Tibial plateau morphology in dogs with cranial cruciate ligament insufficiency

Abstract

Objective To identify possible biomechanical causes for the predominantly unilateral presentation of cranial cruciate ligament (CCL) insufficiency by comparing the computed tomographic (CT) features of the tibial plateau of CCL affected and contralateral sound stifles in dogs with unilateral CCL insufficiency. Study design Cross‐sectional study. Animals Eighteen dogs, 36 stifles. Methods Eighteen dogs with naturally occurring unilateral CCL insufficiency were included. Stifle CT and radiographs were performed at the time of diagnosis. Follow‐up was performed at a minimum of 1 year from the original diagnosis to ensure that there was no evidence of contralateral CCL insufficiency. The medial tibial plateau angle (m‐TPA), lateral TPA (and l‐TPA), medial tibial plateau midsagittal radius of curvature (m‐TPr), and lateral TPr (l‐TPr) were measured from the CT images. Variables were compared with paired t tests. A Bonferroni correction was performed, and P < .006 was considered significant. Results Mean m‐TPr was steeper (P = .002) and m‐TPr:l‐TPr ratio was greater (P < .001) in affected stifles compared with contralateral sound stifles. No other variables differed between groups. Mean l‐TPA was steeper than mean m‐TPA (P < .001). Conclusion Tibial plateau convexity differed between the CCL affected and contralateral sound stifle in dogs with unilateral CCL insufficiency. Clinical significance Medial tibial plateau convexity may play a role in the development of CCL insufficiency.

The Role of Tibial Plateau Angle in Canine Cruciate Ligament Rupture—A Review of the Literature

“…60 However, the radius of medial tibial plateau curvature was larger (p ¼ 0.002) in cranial cruciate ligament affected stifles compared with contralaterally sound healthy stifles. 60 The same finding was also reported in radiographic studies. 61 At the same time, no differences in the radiuses of lateral tibial plateau curvature between stifles with cranial cruciate ligament disease and contralaterally sound stifles were established, suggesting that increased plateau Fig.…”

“…Even though, quantifying the lateral tibial plateau angle was more variable both between and within observers, no differences in the radiuses of lateral tibial plateau curvature between stifles with cranial cruciate ligament insufficiency and contralaterally sound stifles were established. 60 On the other hand, the larger radius of medial tibial plateau curvature and, therefore, less convex medial tibial plateau may predispose to the cranial cruciate ligament insufficiency in dogs ( Fig. 7 ).…”

“…60 It was concluded that the lateral tibial plateau angle was steeper than the medial angle ( p < 0.001), but there were no differences in medial or lateral tibial plateau angles between cranial cruciate ligament affected stifles and contralaterally sound healthy stifles. 60 However, the radius of medial tibial plateau curvature was larger ( p = 0.002) in cranial cruciate ligament affected stifles compared with contralaterally sound healthy stifles. 60 The same finding was also reported in radiographic studies.…”

“…61 At the same time, no differences in the radiuses of lateral tibial plateau curvature between stifles with cranial cruciate ligament disease and contralaterally sound stifles were established, suggesting that increased plateau asymmetry may be a trigger for cranial cruciate ligament damage. 60…”

Genetic mapping of distal femoral, stifle, and tibial radiographic morphology in dogs with cranial cruciate ligament disease

“…It may be that a multivariate model which includes TPA might be predictive of CCLD but predicting CCLD risk in an individual dog is difficult with the tools veterinarians now have available. [59, 60] Axial and abaxial[61] TPAs and measures of tibial concavity and femoral condylar convexity might be more sensitive measurements of proclivity for CCLD[62] but require computed tomographic imaging. Lastly, other measures of stifle plateau mechanics, like the anatomic mechanical axis of the tibia, may be a more accurate predictor of CCLD.…”