Short-term comparison of tibial tuberosity advancement and tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease using kinetic analysis

Márcio P. Ferreira; Cássio R. A. Ferrigno; Alexandre N. A. de Souza; Daniela F. I. Caquias; Adriana V. de Figueiredo

doi:10.3415/VCOT-15-01-0009

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2016; 29(03): 209-213
DOI: 10.3415/VCOT-15-01-0009

Original Research

Schattauer GmbH

Short-term comparison of tibial tuberosity advancement and tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease using kinetic analysis

Authors

Márcio P. Ferreira

¹Department of Animal Medicine, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
Cássio R. A. Ferrigno

²Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
Alexandre N. A. de Souza

²Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
Daniela F. I. Caquias

³Universidad de la República Oriental del Uruguay, Montevideo, Uruguay
Adriana V. de Figueiredo

¹Department of Animal Medicine, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

Abstract

Summary

Objectives: This study set out to compare the outcomes of tibial tuberosity advancement (TTA) and tibial plateau levelling osteotomy (TPLO) procedures in the treatment of dogs affected with unilateral cranial cruciate ligament disease (CCLD) based on subjective parameters and objective pressure platform analysis (baropodometry).

Methods: Twenty-seven adult dogs weighing over 20 kg that were presented with unilateral CCLD and were treated by the TTA (12 dogs) or TPLO (15 dogs) surgical procedure. Patient allocation to either group was based on tibial plateau angle (TPA), according to clinical guidelines (indication for TTA for dogs was a TPA up to 25°, and indication for TPLO was any TPA). Pressure platform analysis was performed prior to surgery and at four different postoperative time points (14, 30, 60 and 90 days).

Results: Limb function significantly improved following TTA and TPLO, with no significant differences between groups.

Conclusion: The TTA and TPLO surgical procedures were considered to be equally effective in promoting weight bearing capacity recovery in dogs affected with unilateral CCLD under the conditions of this trial.

Keywords

Cranial cruciate ligament - pressure platform - baropodometry - orthopaedics

Full Text

References

References
1 Lampman TJ, Lund EM, Lipowitz AJ. Cranial cruciate disease: current status of diagnosis, surgery and risk for disease. Vet Comp Orthop Traumatol 2003; 16: 122-126.
2 Duval JM, Budsberg SC, Flo GL. et al. Breed, sex, and bodyweight as risk factors for rupture of the cranial cruciate ligament in young dogs. J Am Vet Med Assoc 1999; 215: 811-814.
3 Conzemius MG, Evans RB, Besancon MF. et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005; 226: 232-236.
4 Kim SE, Pozzi A, Kowaleski MP. et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111-125.
5 Bergh MS, Sullivan C, Ferrell CL. et al. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. J Am Anim Hosp Assoc 2014; 50: 315-321.
6 Christopher SA, Beetem J, Cook J. Comparison of long-term outcomes associated with three surgical techniques for treatment of cranial cruciate ligament disease in dogs. Vet Surg 2013; 42: 329-334.
7 Gordon-Evans WJ, Griffon DL, Bubb C. et al. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. J Am Vet Med Assoc 2013; 243: 675-680.
8 Souza AN, Pinto AC, Marvulle V. et al. Evaluation of vertical forces in the pads of German Shepherd dogs. Vet Comp Orthop Traumatol 2013; 26: 6-11.
9 Lequang T, Maitre P, Roger T. et al. Is a pressure walkway system able to highlight a lameness in dog?. J Anim Vet Adv 2009; 8: 1936-1944.
10 Boudrieau RJ, Mccarthy RJ, Sisson Jr RD . Sarcoma of the proximal portion of the tibia in a dog 5.5 years after tibial plateau leveling osteotomy. J Am Vet Med Assoc 2005; 227: 1613-1617.
11 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.
12 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.
13 Vezzoni A. TTA (tibial tuberosity advancement) in the treatment of cranial cruciate ligament injuries. Proceedings of the North American Veterinary Conference 2006. January 7-11. Orlando, FL; United States: 949-952.
14 Ferrigno CRA, Cunha O, Mariani TC. et al. Resultados da técnica de avanço da tuberosidade tibial para tratamento da insuficiência de ligamento cruzado cranial em 17 casos [Tibial tuberosity advancement treatment in 17 dogs with cranial cruciate ligament disease]. MEDVEP 2009; 7: 578-583.
15 Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38: 1-22.
16 Dymond DL, Goldsmid SE, Simpson DJ. Tibial tuberosity advancement in 92 canines stifles: Initial results, clinical outcomes and owner evaluation. Aust Vet J 2010; 88: 381-385.
17 Reif U, Hulse DA, Hauptman JG. Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study. Vet Surg 2002; 31: 147-154.
18 Duerr FM, Duncan CG, Savicky RS. et al. Risk factors for excessive tibial plateau angle in large-breed dogs with cranial cruciate ligament disease. J Am Vet Med Assoc 2007; 231: 1688-1691.
19 Read RA, Robins GM. Deformity of the proximal tibia in dogs. Vet Rec 1982; 111: 295-298.
20 Slocum B, Devine T. Cranial tibial thrust: a primary force in the canine stifle. J Am Vet Med Assoc 1983; 183: 456-459.
21 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: 363-366.
22 Murphy S. Prospective comparison of tibial tuberosity advancement and TPLO. Proceedings of the 17th European Society of Veterinary Orthopaedics and Traumatology Congress 2014. October 2-4. Venice; Italy: 203-205.
23 Evans R, Horstman C, Conzemius M. Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait. Vet Surg 2005; 34: 445-449.
24 Fachon L, Grandjean D. Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs. Am J Vet Res 2007; 68: 1089-1094.
25 Voss K, Damur DM, Guerrero T. et al. Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008; 21: 243-249.
26 Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987; 48: 915-918.
27 Evans R, Gordon W, Conzemius M. Effect of velocity on ground reaction forces in dogs with lameness attributable to tearing of the cranial cruciate ligament. Am J Vet Res 2003; 64: 1479-1481.
28 Newton CD, Nunamaker DM. Normal and abnormal gait. In Nunamaker DM. editor Textbook of Small Animal Orthopaedics Philadelphia: Lippincott Company 1985; 1083-1096.
29 Budsberg SC, Jevens DJ, Brown J. et al. Evaluation of limb symmetry indices, using ground reaction forces in healthy dogs. Am J Vet Res 1993; 54: 1569-1574.
30 Voss K, Galeandro L, Wiestner T. et al. Relationships of body weight, body size, subject velocity, and vertical ground reaction forces in trotting dogs. Vet Surg 2010; 39: 863-869.
31 Riggs CM, Decamp CE, Soutas-Little RW. et al. Effects of subject velocity on force plate-measured ground reaction forces in healthy Greyhounds at the trot. Am J Vet Res 1993; 54: 1523-1526.
32 Shires PK, Lanz O, Martin RA. et al. Early post-operative outcomes in unilateral cranial cruciate ligament deficient dogs treated with tibial tuberosity advancement or tibial plateau leveling osteotomy. Vet Surg 2007; 36: E24.
33 Mölsä SH, Hielm-Björkman AK, Laitinen-Vapaavouri OM. Force platform analysis in clinically healthy Rottweilers: comparison with Labrador Retrievers. Vet Surg 2010; 39: 701-707.
34 Steinberg EJ, Prata RG, Palazzini K. et al. Tibial tuberosity advancement for treatment of CrCL: complications and owner satisfaction. J Am Anim Hosp Assoc 2011; 47: 250-257.