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Vet Comp Orthop Traumatol 2010; 23(01): 37-42
DOI: 10.3415/VCOT-09-04-0043
Original Research
Schattauer GmbH

Long-term outcomes of thigh circumference, stifle range-of-motion, and lameness after unilateral tibial plateau levelling osteotomy

E. M. Moeller
1   Mission MedVet, Mission, Kansas, USA
,
D. A. Allen
1   Mission MedVet, Mission, Kansas, USA
,
E. R. Wilson
1   Mission MedVet, Mission, Kansas, USA
,
J. A. Lineberger
1   Mission MedVet, Mission, Kansas, USA
,
T. Lehenbauer
2   UC Davis, Veterinary Medicine Teaching and Research Center, Davis, Tulare, California, USA
› Author Affiliations
Further Information

Publication History

Received: 06 April 2009

Accepted: 31 July 2009

Publication Date:
19 December 2017 (online)

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Summary

Our study evaluated thigh circumference (TC), stifle range of motion (ROM), and lameness in dogs one to five years after unilateral tibial plateau levelling osteotomy (TPLO). We hypothesised that TC, stifle ROM, and lameness would not be different to the unoperated limb (control), one to five years after surgery. Patients that were one to five years post-TPLO were reviewed and were included if they had a unilateral TPLO, and no additional clinical evidence of orthopaedic disease. Standing mid-thigh TC measurements and stifle extension and flexion angles were made in triplicate. Clinical lameness was graded blindly. Data were evaluated statistically using paired t-tests for TC and stifle flexion and extension. Significance was set at p <0.05. Twenty-nine dogs met the inclusion criteria. Mean results for the surgery limbs and control limbs were 39.5 ± 5.5 cm and 40.1 ± 5.6 cm for TC, 36.6 ± 6.8° and 28.6 ± 4.3° for stifle flexion, and 155.2 ± 6.6° and 159.8 ± 4.9° for stifle extension, respectively. The mean TC for the operated limb was 98.5% of the control limb. A significant difference was found between the operated and the control limbs for all measurements. Time after surgery had no apparent affect on outcome. Four of 29 dogs (14%) exhibited some lameness in the TLPO limb during evaluation (one dog was 1 to 2 years postoperative and three dogs were 2 to 3 years postoperative). These results indicate that TC and stifle ROM in the TLPO limb do not return to control-limb measurements one to five years after a TPLO surgery. The clinical significance is unknown as TC returned to 98.5% of control, and the source of lameness in the lame dogs was not identified.

Keywords

TPLO - thigh circumference - cranial cruciate ligament insufficiency - stifle range of motion
 

