surg 2008; 37: 374-382
