Postoperative TPA

Distal femoral osteotomy in combination with traditional treatment provided predictable osteotomy healing, patellar stabilization, and long-term improvement in patient comfort and function when used to treat combined distal femoral varus and medial patellar luxation in large-breed dogs.

R-FVA may not be an accurate method of femoral varus measurement in dogs with A-FVA<10 degrees. Using Slocum's criteria for distal femoral osteotomy (R-FVA>10 degrees), the procedure would not have been erroneously performed in any of the normal dogs of this study.

Methods of fracture treatment must strike a balance between fracture stability and soft tissue integrity. With highly comminuted diaphyseal fractures, exhaustive attempts at anatomical reconstruction often fail to achieve a load-sharing fixation and concurrently traumatize the vascular supply of the already damaged tissue. The lack of balance in this scenario makes failure likely. The strategies of biological osteosynthesis are used when the surgeon determines before surgery that anatomical reconstruction of the multiple cortical fragments is unlikely to result in load sharing. In these highly comminuted fractures, better results can be achieved by applying a set of biological osteosynthesis strategies in which preservation of vascular supply to the damaged bone is balanced with rigid fracture fixation.

Results suggested that early neutering was a significant risk factor for development of excessive TPA in large-breed dogs with CCLD. Further research into the effects of early neutering on TPA and the pathophysiology of CCLD is warranted.