Download PDF
Vet Comp Orthop Traumatol 2015; 28(04): 250-255
DOI: 10.3415/VCOT-14-12-0188
Original Research
Schattauer GmbH

Accuracy of three pre- and intraoperative measurement techniques for osteotomy positioning in the tibial plateau levelling procedure

H. Mossman
1   Veterinary Surgical Centers, Vienna, VA, USA
,
D.J. F. von Pfeil
2   Friendship Surgical Specialists of the Friendship Hospital for Animals, Washington, DC, USA
,
M. Nicholson
3   Central Animal and Referral Emergency Hospital, Fredricksburg, VA, USA
,
H. Phelps
4   CARE Veterinary Center, Frederick, MD, USA
,
E. Morris
5   Veterinary Surgical Referral Practice of Northern Virginia, Manassas, VA, USA
,
R. Bradley
5   Veterinary Surgical Referral Practice of Northern Virginia, Manassas, VA, USA
,
J. Taylor
6   Veterinary Surgical Centers, Leesburg, VA, USA
,
A. Langenbach
1   Veterinary Surgical Centers, Vienna, VA, USA
› Author Affiliations
Further Information

Publication History

Received:22 December 2014

Accepted:26 April 2015

Publication Date:
28 December 2017 (online)

    Permissions and Reprints

Summary

Objectives: To prospectively compare the accuracy of three preoperative measurement techniques in tibial plateau levelling osteo -tomy (TPLO) planning.

Methods: Fifty-nine dogs were randomly assigned to one of three measurement techniques; A, B or C. Surgeons measured the intended osteotomy location on preoperative radiographs according to the assigned technique. Measurements were used intra-operatively during osteotomy placement. Postoperative measurements were made by a single blinded observer and compared to preoperative measurements.

Results: Fifty-one dogs were included for final statistical analysis. The mean absolute differences between pre- and postoperative measurements was 1.72 mm ± 0.958, 1.79 mm ± 1.010, and 3.56 mm ± 1.839, for techniques A, B and C, respectively. No significant differences were identified for patient age, gender, limb or surgeon. Techniques A and B were not significantly different (p = 0.8799). Techniques A and B were significantly more accurate than C (p = 0.0001 and p = 0.0003, respectively). Weight was significantly different among the groups (p = 0.047) but the statistical results did not change when an adjustment was made for bodyweight (p = 0.4971, p <0.001 and p = 0.0007, respectively).

Clinical significance: Preoperative measuring for planning a TPLO osteotomy is recommended. Techniques A and B in the current study were clinically practical and significantly more accurate compared to technique C.

Keywords

Cranial cruciate ligament - tibial plateau levelling osteotomy - accuracy - dog - stifle
 

