Risk Factors for Tibial Tuberosity Fracture After Tibial Plateau Leveling Osteotomy in Dogs

Abstract

Careful planning of osteotomy positioning is advised while performing TPLO surgery.

Osteosarcoma following tibial plateau leveling osteotomy in dogs: 29 cases (1997–2011)

“…[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The ages of dogs at the time of osteosarcoma diagnosis and TPLO in the present study were similar to those of dogs at the time of treatment for appendicular osteosarcoma and cranial cruciate ligament rupture, respectively, in other reports. 1,[42][43][44][45][46][47][48][49] The study population predominantly comprised large-breed dogs, which is a consistent finding in other studies 1,42-49 of treatment of appendicular osteosarcoma and cranial cruciate ligament rupture. In the present study, all dogs were neutered and most dogs were females, which may reflect the higher prevalence of cranial cruciate ligament rupture that has been reported for these groups, compared with the prevalence for other dogs.…”

Electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies: experimental study

“…The procedures performed resulted in a prominent reduction of the tibial plateau angle in Labrador puppies. Relying on the theory that the tibial plateau angle of dogs is one of the predisposing factors for CCL rupture (Bergh et al, 2008), both proximal tibial epiphysiodesis techniques proved to be efficient procedures and can be an option for the CCL rupture treatment in puppies. In some young dogs predisposed to progressive CCL strains because of the excessive tibial plateau angle (Talaat et al, 2006), a preventive epiphysiodesis technique could be an alternative procedure to avoid the cruciate disease.…”

“…It also prevents joint hyperextension, excessive internal rotation of the tibia and varus or valgus motion (Slocum and Slocum, 1993). One of the most common joint disorders in dogs is a CCL rupture (Kergosien et al, 2004;Shahar and Milgram, 2006;Duerr et al, 2008) which leads to hind limb lameness and degenerative joint disease (DJD) (Robinson et al, 2006;Bergh et al, 2008;Boudrieau, 2009). …”

Novel TPLO Alignment Jig/Saw Guide Reproduces Freehand and Ideal Osteotomy Positions

“…Osteotomy positioning is critical in order to minimize stress on the tibial tuberosity, which may result in a fracture [3]. Attaining the target TPA post-rotation is also dependent on the osteotomy position on the tibia as distal positioning can result in a higher than expected tibial plateau angle and persistent cranial tibial thrust [4,5].…”

“…Subjective guidelines were originally established to avoid these technical errors: orientation of the osteotomy parallel to the joint surface and perpendicular to the sagittal plane of the tibia, and placement sufficiently caudal to preserve tibial tuberosity bone support [1]. Furthermore, more recently, objectively formulated recommendations have been proposed, including centering the osteotomy over the tibial intercondylar tubercles on the long axis of the tibia, and leaving ≥10 mm of bone at the level of the tibial tuberosity in the medium to large breed dogs [3,4,6]. Lastly, the osteotomy necessitates a footprint only sufficiently large to accommodate the head of the plate such that the screws placed to secure it are not directed intra-articularly and/or in the osteotomy [3,6,7].…”