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Vet Comp Orthop Traumatol 2007; 20(04): 312-319
DOI: 10.1160/VCOT-07-02-0013
Clinical Communication
Schattauer GmbH

A comparison of outcomes following tibial plateau levelling osteotomy and cranial tibial wedge osteotomy procedures

S. A. Corr
1   Royal Veterinary College – VCS, Hatfield, Hertfordshire, UK
,
C. Brown
2   Sage Veterinary Group, Bradford, UK
› Author Affiliations
Further Information

Publication History

Received 04 February 2007

Accepted 13 April 2007

Publication Date:
18 December 2017 (online)

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Summary

The objective of this study was to determine whether clinical outcomes were superior and complication rates were lower in dogs that had had a cranial cruciate ligament rupture treated by tibial plateau levelling osteotomy (TPLO), compared to those dogs that had been treated using the original cranial tibial wedge osteotomy (CTWO) procedure. Thirty-seven client-owned dogs with cranial cruciate ligament rupture were included in the study: 19 dogs underwent a TPLO procedure, and 18 dogs underwent a CTWO procedure. The study was retrospective, with the data being obtained from medical records and a review of radiographs. The long-term outcome was assessed by means of an owner questionnaire using a visual analogue scale. For the majority of factors that were reviewed, there was not a significant difference in outcome between the dogs that had a TPLO or those that had undergone a CTWO. All of the dogs showed a rapid return to weight bearing after surgery, and at the six week re-examination, the majority of the dogs did not have any pain on stifle palpation. They displayed a good stifle range of motion and significantly lower lameness scores than those prior to surgery. The complication rates did not differ between the procedures, however, within this small sample of dogs, complications following a CTWO were more likely to require revision surgery.

