Proximal tibial epiphysiodesis to reduce tibial plateau slope in young dogs with cranial cruciate ligament deficient stifle

Abstract

SummaryThe purpose of this study was to evaluate the ability of proximal tibial epiphysiodesis to reduce the tibial plateau slope in young dogs with cranial cruciale ligament (CCL) deficient stifles. Of the 14 treated dogs, eight had a bilateral injury, for a total of 22 joints. After physical and radiographical examination and measurement of tibial plateau slope, all of the dogs underwent surgery. Insertion of the screw was placed in the most proximal part of the tibial plateau, in its medio-lateral centre, aiming to the tibial shaft and using a K wire predriven as a guide; correct position of the screw was confirmed with intraoperative fluoroscopy or radiography. In all of the dogs the tibial slope was decreased at the time of physis fusion and the degree of change depended on the age and the breed of the dog at the time of surgery. The minimum change was 4° and the maximum was 24°. There was a statistically significant difference between tibial slope measured before surgery compared to tibial slope measured at the last follow-up visit after surgery. This study shows that the partial proximal tibial fusion in dogs with ACL injuries was effective in reducing the tibial slope during the residual growing time to such an extent to stabilize the joint, provided that the surgery had been carried out when there was still residual growing potential. The technique appeared to be mini-invasive and malalignment complications could be avoided by correct and precise insertion of the screw.

Corrective Osteotomy in a Dog to Address Increased Distal Femoral Procurvatum Ascribed to a Distal Femoral Salter-Harris Type V Injury

“…23 The PTE has been advocated for reducing the TPA in skeletally immature dogs with cranial cruciate ligament deficiency. 18 The dog in our study did not have any clinical abnormalities consistent with cranial cruciate insufficiency during the study. We decided to perform the PTE as a tentative procedure to reduce the high tibial slope.…”

“…However, no similar data are available regarding the performance of PTE in smallbreed dogs. 18 The increased distal femoral procurvatum resulted in restricted stifle extension and persistent lameness in the dog described in this case report. The CCWO yielded an excellent functional outcome in this dog.…”

“…was inserted cranially in the tibial plateau and directed parallel to the proximal tibial shaft using a limited medial approach. 18 The fascia, subcutaneous tissue and skin were closed routinely in layers.…”

Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis

“…Epiphysiodesis was achieved based on the subsequent radiographic appearance of the physis. Proximal tibial epiphysiodesis using a trans-physeal screw has been described to manage skeletally immature dogs with CCL insufficiency [18]. Whether thermal ablation using electrocautery [16, 17], as performed in the dog in this report, is a suitable modality for performing proximal tibial physeal epiphysiodesis remains unclear.…”

Comparison of fluoroscopic and radiographic imaging of long bones in healthy dogs

“…As surgeons further evaluate the costs and benefits of operating room efficiency with the introduction of fluoroscopy in routine practice in terms of ease of surgical procedures, decreased morbidity, reduction in length of hospital stays and earlier return to function of their patients, the fluoroscopy is likely to become more popular in future in veterinary practice as well. There are only few published reports on the use of fluoroscopy for long-bone fracture repair in dogs and cats (Cook et al 1999;Patel et al 2007;Wadke et al 2007;De´jardin & Cabassu 2008;Gupta et al 2008;Vezzoni et al 2008;Sereda et al 2009;Ayyapan et al 2010); however, fluoroscopic studies of long bones in normal dogs are unavailable. The purpose of the present study was to describe observations based upon fluoroscopic examination of the long bones and to compare these results with the radiographic findings in healthy dogs.…”