  • References

  • 1 Whitehair JG, Vasseur PB, Willits NH.. Epidemiology of cranial cruciate ligament rupture in dogs. J Am Vet Med Assoc 1993; 203: 1016-1019.
    PubMedGoogle Scholar
  • 2 Innes JF, Barr AR.. Clinical natural history of the postsurgical cruciate deficient canine stifle joint: year 1. J Small Anim Pract 1998; 39: 325-332.
    CrossrefPubMedGoogle Scholar
  • 3 Vasseur PB.. Stifle joint. In Slatter D. (Editor) Textbook of Small Animal Surgery. Philadelphia: Saunders; 2003: 2090-2132.
    Google Scholar
  • 4 Millis DL.. Assessing measures and outcomes. In Millis DL, Levine D, Taylor R. (Editors) Canine Rehabilitation & Physical Therapy. St. Louis; Saunders: 2004: 211-227.
    Google Scholar
  • 5 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.
    CrossrefPubMedGoogle Scholar
  • 6 Johnson JM, Johnson AL, Pijanowski GJ. et al. Rehabilitation of dogs with surgically treated cranial cruciate ligament-deficient stifles by use of electrical stimulation of muscles. Am J Vet Res 1997; 58: 1473-1478.
    PubMedGoogle Scholar
  • 7 Marsolais GS, Dvorak G, Conzemius MG.. Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs. J Am Vet Med Assoc 2002; 220: 1325-1330.
    CrossrefPubMedGoogle Scholar
  • 8 Marsolais GS, McLean S, Derrick T. et al. Kinematic analysis of the hind limb during swimming and walking in healthy dogs and dogs with surgically corrected cranial cruciate ligament rupture. J Am Vet Med Assoc 2003; 222: 739-743.
    CrossrefPubMedGoogle Scholar
  • 9 Tyler TF, McHugh MP, Gleim GW. et al. The effect of immediate weight bearing after anterior cruciate ligament reconstruction. Clin Orthop Relat Res 1998; 357: 141-148.
    CrossrefPubMedGoogle Scholar
  • 10 O'Meara PM.. Rehabilitation following reconstruction of the anterior cruciate ligament. Orthopedics 1993; 16: 301-306.
    PubMedGoogle Scholar
  • 11 Shelbourne KD, Nitz P.. Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med 1990; 18: 292-299.
    CrossrefPubMedGoogle Scholar
  • 12 Millis DL, Durant A, Headrick J. et al. Long term kinetic and kinematic comparison of cruciate-deficient dogs treated with tibial plateau leveling osteotomy or modified retinacular imbrication technique. Proceedings: ACVS Veterinary Symposium: The Surgical Summit; 2008 Oct 23. San Diego; California, USA. ACVS: 2008: 23.
    Google Scholar
  • 13 Monk ML, Preston CA, McGowan CM.. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. Am J Vet Res 2006; 67: 529-536.
    CrossrefPubMedGoogle Scholar
  • 14 Jaegger G, Marcellin-Little DJ, Levine D.. Reliability of goniometry in Labrador Retrievers. Am J Vet Res 2002; 63: 979-986.
    CrossrefPubMedGoogle Scholar
  • 15 Francis DA, Millis DL, Head LL.. Bone and lean tissue changes following cranial cruciate ligament transection and stifle stabilization. J Am Anim Hosp Assoc 2006; 42: 127-135.
    CrossrefPubMedGoogle Scholar
  • 16 Appell HJ.. Skeletal muscle atrophy during immobilization. Int J Sports Med 1986; 7: 1-5.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Appell HJ.. Muscular atrophy following immobilisation. A review. Sports Med 1990; 10: 42-58.
    CrossrefPubMedGoogle Scholar
  • 18 Doxey G.. Assessing quadriceps femoris muscle bulk with girth measurements in subjects with patellofe-moral pain. J Orthop Sports Phys Ther 1987; 9: 177-183.
    CrossrefPubMedGoogle Scholar
  • 19 Arangio GA, Chen C, Kalady M. et al. Thigh muscle size and strength after anterior cruciate ligament reconstruction and rehabilitation. J Orthop Sports Phys Ther 1997; 26: 238-243.
    CrossrefPubMedGoogle Scholar
  • 20 Natri A, Jarvinen M, Latvala K. et al. Isokinetic muscle performance after anterior cruciate ligament surgery. Long-term results and outcome predicting factors after primary surgery and late-phase reconstruction. Int J Sports Med 1996; 17: 223-228.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Gerber C, Hoppeler H, Claassen H. et al. The lower-extremity musculature in chronic symptomatic instability of the anterior cruciate ligament. J Bone Joint Surg Am 1985; 67: 1034-1043.
    CrossrefPubMedGoogle Scholar
  • 22 Hoelzler MG, Millis DL, Francis DA. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33: 146-153.
    CrossrefPubMedGoogle Scholar
  • 23 Millis DL, Levine D, Mynatt T.. Changes in muscle mass following transection of the cranial cruciate ligament and immediate stifle stabilization. Proceedings: The First International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine; 1999 Jan 1. Oregon State University, Corvallis, OR, USA: 1999: 155.
