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Vet Comp Orthop Traumatol 2015; 28(03): 215-219
DOI: 10.3415/VCOT-14-08-0130
Original Research
Schattauer GmbH

Single-stage bilateral tibial tuberosity advancement for treatment of bilateral canine cranial cruciate ligament deficiency

J. E. Kiefer
1   Veterinary Surgical Centers, Vienna, Virginia, USA
,
A. Langenbach
1   Veterinary Surgical Centers, Vienna, Virginia, USA
,
J. Boim
2   Department of Mathematics and Statistics, American University, Washington, DC, USA
,
S. Gordon
1   Veterinary Surgical Centers, Vienna, Virginia, USA
,
D. J. Marcellin-Little
3   Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
› Author Affiliations
Further Information

Publication History

Received:26 August 2014

Accepted:11 March 2015

Publication Date:
28 December 2017 (online)

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Summary

Objective: To report complications in dogs with naturally occurring cranial cruciate ligament rupture following single-stage bilateral tibial tuberosity advancement (SS-BTTA) procedures, and to compare these complications to a population of dogs undergoing unilateral tibial tuberosity advancement (UTTA).

Methods: Medical records and radiographs of client-owned dogs treated with tibial tuberosity advancement between August 2008 and December 2011 were reviewed. Forty-four client-owned dogs with bilateral cranial cruciate ligament rupture that underwent SS-BTTA procedures and 82 client-owned dogs that underwent UTTA proced -ures were randomly selected from our hospital population. Complications were recorded and analysed. Major complications were defined as fractures or any complication requiring a second surgery. Minor complications were any problem identified that did not require surgical management.

Results: Incidence for major and minor complications in the UTTA group was 2.3% and 24.4%, respectively. Incidence for major and minor complications in the SS-BTTA group was 12.5% and 26.1%, respectively. Single-stage bilateral tibial tuberosity advancement procedures had a four- to five-fold increase in odds of a major complication (p <0.050) compared to UTTA.

Clinical significance: The findings of our study indicate that SS-BTTA procedures are associated with an increased risk of major complications compared to UTTA procedures.

