Evaluation of a Novel Tibial Plateau Levelling Osteotomy Guidance System

Introduction: Tibial plateau levelling osteotomy (TPLO) is an effective treatment for cranial cruciate ligament injury but poses technical challenges, particularly for novice surgeons. The procedure requires precise osteotomy, rotation, bone stabilization, and implant positioning. The ProCut TPLO guide aims to improve precision compared with the traditional jig-only TPLO.

Materials and Methods: Ten participants without osteotomy experience completed a TPLO (n = 10) and ProCut TPLO (n = 10) using cadaveric limbs. Deviation from intended tibial plateau angle (TPA), distance of eccentricity (DOE), osteotomy trajectory along proximodistal and craniocaudal axes, procedure time, and technical errors were compared. For ProCut TPLO limbs, a trajectory indicating pin was compared with the executed osteotomy trajectory along proximodistal and craniocaudal axes. Interfragmentary compression of the ProCut TPLO was tested using pressure-sensitive film.

Results: ProCut TPLO resulted in less TPA deviation (0.18 degrees vs. 6 degrees, p < 0.001), a more centred DOE (0.7 mm vs. 7.7 mm, p < 0.001), an osteotomy more parallel to joint surface (1.3 degrees vs. 5 degrees, p = 0.001) and perpendicular to the sagittal plane (2.5 degrees vs. 8.8 degrees, p < 0.001), and took less time (23.1 minutes vs. 40.9 minutes, p < 0.001). The mean deviation from the ProCut TPLO trajectory indicating the pin was 0.2 degrees proximodistally and 0.3 degrees craniocaudally. No technical errors occurred with ProCut TPLO. Interfragmentary compression was observed.

Discussion/Conclusion: The ProCut TPLO yielded more precise technical execution across all metrics compared with the traditional jig-only TPLO, and thus may offer novices a precise and efficient method of executing TPLOs.

Acknowledgment

The developed surgical system is proprietary and patented under the second author.

 

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Publication History

Article published online:
15 July 2025