Comparison of Locking and Conventional Screws for Maintenance of Tibial Plateau Positioning and Biomechanical Stability After Locking Tibial Plateau Leveling Osteotomy Plate Fixation

Abstract

These results suggest that conventional screws and careful contouring of the TPLO plate can provide comparable mechanical stability to fixation with locking screws in the tibial plateau under load-sharing conditions, but potentially at the expense of osteotomy reduction.

Accuracy of Fragment Positioning After TPLO and Effect on Biomechanical Stability

“…The materials and methods for this study are similar to those reported in a companion report 11 with minor differences.…”

“…Specimens used in this study were also used in a different study investigating the effect of screw type (conventional or locking) in combination with a locking TPLO plate 11 . Because we found significant differences in fragment positioning between the screw groups in that study, 11 we restricted the current investigation to TPLO stabilization with conventional screws, as this method of fixation is more commonly used in clinical practice. Further studies would be required to determine whether our findings for conventional screw fixation would also apply to TPLO constructs stabilized with locking screws.…”

“…However, over‐rotation may predispose the caudal cruciate ligament to fatigue failure 5,6,17 . Major influences on the rotational accuracy of the TPLO procedure might be the use of the Slocum chart with subsequent pen marking, visual fragment rotation, and use of conventional screws 11 . Furthermore, the plate application was proven to result in further, undesired rotation of the tibial plateau fragment about the sawing axis of up to 4.4°.…”

Effect of Screw Insertion Torque on Push‐Out and Cantilever Bending Properties of Five Different Angle‐Stable Systems

“…In the past 2 decades, locking plate systems have become increasingly popular for internal fixation in people and their recent use in veterinary surgery has inspired the development of several angle‐stable systems used exclusively in animals. Most of the published mechanical studies compare standard locking plates; however, few studies compare and validate the mechanical properties of angle‐stable systems …”

Fibular osteotomy to facilitate proximal tibial rotation during tibial plateau leveling osteotomy

“…Although many methods have been described to stabilize the cruciate‐deficient stifle, tibial plateau leveling osteotomy (TPLO) is the most commonly recommended procedure for large‐breed dogs . The efficacy of TPLO depends on several factors, including adequate rotation of the proximal tibial segment, appropriate positioning of the osteotomy, and fixation techniques that minimize postoperative change in tibial plateau angle (TPA) …”