Total Ankle Replacement Requiring Distal Tibiofibular Arthrodesis in a Dog

Abstract

This case report describes distal tibiofibular arthrodesis as a technique for achieving increased confluent bone support for the placement of oversized arthroplasty components for talocrural arthroplasty in an 18-month-old Labrador Retriever with talocrural osteoarthritis secondary to talar osteochondrosis. Computed tomography assessment for suitability for BioMedtrix canine ankle replacement surgery revealed the tibia to be undersized relative to the tibial component. Distal tibiofibular arthrodesis was performed to increase lateral bone support to permit placement of an otherwise oversized prosthesis. Subjective assessment of outcome with owner Liverpool Osteoarthritis in Dogs questionnaire to 6 months postoperatively as well as radiological assessment to 4 months postoperatively documented significant improvement in lameness in the operated limb with no complications. Distal tibiofibular arthrodesis is a means by which to achieve increased bone support prior to BioMedtrix canine total ankle replacement surgery. The surgical technique described herein permitted placement of an oversized talocrural prosthesis in this patient with good clinical function. This technique may permit use of this arthroplasty system in otherwise undersized patients until such a time that smaller implants are available from the manufacturer.

Keywords

tibiofibular arthrodesis - canine ankle replacement

Authors' Contributions

N.J.B. and M.K. both performed the surgery described in this case report, drafted the manuscript, and approved the final version to be published. N.J.B. produced the figures unless otherwise stated.

Publikationsverlauf

Eingereicht: 03. Oktober 2020

Angenommen: 18. Dezember 2020

Artikel online veröffentlicht:
08. Februar 2021

• References

• 1 Marks RM. Mid-term prospective clinical and radiographic outcome of a modern fixed bearing total ankle arthroplasty. J Foot Ankle Surg 2019; 58 (06) 1163-1170
• 2 Saltzman CL, Zimmerman MB, O'Rourke M, Brown TD, Buckwalter JA, Johnston R. Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. J Bone Joint Surg Am 2006; 88 (11) 2366-2372
• 3 Piriou P, Culpan P, Mullins M, Cardon JN, Pozzi D, Judet T. Ankle replacement versus arthrodesis: a comparative gait analysis study. Foot Ankle Int 2008; 29 (01) 3-9
• 4 Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am 2007; 89 (09) 1899-1905
• 5 Stengel D, Bauwens K, Ekkernkamp A, Cramer J. Efficacy of total ankle replacement with meniscal-bearing devices: a systematic review and meta-analysis. Arch Orthop Trauma Surg 2005; 125 (02) 109-119
• 6 Slater MR, Scarlett JM, Donoghue S. et al. Breed, gender and age risk factors for canine osteochondrosis dissecans. Vet Comp Orthop Traumatol 1991; 4: 100-106
• 7 LaFond E, Breur GJ, Austin CC. Breed susceptibility for developmental orthopedic diseases in dogs. J Am Anim Hosp Assoc 2002; 38 (05) 467-477
• 8 Fitzpatrick N. Arthrodesis verses novel joint replacement of the shoulder, elbow, stifle and hock in cats and dogs. In: Proceedings 16th ESVOT Congress, September 12–15, 2012, Bologna, Italy. pp 164–166
• 9 Acker RL. Tarsal joint replacement. In: Proceedings of the BioMedtrix 2018 Total joint conference, May 18–19, 2018; Hyatt Rosemont at Chicago O'Hare, Chicago, USA. pp 42–43
• 10 Van Der Meulen G. Design Rationale / System Overview. In: Proceedings of BioMedtrix TATE Elbow™ Workshop; 25–26th April 2009; Glasgow, UK
• 11 Sumner-Smith G. Gait Analysis and Orthopedic Examination. In: Slatter DS. ed. Textbook of small animal surgery 2nd ed. Philadelphia: WB Saunders; 1993: 1578
• 12 Jaegger G, Marcellin-Little DJ, Levine D. Reliability of goniometry in Labrador Retrievers. Am J Vet Res 2002; 63 (07) 979-986
• 13 Piermattei DL, Johnson KA. Approach to the wing of the ilium and dorsal aspect of the ilium. In: An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 4th edition.. Philadelphia: W.B. Saunders; 2004: 278-281
• 14 Piermattei DL, Johnson KA. Approach to the lateral and medial malleolus and talocrural joint. In: An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 4th edition.. Philadelphia: W.B. Saunders; 2004: 375-379
• 15 Walton MB, Cowderoy E, Lascelles D, Innes JF. Evaluation of construct and criterion validity for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) clinical metrology instrument and comparison to two other instruments. PLoS One 2013; 8 (03) e58125
• 16 Gielen I, van Bree H, Van Ryssen B, De Clercq T, De Rooster H. Radiographic, computed tomographic and arthroscopic findings in 23 dogs with osteochondrosis of the tarsocrural joint. Vet Rec 2002; 150 (14) 442-447
• 17 van der Peijl GJW, Schaeffer IGF, Theyse LFH, Dijkshoorn NA, Schwencke M, Hazewinkel HA. Osteochondrosis dissecans of the tarsus in Labrador Retrievers: clinical signs, radiological data and force plate gait evaluation after surgical treatment. Vet Comp Orthop Traumatol 2012; 25 (02) 126-134
• 18 Evans HE. Miller's Anatomy of the Dog. 3rd edition.. Philadelphia, PA: Saunders-Elsevier; 1993: 252
• 19 Barnett CH, Napier JR. The rotatory mobility of the fibula in eutherian mammals. J Anat 1953; 87 (01) 11-21
• 20 Ribbans WJ, Chadwick J, Natarajan R. Bilateral arthrodesis of the distal tibiofibular joint for deforming osteochondromatas. JRSM Open 2017; 8 (08) 2054270417718712 https://journals.sagepub.com/doi/10.1177/2054270417718712 Accessed September 03 2020
• 21 Rafferty M, Al-Nammari SS, Sleat G. et al. Syndesmotic arthrodesis for chronic inferior tibiofibular joint instability. Orthop. Proc 2018; 96-B Supplement 17. Accessed September 03, 2020 at: https://online.boneandjoint.org.uk/doi/abs/10.1302/1358-992X.96BSUPP_17.BOFAS2014-016
• 22 Barrow CR, Pomeroy GC. Enhancement of syndesmotic fusion rates in total ankle arthroplasty with the use of autologous platelet concentrate. Foot Ankle Int 2005; 26 (06) 458-461
• 23 Pyevich MT, Saltzman CL, Callaghan JJ, Alvine FG. Total ankle arthroplasty: a unique design. Two to twelve-year follow-up. J Bone Joint Surg Am 1998; 80 (10) 1410-1420