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Surgery

Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs

Summary:

To develop and test a novel extracapsular technique, TightRope CCL technique (TR), and compare its 6-month clinicaloutcomes to tibial plateau leveling osteotomy (TPLO) in dogs with cranial cruciate ligament (CCL) deficiency.

Conclusion:

TR resulted in 6-month outcomes that were not different than TPLO in terms of radiographic progression of OA and client-evaluated level of function. TR was associated with shorter anesthesia and surgery times as well as a lower complication rate.

Author & Journal:11. Cook J, et al, Vet Surg 2010;39(3):315-23
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Ununited anconeal process: lag-screw fixation with proximal ulnar osteotomy

Summary:

The aim of this study was to determine if internal fixation of the anconeus combined with a proximal ulnar osteotomy was more likely to result in fusion of the anconeus to the ulna compared with a proximal ulnar osteotomy alone.

Conclusion:

total of 47 elbows (44 dogs) were identified. Of these, 28 cases (average age 7.6 months) were treated with proximal ulnarosteotomy (of which eight were stabilised with an intramedullary pin) alone. Nineteen cases (average age 7.1 months) were treated with proximal ulnar osteotomy + internal fixation. The two groups were not significantly different in age (P=0.638, Mann-Whitney U test). Fourteen of 28 cases with proximal ulnar osteotomy alone displayed anconeal union at follow-up compared with 16 of 19 cases of proximal ulnar osteotomy + internal fixation, and this difference was statistically significant (P=0.029, Fisher’s exact test).

Author & Journal:Krotscheck U, et al, V Comp Ortho Trauma 13:212-216
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Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog. Surgical technique, radiographic and clinical outcomes.

Summary:

To report surgical technique, morphometric effects and clinical outcomes for tibial tuberosity transposition-advancement(TTTA), sulcoplasty and para-patellar fascial imbrication for management of concomitant medial patellar luxation (MPL) and cranialcruciate ligament (CCL) disease in 32 dogs.

Conclusion:

Thirty-nine stifles were treated by surgery. Medial patellar luxation grade ranged from II to IV/IV. The CCL rupture was complete in 17/39 stifles, and incomplete in 22/39. Complications occurred in 11/39 stifles including MPL recurrence (n=4). Resolution of subjectively-assessed lameness occurred in 29/39 stifles at the six to eight week assessment. Resolution of lameness was eventually documented in 35/39 stifles (4/39 lost to follow-up), and was maintained at the six to 20 month reassessment where available. The TTTA induced relative patella baja in 31/39 stifles. Magnitude of actual tibial tuberosity advancement was lower than that predicted by cage size.

Author & Journal:Yeadon R, et al, V Comp Orthop Traumatol 2011 24:18-26
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Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs.

Summary:

To compare owner satisfaction between custom-made stifle joint orthoses and tibial plateau leveling osteotomy (TPLO) for the management of medium- and large-breed dogs with cranial cruciate ligament disease (CCLD). DESIGN Owner survey.

Conclusion:

Results indicated high owner satisfaction rates for both interventions. Owners considering nonsurgical management with an orthosis should be advised about potential complications such as persistent lameness, skin lesions, patient intolerance of the device, and the need for subsequent surgery.

Author & Journal:Hart JL, et al, J Am Vet Med Assoc 2016;249(4):391-398
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Long-term results of conservative treatment, excision arthroplasty and triple pelvic osteotomy for the treatment of hip dysplasia in the immature dog

Summary:

The efficiency of conservative treatment, excision arthroplasty of the femoral head and neck and triple pelvic osteotomy for the treatment of hip dysplasia in the immature dog were compared using locomotor, physical and radiographic examinations and owner’s evaluation.

Conclusion:

Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment for joint congruence and control of degenerative joint disease.

Author & Journal:Plante J, Dupuis, et al, Vet Comp Orthop Trauma 10: 101-110, 1997
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Tibial plateau leveling osteotomy or tibial tuberosity advancement?

Summary:

To review the proposed biomechanical basis of the tibial plateau leveling osteotomy (TPLO) and tibial tuberosityadvancement (TTA) and recommendations for these techniques.

Conclusion:

There are many similarities between TPLO and TTA although it remains to be fully elucidated if either procedure is superior and under what conditions.

Author & Journal:Boudrieau RJ, Vet Surg. 2009 Jan;38(1):1-22
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Effect of surgical technique on radiographic fusion of the anconeus in the treatment of ununited anconeal process

Summary:

The aim of this study was to determine if internal fixation of the anconeus combined with a proximal ulnar osteotomy was more likely to result in fusion of the anconeus to the ulna compared with a proximal ulnar osteotomy alone.

Conclusion:

A total of 47 elbows (44 dogs) were identified. Of these, 28 cases (average age 7.6 months) were treated with proximal ulnar osteotomy (of which eight were stabilised with an intramedullary pin) alone. Nineteen cases (average age 7.1 months) were treated with proximal ulnar osteotomy + internal fixation. The two groups were not significantly different in age (P=0.638, Mann-Whitney U test). Fourteen of 28 cases with proximal ulnar osteotomy alone displayed anconeal union at follow-up compared with 16 of 19 cases of proximal ulnar osteotomy + internal fixation, and this difference was statistically significant (P=0.029, Fisher’s exact test).

Author & Journal:Pettitt RA, et al, J Small Anim Prac 2009 50:545-548
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Tibial tuberosity advancement in 65 canine stifles.

Summary:

The tibial tuberosity advancement (TTA) procedure was developed to treat dogs with cranial cruciate ligament deficient stifles. A retrospective, descriptive study was performed on 57 dogs that underwent unilateral or bilateral TTA.

Conclusion:

TTA subjectively appears to be a useful alternative in the management of cranial cruciate ligament disease. Few severe complications were encountered. Good clinical outcome and owner satisfaction was reported with the procedure in this set of cases.

Author & Journal:2. Hoffmann DE, et al, Vet Comp Orthop Traumatol 19:219–227, 2006
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Canine hip dysplasia treated by juvenile pubic symphysiodesis. Part I: two year results of computed tomography and distraction index.

Summary:

To measure one and two year effects of juvenile pubic symphysiodesis (JPS) in puppies defined as ‘at-risk’ for canine hip dysplasia (CHD) using the following objective hip conformation criteria: Acetabular angle (AA), dorsal acetabular rim angle (DARA) and hip laxity (PennHIP© distraction index (DI).

Conclusion:

Juvenile pubic symphysiodesis surgery at 12-24 weeks of age significantly improved hip conformation and decreased laxity in at-risk CHD dogs. Early-age (12 to 16 week) recognition of hip laxity offered greater JPS benefits than surgery performed at 19- to 24-weeks-old. Dogs with severe laxity (DI≥0.70) continued to increase in osteoarthritis. An early (12-16 weeks) positive laxity test (Ortolani) should alert one to obtain objective laxity determinations (PennHIP© DI).

Author & Journal:Dueland RT, et al, VCOT 2010
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Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog.

Summary:

Comparison of 2 methods of surgical management of cranial cruciate ligament (CCL) injury in large-breed dogs using a radiographic osteoarthrosis (OA) scoring system.

Conclusion:

Based on logistic regression analysis, dogs with larger OA score differences were 5.78 times more likely to have had ECR than TPLO.

Author & Journal:Lazar TP, et al, Vet Surg. 2005 Mar-Apr;34(2):133-41
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