Impacts of tibial plateau levelling osteotomy on the tibial insertion of the medial collateral ligament of the canine stifle joint – A cadaveric study

Palierne, Sophie; Blondel, Margaux; Patard, François; Autefage, A.

doi:10.1016/j.rvsc.2022.11.011

Cited by 1 publication

(2 citation statements)

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“…A recent study demonstrated an increased risk of MCL transection when using saws with a small radius or by placement of the osteotomy more proximally. 41 It is possible that the inadvertent caudo-proximal shift in the positioning of the saw resulting from TWT could pose similar risks. The TWT most commonly resulted in a DCR more caudal and proximal to the planned DCR, hence the increase in resultant TWT.…”

Section: Discussionmentioning

confidence: 99%

“…Contrary to MCLT, TWT resulted in a TTW greater than planned, which based on the known risk factors for tibial tuberosity fracture, is preferable, although this may result in an inadequately sized tibial plateau fragment and thus difficulty in placing a plate of adequate size. A recent study demonstrated an increased risk of MCL transection when using saws with a small radius or by placement of the osteotomy more proximally 41 . It is possible that the inadvertent caudo‐proximal shift in the positioning of the saw resulting from TWT could pose similar risks.…”

Section: Discussionmentioning

confidence: 99%

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Cadaveric comparison of two techniques for intraoperative placement of tibial plateau levelling osteotomies in dogs

Jaworski,

Meek,

Malortie

et al. 2024

Veterinary Record

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BackgroundBoth tibial tuberosity fractures and deviation from the planned postoperative tibial plateau angle have been associated with poor centring of tibial plateau levelling osteotomies (TPLOs). The aim of this cadaveric study was to compare two techniques for centring the osteotomy and preserving the tibial tuberosity width (TTW).MethodsStifle radiographs were obtained from 20 limbs of 10 dogs. TPLO was planned on each stifle, and a two‐wire technique (TWT) and a technique using the medial collateral ligament (MCL) as an intraoperative landmark were planned. The techniques were executed and marked with radiopaque pins. Further radiographs were obtained and analysed.ResultsOn average, TWT resulted in a 20.4% increase in TTW and medial collateral ligament technique (MCLT) resulted in a 13.4% decrease. Expressed as a percentage of the radial saw size, the average error in the centring of the osteotomy arising from the TWT was 13.4% and that from the MCLT was 14.2%.LimitationsThis study had a small sample size and involved a single surgeon.ConclusionNeither technique reliably identified the desired centre of the osteotomy, and both had a similar magnitude of error. MCLT resulted in reduced TTW, while TWT resulted in increased TTW. A reduced TTW has been associated with an increased risk of tibial tuberosity fracture, so MCLT is not recommended for clinical use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%