Keywords

Plateau levelling - tibia - osteotomy - cruciate
 

  • References

  • 1 Marshall Marshall, Olsson SE. Instability ofthe knee: A long term experimental study in dogs. J Bone Joint Surg Am 1971; 53: 1561-1570.
    CrossrefPubMedGoogle Scholar
  • 2 DeAngelis DeAngelis, Lau RE. Alateralretinacular imbrication technique for surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970; 157: 79-84.
    PubMedGoogle Scholar
  • 3 Smith Smith, Torg JS. Fibular headtransposition for repair of cruciate deficient stifle in the dog. J Am VetMed Assoc 1985; 187: 375-383.
    PubMedGoogle Scholar
  • 4 Arnoczky SP, Tarvn GB, Marshall JL. The ‘over- the-top’ procedure: a technique for anterior cruciate ligament substitution in the dog. J Am Anim Hosp Assoc 1979; 15: 283-290.
    PubMedGoogle Scholar
  • 5 Henderson Henderson, Milton JL. The tibial compression mechanism: a diagnostic aid in stifle injuries. J Am Anim Hosp Assoc 1978; 14: 474-479.
    PubMedGoogle Scholar
  • 6 Slocum Slocum, Devine T. Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair. J Am Vet Med Assoc 1984; 184: 564-569.
    PubMedGoogle Scholar
  • 7 Slocum Slocum, Slocum TD. Tibial plateau levelling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small AnimPract 1993; 23: 777-795.
    PubMedGoogle Scholar
  • 8 Dejardin LM. Tibial plateau levelling osteotomy. In: Textbook of Small Animal Surgery. Slatter DH. (ed). Philadelphia: WB. Saunders Co; 2003: 2133-2143.
    Google Scholar
  • 9 Innes Innes, Barr ARS. Can owners assess outcome following treatment of canine cruciate ligament deficiency?. J Small Anim Pract 1998; 39: 373-378.
    CrossrefPubMedGoogle Scholar
  • 10 Talaat MB, Kowaleski MP, Boudrieau RJ. Combination of tibial plateau levelling osteotomy and cranial closing wedge osteotomy of the tibia for the treatment of cranial cruciate ligament-deficient stifles with excessive tibial plateau angle. Vet Surg 2006; 35: 729-739.
    CrossrefPubMedGoogle Scholar
  • 11 Thieman KM, Tomlinson JL, Fox DB. et al. Effect ofmeniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau levelling osteotomy. Vet Surg 2006; 35: 705-710.
    CrossrefPubMedGoogle Scholar
  • 12 Hoffmann DE, Miller JM, Ober CP. et al. Tibial tuberosity advancement in 65 canine stifles. Vet Comp Orthop Traumatol 2006; 19: 219-227.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Moser CA, Kalton G. Survey methodsinsocial investigation. London: Heinemann Educational Books Ltd; 1971
    Google Scholar
  • 14 Bowling A. Research methods in health: investigating health and health services. Buckingham: Open University Press; 1997
    Google Scholar
  • 15 Watt PR, Sommerlad SM, Robins GM. Tibial wedge osteotomy for treatment of cranial cruciate rupture. Vet Surg. 2001 29. 478.
    PubMedGoogle Scholar
  • 16 Vezzoni A, Baroni E, Demaria M. et al. Surgical treatment of canine cranial cruciate ligament injuries with tibial plateau levelling g osteotomy (TPLO): principles and clinical experience in293 cases. Eur JComp Anim Pract 2004; 14: 143-155.
    PubMedGoogle Scholar
  • 17 Ballagas AJ, Montgomery RD, Henderson RA. et al. Pre- and postoperative force plate analysis of dogs with experimentally transected cranial cruciate ligaments treated using tibial plateau levelling osteotomy. Vet Surg 2004; 33: 187-190.
    CrossrefPubMedGoogle Scholar
  • 18 Conzemius MG, Evans RB, Besancon MF. et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. JAmVet MedAssoc 2005; 226: 232-236.
    PubMedGoogle Scholar
  • 19 Lozier SM. Tibial plateau levelling osteotomy: two years of clinical experience and findings. Proceedings ofthe 7'1 ACVS Symposium. 1997 Orlando, Florida: 161.
    PubMedGoogle Scholar
  • 20 Priddy NH, Tomlinson JL, Dodam JR. et al. Complications with and owner assessment of the outcome of tibial plateau levelling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001). J Am Vet Med Assoc 2003; 222: 1726-1732.
    CrossrefPubMedGoogle Scholar
  • 21 Aikman H. The association between arthritis and the weather. Int J Biometeor 1997; 40: 192-199.
    CrossrefPubMedGoogle Scholar
  • 22 Mahajan A, Verma S, Tandon V. Osteoarthritis. J Assoc Physicians of India 2005; 53: 634-641.
    PubMedGoogle Scholar
  • 23 Lineberger JA, Allen DA, Wilson ER. et al. Comparison of radiographic arthritic changes associated with two variations of tibial plateau levelling osteotomy: a retrospective clinical study. Vet CompOrthop Traumatol 2005; 18: 13-17.
    PubMedGoogle Scholar
  • 24 Lazar TP, Berry CR, deHaan JJ. et al. Long-term radiographic comparison of tibial plateau levelling osteotomy versus extracapsular stabilization of cranial cruciate ligament rupture in the dog. Vet Surg 2005; 34: 133-141.
    CrossrefPubMedGoogle Scholar
  • 25 Gordon WJ, Conzemius MG, Riedesel E. et al. The relationship between limb function and radiographic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003; 32: 451-454.
    CrossrefPubMedGoogle Scholar
  • 26 Fettig AA, Rand WM, Sato AF. et al. Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints. Vet Surg 2003; 32: 471-478.
    CrossrefPubMedGoogle Scholar
  • 27 Reif U, Dejardin LM, Probst CW. et al. Influence of limb positioning and measurement method on the magnitude of the tibial plateau angle. Vet Surg 2004; 33: 368-375.
    CrossrefPubMedGoogle Scholar
  • 28 Slocum B, Slocum TD. Tibial plateau levelling osteotomy for cranial cruciate ligament rupture. In: Current Techniques in Small Animal Surgery. Bojrab MJ, Ellison GW, Slocum B. (eds). Philadelphia: Williams and Wilkins; 1998: 1209-1215.
    Google Scholar
  • 29 Warzee CC, Dejardin LM, Arnoczky SP. et al. Effect of tibial plateau levelling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: an in vitro experimental study. Vet Surg 2001; 30: 278-286.
    CrossrefPubMedGoogle Scholar
  • 30 Robinson Robinson, Mason DR, Evans R. et al. The effect of tibial plateau angle on ground reaction forces 4-17 months after tibial plateau levelling osteotomy in Labrador Retrievers. Vet Surg 2006; 35: 294-299.
    CrossrefPubMedGoogle Scholar
  • 31 Pacchiana PD, Morris E, Gillings SL. et al. Surgical and postoperative complications associated with tibial plateau levelling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001). J Am Vet Med Assoc 2003; 222: 184-193.
    CrossrefPubMedGoogle Scholar
  • 32 Stauffer KD, Tuttle TA, Elkins AD. et al. Complications associated with 696 tibial plateau levelling osteotomies (2001-2003). J Am Anim Hosp Assoc 2006; 42: 44-50.
    CrossrefPubMedGoogle Scholar
  • 33 Slocum B, Slocum TD. Meniscal release. In: Current Techniques in Small Animal Surgery. Bojrab MJ, Ellison GW, Slocum B. (eds). Philadelphia: Williams and Wilkins; 1998: 1197-1199.
    Google Scholar
  • 34 Pozzi A, Kowaleski MP, Apelt D. et al. Effect of Medial Meniscal Release on Tibial Translation After Tibial Plateau Levelling. Vet Surg 2006; 35: 486-494.
    CrossrefPubMedGoogle Scholar