Comparison of the Effect of Dog, Surgeon and Surgical Procedure Variables on Improvement in Eight-Week Static Weight-Bearing following Tibial Plateau Levelling Osteotomy

Abstract

Objective The purpose of this article was to compare the effect of surgeon and tibial plateau levelling osteotomy (TPLO) procedure variations on the outcome of TPLO in naturally occurring cranial cruciate ligament disease.

Materials and Methods Records from 142 dogs that had a TPLO procedure were reviewed for information regarding surgical procedure, status of meniscus at the time of surgery, surgeon identity, ACVS diplomate or resident, meniscal release, progression of healing at the progress evaluation based on radiographic interpretation and complications encountered. The primary outcome measure was static force on the affected limb at re-evaluation (42–84 days postoperatively) on a PetSafe Stance Analyzer.

Results Re-evaluation tibial plateau angle (TPA) was negatively and significantly correlated with improvement (r = −0.2132, p = 0.013). Postoperative and re-evaluation TPA were all significantly correlated with one another. The amount of TPA change from initial to immediate postoperative values was significantly correlated with the preoperative TPA (r = 0.628, p < 0.001). Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and preoperative TPA had no significant effect on weight-bearing at recheck.

Clinical Significance TPLO show improvement of 4.58% body weight on the affected limb at 6 to 12 weeks rechecks on a Stance Analyzer. Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and initial TPA have no effect on this measurement of surgical outcome.

Keywords

cranial cruciate ligament - cruciate ligament disease - dog - tibial plateau levelling osteotomy - static weight bearing

Author Contributions

Megan L. Wilson and James K. Roush contributed to conception of study, study design, and acquisition of data and data analysis and interpretation. Walter C. Renberg contributed to conception of study, study design and acquisition of data. All authors drafted, revised and approved the submitted manuscript.

