Vet Comp Orthop Traumatol 2012; 25(05): 402-409
DOI: 10.3415/VCOT-11-12-0175
Clinical Communication
Schattauer GmbH

Evaluation of complications and short-term outcome after unilateral or single-session bilateral tibial tuberosity advancement for cranial cruciate rupture in dogs

M. S. Hirshenson
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
U. Krotscheck
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
M. S. Thompson
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
H. M. Knapp-Hoch
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
A. R. Jay-Silva
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
M. McConkey
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
,
S. P. Bliss
1   Department of Clinical Science, Cornell University, Ithaca, NY , USA
2   Current: Port City Veterinary Referral Hospital, Portsmouth, NH, USA
,
R. Todhunter
3   College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
,
H. O. Mohammed
4   Department of Population Medicine, Cornell University, Ithaca, NY, USA
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Publikationsverlauf

Received 15. Dezember 2011

Accepted 08. Mai 2012

Publikationsdatum:
18. Dezember 2017 (online)

Summary

Objective: To compare the resulting complications, short-term results, and client satisfaction for treatment of cranial cruciate ligament rupture using either unilateral or bilateral single-session tibial tuberosity advancement (TTA) in dogs.

Methods: Medical records of 68 dogs (101 stifles) undergoing unilateral or bilateral single-session TTA were evaluated. Data gathered included signalment, history, physical examination findings, anaesthesia and surgical time, type of cranial cruciate ligament rupture and meniscal injury, implants, and intra-operative and postoperative complications. A mixed effect logistic regression analysis was performed to determine if complications were grouped by surgical procedure. Linear regression was performed to determine the influence of the variables on the occurrence of complications. Values of p <0.05 were considered significant.

Results: No major intra-operative complications occurred. Twenty stifles (20%) developed a complication after surgery (11 minor, 9 major). There was no significant difference in occurrence of complications between dogs undergoing unilateral (n = 8) or bilateral single-session (n = 12) TTA (p = 0.69). The only risk factor found to be associated with complication occurrence was age.

Clinical significance: This is the first report evaluating the use of bilateral simultaneous TTA. There was no significant difference in complication rates between unilateral and bilateral single-session TTA. Additional evaluation is needed to fully determine the extent of complications and long-term outcome of bilateral single-session TTA.

 
  • References

  • 1 Lazar TP, Berry CR, deHaan JJ. et al. Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog. Vet Surg 2005; 34: 133-141.
  • 2 Vasseur PB. Stifle Joint. In: Slatter DH. editor. Textbook of Small Animal Surgery. Philadelphia: Saunders; 2003. pg. 2090-2132.
  • 3 Lampman TJ, Lund EM, Lipowitz AJ. Cranial cruciate disease: current status of diagnosis, surgery, and risk for disease. Vet Surg 2003; 3: 122-126.
  • 4 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.
  • 5 Pacchiana PD, Morris E, Gillings SL. et al. 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: 184-193.
  • 6 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.
  • 7 Johnson JM, Johnson AL. Cranial cruciate ligament rupture. Pathogenesis, diagnosis, and postoperative rehabilitation. Vet Clin North Am Small Anim Pract 1993; 23: 717-733.
  • 8 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.
  • 9 Stauffer KD, Tuttle TA, Elkins AD. et al. Complications associated with 696 tibial plateau leveling osteotomies (2001-2003). J Am Anim Hosp Assoc 2006; 42: 44-50.
  • 10 Hoffmann DE, Miller JM, Ober CP. et al. Tibial tuberosity advancement in 65 canine stifles. Vet Comp Orthop Traumatol 2006; 19: 219-227.
  • 11 Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38: 1-22.
  • 12 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.
  • 13 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.
  • 14 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.
  • 15 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.
  • 16 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.
  • 17 Boudrieau RJ. Tibial tuberosity advancement: a step-by-step approach to using the common tangent method for determining advancement in cranial cruciate deficient stifles (created June 2009). KYON Instructional Course: Tibial Tuberosity Advancement for Cranial Cruciate Deficient Stifle in Dogs. March 2012
  • 18 Campoy L, Bezuidenhout AJ, Gleed RD. et al. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs. Vet Anaesth Analg 2010; 37: 144-153.
  • 19 Verhoeven G. Tibial tuberosity advancement: a step-by-step approach to the surgical technique and anatomical landmarks (created 2007). KYON Instructional Course: Tibial Tuberosity Advancement for Cranial Cruciate Deficient Stifle in Dogs. March 2010
  • 20 Olmstead ML. The canine cemented modular total hip prosthesis. J Am Anim Hosp Assoc 1995; 31: 109-124.
  • 21 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.
  • 22 Fleiss JL. Statistical Methods for Rates and Proportions. New York: Wiley-Interscience; 1981
  • 23 Rosner B. Multivariate methods for clustered binary data with multiple subclasses, with application to binary longitudinal data. Biometrics 1992; 48: 721-731.
  • 24 Polanczyk C, Marcantonio E, Lee T. et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med 2001; 134: 637-643.
  • 25 Casale SA, McCarthy RJ. Complications associated with lateral fabellotibial suture surgery for cranial cruciate ligament injury in dogs: 363 (1997-2005). J Am Vet Med Assoc 2009; 234: 229-235.
  • 26 Frey TN, Hoelzler MG, Scavelli TD. et al. Risk factors for surgical site infection-inflammation in dogs undergoing surgery for rupture of the cranial cruciate ligament: 902 cases (2005-2006). J Am Vet Med Assoc 2010; 236: 88-94.
  • 27 Johnson AL, Broaddus KD, Hauptman JG. et al. Vertical patellar position in large-breed dogs with clinically normal stifles and large-breed dogs with medial patellar luxation. Vet Surg 2006; 35: 78-81.
  • 28 Carey K, Aiken SW, DiResta GR. et al. Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy 94 cases (2000-2003). Vet Comp Orthop Traumatol 2005; 18: 235-242.
  • 29 Kuhn K, Ohlerth S, Makara M. et al. Radiographic and ultrasonographic evaluation of the patellar ligament following tibial tuberosity advancement. Vet Radiol Ultrasound 2011; 52: 466-471.