Vet Comp Orthop Traumatol 2016; 29(06): 528-535
DOI: 10.3415/VCOT-15-11-0184
Clinical Communication
Schattauer GmbH

Tibial plateau levelling osteotomy in eleven cats with cranial cruciate ligament rupture

Julia K. Mindner
1   Tierklinik Haar, Haar, Germany
,
Malgorzata J. Bielecki
1   Tierklinik Haar, Haar, Germany
,
Stefan Scharvogel
1   Tierklinik Haar, Haar, Germany
,
Diane Meiler
1   Tierklinik Haar, Haar, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received: 12. November 2015

Accepted: 27. Juli 2016

Publikationsdatum:
19. Dezember 2017 (online)

Summary

Objective: To report the surgical procedure, intra- and postoperative complications, and short-term follow-up of tibial plateau levelling osteotomy (TPLO) in feline patients with cranial cruciate ligament (CrCL) rupture using a 2.0 or 2.4 mm Synthes® TPLO plate.

Study design: Prospective study.

Material and methods: Eleven cats with a CrCL rupture were included in the study. Inspection of intra-articular structures was carried out via arthroscopy or arthrotomy. Each patient was re-examined one and 10 days after surgery. Orthopaedic examination and follow-up radiographs were obtained four to 12 weeks postoperatively.

Results: Two meniscopathies and one partial CrCL rupture were detected. Minor intra- operative complications occurred in five cats (suboptimal positioning of the plate [n = 3], proximal fibular fracture [n = 1], a visible osteotomy gap [n = 1]). Postoperatively, minor complications were detected in three cats (mild patellar desmitis [n = 2], superficial wound infection [n = 1]). No additional surgical reintervention, graded as major complication, was necessary. Four to eight weeks postoperatively, all cats showed no to mild intermittent lameness. Complete bone union was apparent within four to 12 weeks. Owners reported a high level of comfort and mobility during the last follow-up.

Conclusion: The preliminary results of this study support the use of TPLO in cats, but larger case numbers are needed to evaluate its practicability, as well as long-term outcome (>1 year), especially evaluating the development and the clinical relevance of osteoarthritis.

Supplementary Material to this article is available online at http://dx.doi.org/10.3415/VCOT-15-11-0184.

