Objective To evaluate the effect of postoperative tibial plateau angle (TPA) following tibial plateau leveling osteotomy (TPLO) on the risk of patella fracture during the convalescent period. Study Design Retrospective study. Sample Population Fracture group: 20 stifles; reference group: 65 stifles. Methods Medical records were reviewed for stifles with patellar fractures after a TPLO procedure (fracture group) and stifles with >180 days radiographic examination with no complications following TPLO (reference group). Stifle radiographs were masked to group and final TPA (fTPA) was measured, at the time of fracture diagnosis (fracture group) and at last follow‐up (reference group), using PACS software. TPAs in the fracture and reference groups were compared using the Wilcoxon rank‐sum test. Statistical significance was set at .05. Results Patellar fractures were diagnosed at a median of 69 days (range 31–189) after surgery. The median duration of follow‐up time for the reference group was 471 days (range 180–1868). Median fTPA for the fracture group was 1.4° (range [−10.3]–7.1). Median fTPA for the reference group was 4.1° (range [−3.9]–14.1). The odds of patellar fractures increased by 21.7% (95% CI: 8.6%–35.6%) for every 1° decrease in fTPA. Conclusion The risk of patella fractures increased as TPAs after TPLOs decreased. Clinical Significance Care should be taken to avoid excessive rotation during TPLO to decrease the likelihood of postoperative patellar fractures.

To evaluate the effectiveness of a smoke-evacuation unit on reducing ultrafine particle concentration in the operating room (OR) during the approach to the proximal tibia for tibial plateau-leveling osteotomy (TPLO).Study design: Prospective, randomized, controlled clinical trial. Sample population: Twenty-nine client-owned dogs undergoing unilateral TPLO at a single institution were assigned to either smoke-evacuator groups (SE; n = 15) or non-smoke-evacuator groups (NSE; n = 14). Methods: Dogs were randomly assigned to the SE group or the NSE group.An airborne particle measuring device measured and recorded baseline and intraoperative particles per cm 3 (ppc) during the approach to the proximal tibia during which electrosurgery was used to provide hemostasis, dissect subcutis, transect and elevate fascia. The mean ppc, maximum ppc, and baseline ppc were compared between groups. Mean ppc was also compared to the baseline ppc within each group. Results: During surgery, mean ppc (1352) and maximum ppc (62 450) for the NSE group were higher in than mean ppc (763) and maximum ppc (10 100) for the SE group (P < .0001, P < .0001, respectively). Mean ppc was higher in both SE (mean ppc = 763; P < .0001) and NSE (mean ppc = 1352; P = .0001) than their respective baseline ppc (213 and 240). Conclusion:The use of a smoke evacuator decreased particle concentrations 56.4% during the approach to the proximal tibia. Performing the approach to the proximal tibia resulted in higher particle concentrations than the baseline, regardless of smoke-evacuator use.Clinical significance: Surgeons should be aware of smoke produced by electrosurgery, potential health consequences, and methods of smoke mitigation (smoke evacuation).