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Surgery

Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling.

Summary:

To evaluate a novel surgery aimed at managing concurrent medial patellar luxation (MPL) and cranial cruciate ligament(CCL) ruptures in dogs weighing more than 30 kg.

Conclusion:

Thirteen surgeries were performed in 12 dogs with a mean weight of 39.8 kg. The mean postoperative tibial plateau slope was 8.1 degrees. Additional surgery was required in two cases, one due to failure of fixation and another due to screw breakage. The mean lameness score was 3.5 (out of 5) before surgery, 0.7 after 8 to 12 weeks, and 0.3 at final follow-up. Median follow-up was 1115 days (range, 270 to 2040 days). No patella luxated after surgery.

Author & Journal:Langenbach A, et al, J Small Anim Prac 2010 51:97-103
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Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs

Summary:

To determine the outcome and effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament (RCCL) and injury to the medial meniscus in Labrador Retrievers.

Conclusion:

Surgical technique can influence limb function after surgery. Labrador Retrievers treated via LSS, ICS, or TPLO for repair for of RCCL and medial meniscal injury managed with partial or complete meniscectomy infrequently achieve normal function. Results of LSS and TPLO are similar and superior to ICS.

Author & Journal:Conzemius MG, et al, J Am Vet Med Assoc. 2005 Jan 15;226(2):232-6
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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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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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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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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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