    Google Scholar
  • 24 Reynolds NL, Worrell TW, Perrin DH.. Effect of a lateral step-up exercise protocol on quadriceps isokinetic peak torque values and thigh girth. J Orthop Sports Phys Ther 1992; 15: 151-155.
    CrossrefPubMedGoogle Scholar
  • 25 Ross M, Worrell TW.. Thigh and calf girth following knee injury and surgery. J Orthop Sports Phys Ther 1998; 27: 9-15.
    CrossrefPubMedGoogle Scholar
  • 26 Jarvela T, Kannus P, Latvala K. et al. Simple measurements in assessing muscle performance after an ACL reconstruction. Int J Sports Med 2002; 23: 196-201.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Lauer S, Hosgood G, Ramirez S. et al. In vivo comparison of two hinged transarticular external skeletal fixators for multiple ligamentous injuries of the canine stifle. Vet Comp Orthop Traumatol 2008; 21: 25-35.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Kannus P, Jarvinen M, Jozsa L.. Thigh muscle atrophy and postoperative osteoarthrosis after knee ligament tears. Acta Chir Hung 1988; 29: 151-161.
    PubMedGoogle Scholar
  • 29 Raab DJ, Fischer DA, Smith JP. et al. Comparison of arthroscopic and open reconstruction of the anterior cruciate ligament. Early results. Am J Sports Med 1993; 21: 680-683.
    CrossrefPubMedGoogle Scholar
  • 30 Scavelli TD, Schrader SC.. Nonsurgical management of rupture of the cranial cruciate ligament in 18 cats. J Am Anim Hosp Assoc 1987; 23: 337-340.
    PubMedGoogle Scholar
  • 31 Duff R, Campbell JR.. Long term results of excision arthroplasty of the canine hip. Vet Rec 1977; 101: 181-184.
    CrossrefPubMedGoogle Scholar
  • 32 Millis DL, Levine D, Scroggs L.. Variables affecting thigh circumference measurements in dogs. Proceedings: The First International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine; 1999 Jan 1 Oregon State University, Corvallis, OR, USA: 1999: 157.
    Google Scholar
  • 33 Martin AD, Spenst LF, Drinkwater DT. et al. Anthropometric estimation of muscle mass in men. Med Sci Sports Exerc 1990; 22: 729-733.
    CrossrefPubMedGoogle Scholar
  • 34 Grimby G, Gustafsson E, Peterson L. et al. Quad-riceps function and training after knee ligament surgery. Med Sci Sports Exerc 1980; 12: 70-75.
    PubMedGoogle Scholar
  • 35 Evans R, Horstman C, Conzemius M.. Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait. Vet Surg 2005; 34: 445-449.
    CrossrefPubMedGoogle Scholar
  • 36 Voss K, Imhof J, Kaestner S. et al. Force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness. Vet Comp Orthop Traumatol 2007; 20: 299-304.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Mariani PP, Santori N, Rovere P. et al. Histological and structural study of the adhesive tissue in knee fibroarthrosis: a clinical-pathological correlation. Arthroscopy 1997; 13: 313-318.
    CrossrefPubMedGoogle Scholar
  • 38 Enneking WF, Horowitz M.. The intra-articular effects of immobilization on the human knee. J Bone Joint Surg Am 1972; 54: 973-985.
    CrossrefPubMedGoogle Scholar
  • 39 Marzo JM, Bowen MK, Warren RF. et al. Intraarticular fibrous nodule as a cause of loss of extension following anterior cruciate ligament reconstruction. Arthroscopy 1992; 8: 10-18.
    CrossrefPubMedGoogle Scholar
  • 40 Jandi AS, Schulman AJ.. Incidence of motion loss of the stifle joint in dogs with naturally occurring cranial cruciate ligament rupture surgically treated with tibial plateau leveling osteotomy: longitudinal clinical study of 412 cases. Vet Surg 2007; 36: 114-121.
    CrossrefPubMedGoogle Scholar
  • 41 Lineberger JA, Allen DA, Wilson ER. et al. Comparison of radiographic arthritic changes associated with two variations of tibial plateau leveling osteotomy. Vet Comp Orthop Traumatol 2005; 18: 13-17.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Gordon WJ, Conzemius MG, Riedesel E. et al. The relationship between limb function and radio-graphic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003; 32: 451-454.
    CrossrefPubMedGoogle Scholar
  • 43 Palmieri-Smith RM, Thomas AC, Wojtys EM.. Maximizing quadriceps strength after ACL reconstruction. Clin Sports Med 2008; 27: 405-424 viiix
    CrossrefPubMedGoogle Scholar
  • 44 Iles JF, Stokes M, Young A.. Reflex actions of knee joint afferents during contraction of the human quadriceps. Clin Physiol 1990; 10: 489-500.
    CrossrefPubMedGoogle Scholar