Download PDF
Vet Comp Orthop Traumatol 2023; 36(04): 193-198
DOI: 10.1055/s-0043-1761246
Original Research

Effects of Angled Dynamic Compression Holes in a Tibial Plateau Levelling Osteotomy Plate on Cranially Directed Fragment Displacement

Richard C.Y. Looi 
1   Surgery Department, Small Animal Specialist Hospital, Sydney, Australia
,
Joanna D. White
2   Internal Medicine Department, Small Animal Specialist Hospital, Sydney, Australia
,
Daniel R. James
1   Surgery Department, Small Animal Specialist Hospital, Sydney, Australia
› Author Affiliations Funding We thank Dr. Vince Frank from Knight Benedikt for providing the necessary implants needed for the study.
› Further Information
    Permissions and Reprints

Abstract

Objective To compare angled dynamic compression holes in a tibial plateau levelling osteotomy (TPLO) plate to a commercially available TPLO plate in an ovine cadaveric model.

Study Design Ovine tibias (40 bones) were mounted on a custom-made securement device and radiopaque markers were placed to aid radiographic measurements. A standard TPLO procedure was performed on each tibia with either a custom-made six-hole 3.5 mm angled compression hole plate (APlate) or a six-hole 3.5 mm standard commercial plate (SPlate). Radiographs were obtained before and after tightening of the cortical screws and evaluated by an observer blinded to the plate. Measurements of cranio-caudal displacement (CDisplacement), proximo-distal displacement (PDisplacement) in relation to the long axis of the tibia, and change in tibial plateau angle (TPA) were determined.

Results CDisplacement was significantly greater in APlate (median 0.85 mm, Q1-Q3: 0.575-1.325 mm) compared to SPlate (median 0.00 mm, Q1-Q3: -0.35-0.50 mm, p < 0.0001). There were no significant differences in the PDisplacement (median 0.55 mm, Q1-Q3: 0.075-1.00 mm, p = 0.5066) or TPA change (median -0.50°, Q1-Q3: -1.225-0.25°, p = 0.1846) between the two plate types.

Conclusion APlate increases cranially directed displacement of the osteotomy in a TPLO procedure without causing TPA change. The reduced interfragmentary distance across the whole osteotomy could improve osteotomy healing compared to standard commercial TPLO plates.

Keywords

Tibial plateau levelling osteotomy - Dynamic Compression Plate - Dog - Tibia

Authors' Contribution

R.C.Y.L. and D.R.J. contributed to conception of study, study design, data analysis and interpretation. J.D.W. contributed to the study design, statistical analysis and interpretation. All authors drafted, revised, and approved the submitted manuscript.




Publication History

Received: 18 April 2022

Accepted: 15 December 2022

Article published online:
16 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Taylor-Brown FE, Meeson RL, Brodbelt DC. et al. Epidemiology of cranial cruciate ligament disease diagnosis in dogs attending primary-care veterinary practices in England. Vet Surg 2015; 44 (06) 777-783
    CrossrefPubMedGoogle Scholar
  • 2 Witsberger TH, Villamil JA, Schultz LG, Hahn AW, Cook JL. Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs. J Am Vet Med Assoc 2008; 232 (12) 1818-1824
    CrossrefPubMedGoogle Scholar
  • 3 von Pfeil DJF, Kowaleski MP, Glassman M, Dejardin LM. Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds). J Am Vet Med Assoc 2018; 253 (05) 586-597
    CrossrefPubMedGoogle Scholar
  • 4 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
    CrossrefPubMedGoogle Scholar
  • 5 Solano MA, Danielski A, Kovach K, Fitzpatrick N, Farrell M. Locking plate and screw fixation after tibial plateau leveling osteotomy reduces postoperative infection rate in dogs over 50 kg. Vet Surg 2015; 44 (01) 59-64
    CrossrefPubMedGoogle Scholar
  • 6 Thompson AM, Bergh MS, Wang C, Wells K. Tibial plateau levelling osteotomy implant removal: a retrospective analysis of 129 cases. Vet Comp Orthop Traumatol 2011; 24 (06) 450-456
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 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
    CrossrefPubMedGoogle Scholar
  • 8 Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 2002; 84 (08) 1093-1110
    CrossrefPubMedGoogle Scholar
  • 9 Danis R. Theorie et pratique de l'osteosynthèse. Paris: Masson & Cie Éditeurs; 1949
    Google Scholar
  • 10 Schenk RK, Willenegger H. Zum histologischen Bild der sogenannten Primärheilung der Knochenkompakta nach experimentellen Osteotomien am Hund. Experientia 1963; 19: 593-595
    CrossrefPubMedGoogle Scholar
  • 11 McGregor RE, Buffa EA, Tan CJ, Schembri MA, Badcock CA, Lai A. A Retrospective study using the String of Pearls tibial plateau levelling osteotomy locking plate for the treatment of cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2019; 32 (06) 483-491
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Kowaleski MP, Boudrieau RJ, Beale BS, Piras A, Hulse D, Johnson KA. Radiographic outcome and complications of tibial plateau leveling osteotomy stabilized with an anatomically contoured locking bone plate. Vet Surg 2013; 42 (07) 847-852
    CrossrefPubMedGoogle Scholar
  • 13 Bergh MS, Rajala-Schultz P, Johnson KA. Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs. Vet Surg 2008; 37 (04) 374-382
    CrossrefPubMedGoogle Scholar
  • 14 Mehrkens LR, Hudson CC, Cole GL. Factors associated with early tibial tuberosity fracture after tibial plateau leveling osteotomy. Vet Surg 2018; 47 (05) 634-639
    CrossrefPubMedGoogle Scholar
  • 15 Hart MB, Wu JJ, Chao EY, Kelly PJ. External skeletal fixation of canine tibial osteotomies. Compression compared with no compression. J Bone Joint Surg Am 1985; 67 (04) 598-605
    CrossrefPubMedGoogle Scholar
  • 16 Leitner M, Pearce SG, Windolf M. et al. Comparison of locking and conventional screws for maintenance of tibial plateau positioning and biomechanical stability after locking tibial plateau leveling osteotomy plate fixation. Vet Surg 2008; 37 (04) 357-365
    CrossrefPubMedGoogle Scholar
  • 17 Fettig AA, Rand WM, Sato AF, Solano M, McCarthy RJ, Boudrieau RJ. Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints. Vet Surg 2003; 32 (05) 471-478
    CrossrefPubMedGoogle Scholar
  • 18 Jermyn K, Roe SC. Influence of screw insertion order on compression generated by bone plates in a fracture model. Vet Comp Orthop Traumatol 2011; 24 (06) 403-407
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Ya'ish FM, Nanu AM, Cross AT. Can DCP and LCP plates generate more compression? The effect of multiple eccentrically placed screws and their drill positioning guides. Injury 2011; 42 (10) 1095-1100
    CrossrefPubMedGoogle Scholar