• References

• 1 Christopher SA, Beetem J, Cook JL. Comparison of long-term outcomes associated with three surgical techniques for treatment of cranial cruciate ligament disease in dogs. Vet Surg 2013; 42 (03) 329-334
• 2 Innes JF, Bacon D, Lynch C, Pollard A. Long-term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147 (12) 325-328
• 3 Bergh MS, Sullivan C, Ferrell CL, Troy J, Budsberg SC. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. J Am Anim Hosp Assoc 2014; 50 (05) 315-321
• 4 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. J Am Vet Med Assoc 2005; 226 (02) 232-236
• 5 Böddeker J, Drüen S, Meyer-Lindenberg A, Fehr M, Nolte I, Wefstaedt P. Computer-assisted gait analysis of the dog: comparison of two surgical techniques for the ruptured cranial cruciate ligament. Vet Comp Orthop Traumatol 2012; 25 (01) 11-21
• 6 Gordon-Evans WJ, Griffon DJ, Bubb C, Knap KM, Sullivan M, Evans RB. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. J Am Vet Med Assoc 2013; 243 (05) 675-680
• 7 Kalff S, Meachem S, Preston C. Incidence of medial meniscal tears after arthroscopic assisted tibial plateau leveling osteotomy. Vet Surg 2011; 40 (08) 952-956
• 8 Ralphs SC, Whitney WO. Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000). J Am Vet Med Assoc 2002; 221 (11) 1601-1604
• 9 Ritzo ME, Ritzo BA, Siddens AD, Summerlott S, Cook JL. Incidence and type of meniscal injury and associated long-term clinical outcomes in dogs treated surgically for cranial cruciate ligament disease. Vet Surg 2014; 43 (08) 952-958
• 10 Neal BA, Ting D, Bonczynski JJ, Yasuda K. Evaluation of meniscal click for detecting meniscal tears in stifles with cranial cruciate ligament disease. Vet Surg 2015; 44 (02) 191-194
• 11 Dillon DE, Gordon-Evans WJ, Griffon DJ, Knap KM, Bubb CL, Evans RB. Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease. Vet Surg 2014; 43 (04) 446-450
• 12 Franklin SP, Cook JL, Cook CR, Shaikh LS, Clarke KM, Holmes SP. Comparison of ultrasonography and magnetic resonance imaging to arthroscopy for diagnosing medial meniscal lesions in dogs with cranial cruciate ligament deficiency. J Am Vet Med Assoc 2017; 251 (01) 71-79
• 13 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 (04) 777-795
• 14 Pozzi A, Kowaleski MP, Apelt D, Meadows C, Andrews CM, Johnson KA. Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy. Vet Surg 2006; 35 (05) 486-494
• 15 Lascelles BDX, Freire M, Roe SC, DePuy V, Smith E, Marcellin-Little DJ. Evaluation of functional outcome after BFX total hip replacement using a pressure sensitive walkway. Vet Surg 2010; 39 (01) 71-77
• 16 Evans R, Gordon W, Conzemius M. Effect of velocity on ground reaction forces in dogs with lameness attributable to tearing of the cranial cruciate ligament. Am J Vet Res 2003; 64 (12) 1479-1481
• 17 Seibert R, Marcellin-Little DJ, Roe SC, DePuy V, Lascelles BD. Comparison of body weight distribution, peak vertical force, and vertical impulse as measures of hip joint pain and efficacy of total hip replacement. Vet Surg 2012; 41 (04) 443-447
• 18 Hyytiäinen HK, Mölsä SH, Junnila JT, Laitinen-Vapaavuori OM, Hielm-Björkman AK. Use of bathroom scales in measuring asymmetry of hindlimb static weight bearing in dogs with osteoarthritis. Vet Comp Orthop Traumatol 2012; 25 (05) 390-396
• 19 Phelps HA, Ramos V, Shires PK, Werre SR. The effect of measurement method on static weight distribution to all legs in dogs using the Quadruped Biofeedback System. Vet Comp Orthop Traumatol 2007; 20 (02) 108-112
• 20 Chapinal N, de Passillé AM, Rushen J, Wagner S. Automated methods for detecting lameness and measuring analgesia in dairy cattle. J Dairy Sci 2010; 93 (05) 2007-2013
• 21 Neveux S, Weary DM, Rushen J, von Keyserlingk MA, de Passillé AM. Hoof discomfort changes how dairy cattle distribute their body weight. J Dairy Sci 2006; 89 (07) 2503-2509
• 22 Hicks DA, Miliis DL, Arnold GA. , et al. Comparison of weight bearing at a stance vs. trotting in dogs with rear limb lameness. Abstract presented at: Veterinary Orthopedic Society; March, 5-12, 2005; Snowmass, Colorado, United States
• 23 Dismukes DI, Tomlinson JL, Fox DB, Cook JL, Witsberger TH. Radiographic measurement of canine tibial angles in the sagittal plane. Vet Surg 2008; 37 (03) 300-305
• 24 Unis MD, Johnson AL, Griffon DJ. , et al. Evaluation of intra- and interobserver variability and repeatability of tibial plateau angle measurements with digital radiography using a novel digital radiographic program. Vet Surg 2010; 39 (02) 187-194
• 25 Voss K, Imhof J, Kaestner S, Montavon PM. Force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness. Vet Comp Orthop Traumatol 2007; 20 (04) 299-304
• 26 Coletti TJ, Anderson M, Gorse MJ, Madsen R. Complications associated with tibial plateau leveling osteotomy: a retrospective of 1519 procedures. Can Vet J 2014; 55 (03) 249-254
• 27 Priddy II NH, Tomlinson JL, Dodam JR, Hornbostel JE. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001). J Am Vet Med Assoc 2003; 222 (12) 1726-1732
• 28 Au KK, Gordon-Evans WJ, Dunning D. , et al. Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization. Vet Surg 2010; 39 (02) 173-180
• 29 Chalayon P, Soontornvipart K, Tangwongsan C. Standing analysis of healthy and abnormal canines using force platform system. Abstract presented at the 8th Biomedical Engineering International Conference; November 25–27, 2015; Pattaya, Thailand
• 30 Budsberg SC, Verstraete MC, Soutas-Little RW, Flo GL, Probst CW. Force plate analyses before and after stabilization of canine stifles for cruciate injury. Am J Vet Res 1988; 49 (09) 1522-1524
• 31 Rumph PF, Kincaid SA, Visco DM, Baird DK, Kammermann JR, West MS. Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hindlimb lameness. Vet Surg 1995; 24 (05) 384-389
• 32 Griffon DJ, McLaughlin RM, Roush JK. Vertical ground reaction force redistribution during experimentally induced shoulder lameness in dogs. Vet Comp Orthop Traumatol 1994; 7: 154-157
• 33 Bergh MS, Peirone B. Complications of tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2012; 25 (05) 349-358
• 34 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 (02) 184-193
• 35 Conkling AL, Fagin B, Daye RM. Comparison of tibial plateau angle changes after tibial plateau leveling osteotomy fixation with conventional or locking screw technology. Vet Surg 2010; 39 (04) 475-481
• 36 Robinson DA, Mason DR, Evans R, Conzemius MG. The effect of tibial plateau angle on ground reaction forces 4-17 months after tibial plateau leveling osteotomy in Labrador Retrievers. Vet Surg 2006; 35 (03) 294-299
• 37 Plesman R, Gilbert P, Campbell J. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture: a retrospective, cohort study. Vet Comp Orthop Traumatol 2013; 26 (01) 42-46
• 38 Thieman KM, Tomlinson JL, Fox DB, Cook C, Cook JL. Effect of meniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau leveling osteotomy. Vet Surg 2006; 35 (08) 705-710
• 39 Morris E, Lipowitz AJ. Comparison of tibial plateau angles in dogs with and without cranial cruciate ligament injuries. J Am Vet Med Assoc 2001; 218 (03) 363-366