Combination tibial plateau leveling osteotomy and transverse corrective osteotomy of the proximal tibia for the treatment of complex tibial deformities in 12 dogs.

Abstract

OBJECTIVE:

To describe a surgical technique, and outcome, for treatment of proximal tibial deformity (varus, valgus, excessive tibial plateau angle [eTPA], tibial torsion and patellar luxation) by combined tibial plateau leveling osteotomy (TPLO) and transverse corrective osteotomy.

STUDY DESIGN:

Cases series.

ANIMALS:

Dogs (n=12; 19 stifle joints).

METHODS:

Medical records of dogs that had combination TPLO and transverse corrective osteotomy, were reviewed. Pre- and postoperative tibial angulation, tibial torsion, tibial plateau angle (TPA), corrective osteotomy technique, method of fixation, and complications were recorded. In hospital re-evaluation of limb function and alignment and length of time to radiographic healing were reviewed. Long-term outcome was assessed by visual analog scale (VAS) questionnaire and owner telephone interview.

RESULTS:

Proximal tibial varus or valgus was present in 68.4%; 73.7% had eTPA; and 47.4% had both. Medial patellar luxation (MPL) was present in 57.9%, of which 47.4% had tibial tuberosity displacement. Severe tibial torsion was present in 68.4%. Mean pre- and postoperative TPA was 37.5° and 5.7°, respectively. The mean postoperative mechanical medial proximal tibial angle (mMPTA) and mechanical medial distal tibial angle (mMDTA) were 92.2° (range, 88-96°) and 96.1° (range, 94-101°), respectively. Postoperative surgical complications were documented in 21.0%, which included implant loosening or breakage (5.3%), seroma (5.3%), septic arthritis (5.3%), and infection of the proximal tibia (5.3%). All complications were considered major because they required additional surgery. Mean time to document radiographic healing was 10.4 weeks. In-hospital re-evaluation of lameness was obtained at the same time; 82.4% were not lame or had a mild lameness, 17.6% had severe lameness (2/3 with infection). The VAS evaluation revealed excellent results and owner satisfaction in all ten dogs in which long-term follow-up was obtained.

CONCLUSIONS:

Long-term clinical outcome of combination TPLO and transverse corrective osteotomy was excellent, and had a high owner satisfaction. Healing times were comparable to standard TPLO with a similar complication rate.

• Authors: Jennifer L Weh, Michael P Kowaleski, Randy J Boudrieau
• Journal: Veterinary surgery : VS (Vet Surg) Vol. 40 Issue 6 Pg. 670-86 (Aug 2011) ISSN: 1532-950X [Electronic] United States
• PMID: 21699550 (Publication Type: Journal Article)
• Copyright: © Copyright 2011 by The American College of Veterinary Surgeons.

Topics

• Animals
• Anterior Cruciate Ligament (surgery)
• Anterior Cruciate Ligament Injuries
• Dog Diseases (surgery)
• Dogs
• Female
• Male
• Osteotomy (methods, veterinary)
• Postoperative Complications (veterinary)
• Retrospective Studies
• Stifle (injuries)
• Tibia (surgery)
• Treatment Outcome