  • References

  • 1 Kowaleski MP, Boudrieau RJ, Pozzi A. Stifle joint. In Tobias KM, Johnston SA.. editors Veterinary Surgery: Small Animal. Vol. 1. St. Louis: Saunders; 2012: 906-998.
    Google Scholar
  • 2 Johnson JA, Austin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994; 7: 56-69.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Kim SE, Pozzi A, Kowaleski MP. et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111-125.
    CrossrefPubMedGoogle Scholar
  • 4 DeAngelis M, Lau RE. A lateral retinacular imbrication technique for the surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970; 157: 79-84.
    PubMedGoogle Scholar
  • 5 Montavon PM, Damur DM, Tepic S. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. In: Proceedings of 1st World Orthopedic Veterinary Congress. 2002. September 5-8 Munich, Germany: 152.
    Google Scholar
  • 6 Slocum B, Slocum TD. Tibial plateau levelling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777-795.
    CrossrefPubMedGoogle Scholar
  • 7 Leighton R. Preferred method of repair of cranial cruciate ligament rupture in dogs — A survey of ACVS diplomates specializing in canine orthopedics. Vet Surg 1999; 28: 194.
    CrossrefPubMedGoogle Scholar
  • 8 Warzee CC, Dejardin LM, Arnoczky SP. et al. Effect of tibial plateau levelling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: An in vitro experimental study. Vet Surg 2001; 30: 278-286.
    CrossrefPubMedGoogle Scholar
  • 9 Reif U, Hulse DA, Hauptman JG. Effect of tibial plateau levelling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study. Vet Surg 2002; 31: 147-154.
    CrossrefPubMedGoogle Scholar
  • 10 Kowaleski MP, Apelt D, Mattoon JS. et al. The effect of tibial plateau levelling osteotomy position on cranial tibial subluxation: an in vitro study. Vet Surg 2005; 34: 332-336.
    CrossrefPubMedGoogle Scholar
  • 11 Kalff S, Meachem S, Preston C. Incidence of medial meniscal tears after arthroscopic assisted tibial plateau levelling osteotomy. Vet Surg 2011; 40: 952-956.
    PubMedGoogle Scholar
  • 12 Taylor J, Langenbach A. Marcellin, Little DJ. Risk factors for fibular fracture after TPLO. Vet Surg 2011; 40: 687-693.
    CrossrefPubMedGoogle Scholar
  • 13 von Pfeil DJF, Edwards MR, Nelson NC. Handling of the tibial muscle envelope in tibial plateau levelling osteotomy-to elevate or not?. Vet Comp Orthop Traumatol 2013; 26: 392-398.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Kowaleski MP, Boudrieau RJ, Beale BS. et al. Radiographic outcome and complications of tibial plateau levelling osteotomy stabilized with an anatomically contoured locking bone plate. Vet Surg 2013; 42: 847-852.
    CrossrefPubMedGoogle Scholar
  • 15 Coletti T, Anderson M, Gorse MJ. et al. Complications associated with tibial plateau levelling osteotomy: a retrospective of 1519 procedures. Can Vet J 2014; 55: 249-254.
    PubMedGoogle Scholar
  • 16 Wheeler JL, Cross AR, Gingrich W. In vitro effects of osteotomy angle and osteotomy reduction on tibial angulation and rotation during the tibial plateau-levelling osteotomy procedure. Vet Surg 2003; 32: 371-377.
    CrossrefPubMedGoogle Scholar
  • 17 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
  • 18 Kowaleski MP, McCarthy RJ. Geometric analysis evaluating the effect of tibial plateau levelling osteotomy position on postoperative tibial plateau slope. Vet Comp Orthop Traumatol 2004; 17: 30-34.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Talatt MB, Kowaleski MP, Boudrieau RJ. Combination tibial plateau levelling osteotomy and cranial closing wedge osteotomy of the tibia for the treatment of cranial cruciate ligament-deficient stifles with excessive tibial plateau angle. Vet Surg 2006; 35: 729-739.
    CrossrefPubMedGoogle Scholar
  • 20 Collins JE, Degner DA, Hauptman JG. et al. Benefits of pre- and intraoperative planning for tibial plateau levelling osteotomy. Vet Surg 2014; 43: 142-149.
    CrossrefPubMedGoogle Scholar
  • 21 Woodbridge N, Knuchel-Takano A, Brissot H. et al. Accuracy evaluation of a two-wire technique for osteotomy positioning in the tibial plateau levelling procedure. Vet Comp Orthop Traumatol 2014; 27: 8-13.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Tan CJ, Bergh MS, Schembri MA. et al. Accuracy of tibial osteotomy placement using 2 different tibial plateau levelling osteotomy jigs. Vet Surg 2014; 43: 525-533.
    CrossrefPubMedGoogle Scholar
  • 23 O'Brien CS, Martinez SA. Potential iatrogenic medial meniscal damage during tibial plateau levelling osteotomy. Vet Surg 2009; 38: 868-873.
    CrossrefPubMedGoogle Scholar
  • 24 Fettig AA, Rand WM, Sato AF. et al. Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints. Vet Surg 2003; 32: 471-478.
    CrossrefPubMedGoogle Scholar
  • 25 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