 
  • References

  • 1 Wilke V, Robinson D, Evans R. et al. Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States. J Am Vet Med Assoc 2005; 227: 1604-1607.
  • 2 Hayashi K, Manley PA, Muir P. Cranial cruciate ligament pathophysiology in dogs with cruciate disease: a review. J Am Anim Hosp Assoc 2004; 40: 385-390.
  • 3 MacLaughlin RM. Surgical disease of the feline stifle joint. Vet Clin Small Anim 2002; 32: 963-982.
  • 4 Umphlet RC. Feline Stifle Disease. Vet Clin North Am Small Anim Pract 1993; 23: 897-913.
  • 5 Scavelli TD, Schrader SC. Nonsurgical management of rupture of the cranial cruciate ligament in 18 cats. J Am Anim Hosp Assoc 1986; 23: 337-340.
  • 6 Harasen GLG. Feline cranial cruciate rupture. Vet Comp Orthop Traumatol 2005; 4: 254-257.
  • 7 Byod SK, Müller R, Leonard T. et al. Long-term periarticular bone adaptation in a feline knee injury model for post-traumatic experimental osteoarthritis. Osteoarthritis Cartilage 2005; 13: 235-242.
  • 8 Suter E, Herzog W, Leonard TR. et al. One-year changes in hind limb kinematics, ground reaction forces and knee stability in an experimental model of osteoarthritis. J Biomech 1998; 31: 511-517.
  • 9 Herzog W, Adams ME, Matyas JR. et al. Hindlimb loading, morphology and biochemistry of articular cartilage in the ACL-deficient cat knee. Osteoarthritis Cartilage 1993; 1: 243-251.
  • 10 Kunkel K, Basinger RR, Suber JT. et al. Evaluation of a transcondylar toggle system for stabilization of the cranial cruciate deficient stifle in small dogs and cats. Vet Surg 2009; 38: 975-982.
  • 11 Slocum B, Devine T. Tibial plateau levelling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin Am Small Anim Pract 1993; 23: 777-786.
  • 12 Kim SE, Pozzi A, Kowaleski MP. et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111-125.
  • 13 Hoots EA, Petersen SW. Tibial plateau leveling osteotomy and cranial closing wedge ostectomy in a cat with cranial cruciate ligament rupture. J Am Anim Hosp Assoc 2005; 41: 395-399.
  • 14 Allan RM. A modified Maquet technique for management of cranial cruciate avulsion in a cat. J Small Anim Prac 2014; 55: 52-56.
  • 15 Freire M, Robertson I, Bondell HD. et al. Radiographic evaluation of feline appendicular degenerative joint disease vs. macroscopic appearance of articular cartilage. Vet Radiol Ultrasound 2011; 52: 239-247.
  • 16 Wilke VL, Conzemius MG, Besancon MF. et al. Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament. J Am Vet Med Assoc 2002; 221: 1426-1429.
  • 17 Schnabl E, Reese S, Lorinson K. et al. Measurement of the tibial plateau angle in cats with and without cranial cruciate ligament rupture. Vet Comp Orthop Traumatol 2009; 22: 83-86.
  • 18 Cosenza G, Reif U, Martini FM. Tibial plateau levelling osteotomy in 69 small breed dogs using conically coupled 1.9/2.5 mm locking plates. Vet Comp Orthop Traumatol 2015; 5: 1-8.
  • 19 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310.
  • 20 Campos AG, Froes TD, Tatarunas AC. et al. What is your diagnosis? Intra-articular avulsion fracture at the tibial insertion of the cranial cruciate ligament. J Am Vet Med Assoc 2005; 227: 883-884.
  • 21 Ruthrauff CM, Glerum LE, Gottfried SD. Incidence of meniscal injury in cats with cranial cruciate ligament ruptures. Can Vet J 2011; 52: 1106-1110.
  • 22 Gatineau M, Dupuis J, Planté J. et al. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Vet Comp Orthop Traumatol 2011; 24: 333-341.
  • 23 Kerwin S. Orthopedic examination in the cat: clinical tips for ruling in/out common musculoskeletal disease. J Feline Med Surg 2012; 14: 6-12.
  • 24 Stadig SM, Bergh AK. Gait and jump analysis in healthy cats using a pressure mat system. J Feline Med Surg 2015; 17: 523-529.
  • 25 Clarke S, Bennett D. Feline osteoarthritis: a prospective study of 28 cases. J Small Anim Pract 2006; 47: 439-445.
  • 26 Schnabl E, Bockstahler B. Systematic review of ground reaction force measurements in cats. Vet J 2015; 206: 83-90.
  • 27 Caylor KB, Zumpano CA, Evans LM. et al. Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. J Am Anim Hosp Assoc 2001; 37: 263-268.
  • 28 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.
  • 29 Hoelzler MG, Millis DL, Francis DA. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33: 146-153.
  • 30 Plesman R, Gilbert P, Campbell J. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture. Vet Comp Orthop Traumatol 2013; 26: 42-46.
  • 31 Pozzi A, Hildreth BE, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37: 749-755.
  • 32 Miller CW, Presnell KR. Examination of the canine stifle: arthroscopy versus arthrotomy. J Am Anim Hosp Assoc 1985; 21: 623-629.
  • 33 Schmerbach I K, Boeltzig CK, Reif U. et al. In vitro comparison of tibial plateau levelling with and without use of a tibial plateau levelling jig. Vet Surg 2007; 36: 156-163.
  • 34 Taylor J, Langenbach A, Marcellin-Little DJ. Risk factors for fibular fracture after TPLO. Vet Surg 2011; 40: 687-693.
  • 35 Mossmann H, von Pfeil DJF, Nicholson M. et al. Accuracy of three pre- and intraoperative measurement techniques for osteotomy positioning in the tibial plateau levelling procedure. Vet Comp Orthop Traumatol 2015; 4: 250-255.
  • 36 Warzee CC, DeJardin LM, Arnoczky SP. et al. Effect of tibial plateau leveling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: an in vitro experimental study. Vet Surg 2001; 30: 278-286.
  • 37 Robinson DA, Mason DR, Evans R. et al. The effect of tibial plateau angle ground reaction forces 4-17. months after tibial plateau levelling osteotomy in Labrador Retrievers. Vet Surg 2006; 35: 294-299.
  • 38 Bilmont A, Retournard M, Asimus E. Effect of tibial plateau levelling osteotomy on stability of the feline cranial cruciate-deficient stifle joint: an in-vitro experimental study. Scientific Presentation Abstracts of the 2015 European College of Veterinary Surgeons Annual Scientific Meeting; 2015 July 2-4. Berlin, Germany. Vet Surg 2015; 44: E21.
  • 39 Hurley CR, Hammer DL, Shott S. Progression of radiographic evidence of osteoarthritis following tibial plateau levelling osteotomy in dogs with cranial cruciate ligament rupture: 295 cases (2001-2005). J Am Vet Med Assoc 2007; 230: 1674-1679.
  • 40 Godfrey DR. Osteoarthritis in cats: a retrospective radiological study. J Small Anim Prac 2005; 46: 425-429.
  • 41 Lascelles BD, Henry 3rd JB , Brown J. et al. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg 2010; 39: 535-544.
  • 42 Lascelles BD. Feline degenerative joint disease. Vet Surg 2010; 39: 2-13.
  • 43 Lascelles BD, Dong YH, Marcellin-Little DJ. et al. Relationship of orthopaedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats. BMC Vet Res 2012; 8: 10.
  • 44 Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997). J Am Vet Med Assoc 2002; 220: 628-632.