Keywords

Tibial tuberosity advancement - cranial cruciate ligament - bilateral
 

  • References

  • 1 Buote N, Fusco J, Radasch R. Age, tibial plateau angle, sex, and weight as risk factors for contralateral rupture of the cranial cruciate ligament in Labradors. Vet Surg 2009; 38: 481-489.
    CrossrefPubMedGoogle Scholar
  • 2 Doverspike M, Vasseur PB, Harb MF. et al. Contralateral cranial cruciate ligament rupture: incidence in 114 dogs. J Am Anim Hosp Assoc 1993; 29: 167-170.
    PubMedGoogle Scholar
  • 3 Duval JM, Budsberg SC, Flo GL. et al. Breed, sex, and body weight as risk factors for rupture of the cranial cruciate ligament in young dogs. J Am Vet Med Assoc 1999; 215: 811-814.
    PubMedGoogle Scholar
  • 4 Pond MJ, Campbell JR. The canine stifle joint. I. Rupture of the anterior cruciate ligament. An assessment of conservative and surgical treatment. J Small Anim Pract 1972; 13: 1-10.
    CrossrefPubMedGoogle Scholar
  • 5 Cabrera SY, Owen TJ, Mueller MG. et al. Comparison of tibial plateau angles in dogs with unilateral versus bilateral cranial cruciate ligament rupture: 150 cases (2000-2006). J Am Vet Med Assoc 2008; 232: 889-892.
    CrossrefPubMedGoogle Scholar
  • 6 Priddy 2nd NH, Tomlinson JL, Dodam JR. et al. 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: 1726-1732.
    CrossrefPubMedGoogle Scholar
  • 7 Gurunathan U. Perioperative considerations of bilateral total knee replacement: a review. J Clin Anesth 2013; 25: 232-239.
    CrossrefPubMedGoogle Scholar
  • 8 Hoffman 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
  • 9 Kipfer NM, Tepic S, Damur DM. et al. Effect of tibial tuberosity advancement on femorotibial shear in cranial cruciate-deficient stifles. An in vitro study. Vet Comp Orthop Traumatol 2008; 21: 385-390.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 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
  • 11 Bergh MS, Rajala-Schultz P, Johnson KA. Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs. Vet Surg 2008; 37: 374-382.
    CrossrefPubMedGoogle Scholar
  • 12 Barnhart MD. Results of single-session bilateral tibial plateau leveling osteotomies as a treatment for bilaterally ruptured cranial cruciate ligaments in dogs: 25 cases (2000-2001). J Am Anim Hosp Assoc 2003; 39: 573-578.
    CrossrefPubMedGoogle Scholar
  • 13 Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 39: 460-474.
    CrossrefPubMedGoogle Scholar
  • 14 Calvo I, Aisa J, Chase D. et al. Tibial tuberosity fracture as a complication of tibial tuberosity advancement. Vet Comp Orthop Traumatol 2014; 27: 148-154.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Dymond NL, Goldsmid SE, Simpson DJ. Tibial tuberosity advancement in 92 canine stifles: initial results, clinical outcome and owner evaluation. Aust Vet J 2010; 88: 381-385.
    CrossrefPubMedGoogle Scholar
  • 16 Lafaver S, Miller NA, Stubbs WP. et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007; 36: 573-586.
    CrossrefPubMedGoogle Scholar
  • 17 Stein S, Schmoekel H. Short-term and eight to 12 months results of a tibial tuberosity advancement as treatment of canine cranial cruciate ligament damage. J Small Anim Pract 2008; 49: 398-404.
    CrossrefPubMedGoogle Scholar
  • 18 Steinberg EJ, Prata RG, Palazzini K. et al. Tibial tuberosity advancement for treatment of CrCL injury: complications and owner satisfaction. J Am Anim Hosp Assoc 2011; 47: 250-257.
    CrossrefPubMedGoogle Scholar
  • 19 Wolf RE, Scavelli TD, Moelzler MG. et al. Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007-2009). J Am Vet Med Assoc 2012; 240: 1418-1487.
    PubMedGoogle Scholar
  • 20 Hirshenson MS, Krotscheck U, Thompson MS. et al. Evaluation of complications and short-term outcome after unilateral or single-session bilateral tibial tuberosity advancement for cranial cruciate rupture in dogs. Vet Comp Orthop Traumatol 2012; 25: 402-409.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Mawby DI, Bartges JW, d'Avignon A. et al. Comparison of various methods for estimating body fat in dogs. J Am Anim Hosp Assoc 2004; 40: 109-114.
    CrossrefPubMedGoogle Scholar
  • 22 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: 363-363.
    CrossrefPubMedGoogle Scholar
  • 23 Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38: 1-22.
    CrossrefPubMedGoogle Scholar
  • 24 KYON Veterinary Surgical Products. TTA Laboratory [2007 ACVS Veterinary Symposium, The Surgical Summit; Pre-Symposium Laboratories]. Chicago, IL, USA: 2007. October 18-21.
    Google Scholar
  • 25 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39: 905-908.
    CrossrefPubMedGoogle Scholar
  • 26 Montavon PM, Damur DM, Tepic S. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. Proceedings of the 1st World Orthopaedic Veterinary Conference. 2002. september 5-8 Munich, Germany: 152.
    Google Scholar
  • 27 Kim SE, Pozzi A, Banks SA. et al. Effect of tibial tuberosity advancement on femorotibial contact mechanics and stifle kinematics. Vet Surg 2009; 38: 33-39.
    CrossrefPubMedGoogle Scholar
  • 28 Kim SE, Pozzi A, Banks SA. et al. Effect of cranial cruciate ligament deficiency, tibial plateau leveling osteotomy, and tibial tuberosity advancement on contact mechanics and alignment of the stifle in flexion. Vet Surg 2010; 39: 363-370.
    CrossrefPubMedGoogle Scholar
  • 29 Butler JR, Syrcle JA, McLaughlin RM. et al. The effect of tibial tuberosity advancement and meniscal release on kinematics of the cranial cruciate ligament-deficient stifle during early, middle, and late stance. Vet Comp Orthop Traumatol 2011; 24: 342-349.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Thieman KM, Tomlinson JL, Fox DB. et al. 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: 705-710.
    CrossrefPubMedGoogle Scholar
  • 31 Millet M, Bismuth C, Labrunie A. et al. Measurement of the patellar tendon-tibial plateau angle and tuberosity advancement in dogs with cranial cruciate ligament rupture. Vet Comp Orthop Traumatol 2013; 26: 469-478.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Bielecki MJ, Schwandt CS, Scharvogel S. et al. Effect of tibial subluxation on the measurements for tibial tuberosity advancement in dogs with cranial cruciate ligament deficiency. Vet Comp Orthop Traumatol 2014; 27: 470-477.
    Article in Thieme ConnectPubMedGoogle Scholar