Cranial tibial plating in the management of failed tibial tuberosity advancement in four large breed dogs

Abstract

The management of failed surgical procedures involving osteotomy for tibial tuberosity advancement can be demanding due to the limited available bone stock, which must be large enough to counteract the powerful proximal and cranial distractive forces exerted by the quadriceps mechanism. Initial mode of failure may be related to implant failure, fracture of the tibial tuberosity, or a combination of both. The complications and management of the cases reported here were all associated with avulsion fracture of the tibial tuberosity following tibial tuberosity advancement. In all cases, a cranial tibial dynamic compression plate was applied to reduce the fractures and stabilize the osteotomy. No further major complications associated with the implants or fracture occurred. Radiographic evidence of progression of fracture healing was documented in all four cases at the six to eight-week postoperative follow-up. Long-term follow-up information was available for three out of four cases at nine to 23 months after surgery by telephone interview and validated owner questionnaires. Owners reported return to normal exercise with intermittent lameness occurring in two of the three cases. The authors concluded that this technique offers an alternative technique for the management of such fractures, in particular in large breed dogs where sufficient tibial tuberosity bone stock remains.

Treatment of tibial diaphyseal fractures following plateless tibial tuberosity advancement to manage cranial cruciate disease

“…In the present study, LOAD questionnaires were used to assess owner long‐term outcome. Results from these questionnaires produced a mean score of 12/52, which is similar to the findings of a previous study in dogs that sustained tibial tuberosity fractures following TTA (Lorenz & Pettitt ). Further studies are warranted to correlate the level of owner satisfaction and LOAD questionnaire scores.…”

Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs

“…Nevertheless, it is still being studied because of the high rate of complications and the lack of completely satisfactory results [6,7]. The most common major complications of TTA are tibial tuberosity (TT) distal longitudinal fractures with or without avulsion, implant failure, tibial fracture, seroma, dehiscence and infection [8][9][10]. While trying to reduce the major complication rates, the classical TTA procedure has evolved since its first inception in 2002 and various modifications have been proposed [11][12][13].…”

Tibial Tuberosity Advancement Techniques (TTAT): A Systematic Review

“…We found 471 records in database searching from 2011 to June 2022 (depending on the first publication for each technique). After duplicate removal (n = 117) and exclusion of book sections, ex vivo studies, or thesis (n = 178), we screened 176 records, from which we reviewed 68 full-text documents, and finally included 29 papers [ 3 , 11 , 12 , 13 , 15 , 16 , 21 , 22 , 23 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. Later, we searched records from the reference lists of initially included studies, founding one paper that fulfilled inclusion criteria [ 14 ].…”