Locking compression plates versus locking plates for tibial plateau levelling osteotomy in dogs: progression of osteoarthritis, bone healing score and lameness degree

Abstract

Background The partial or complete cranial cruciate ligament rupture is a common skeletal disease affecting the stifle joint in dogs. The tibial plateau levelling osteotomy, performed with several synthesis systems, changed the approach to its treatment in dogs. The aim of this study was to compare two types of fixation implants, locking compression system and locking system, evaluating radiographically the progression of osteoarthritis of the stifle joint in dogs with complete cranial cruciate ligament deficiency treated surgically with tibial plateau levelling osteotomy. Moreover, we evaluated bone healing and lameness scores to show biomechanical effects by the implant used. Twenty-eight dogs, who met the inclusion criteria, were divided into two groups. Group A: 14 dogs treated using locking compression plates; Group B: 14 dogs treated using locking plates. Radiographic osteoarthritis scores were evaluated up to 1 year following tibial plateau levelling osteotomy. At each visit, animals were clinically and radiographically assessed. Each dog was evaluated before (T0) and after two (T2) and twelve (T12) months after the surgery. At T2 the stage of bone healing was evaluated. The clinical follow up was performed before the surgery and at 10, 15 and 20 days after the surgery, grading the lameness at walk and trot. Results An increase in osteoarthritis score at T12 versus T0 in both groups was detected. A decrease of the lameness score was observed in Group A versus Group B. The healing score system at T2 showed a lower score in Group A versus Group B. Conclusions The osteoarthritis score following tibial plateau levelling osteotomy did not differ when comparing the two different fixation systems. The locking compression system allowed a more rapid functional recovery of the limb and a quicker bone healing than the locking system. Locking compression system should be carefully considered for dogs subjected to tibial plateau levelling osteotomy surgery, because it may reduce the recovery time.

Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

“…Three studies only stated that they “randomly assigned” ( 32 , 49 ) or used a “simple randomization procedure” ( 51 ) without giving detailed information on the procedure applied. One study ( 47 ) assigned subjects via a randomized block cohort study on the basis of patient-related data that might had introduced a source of bias.…”

“…The majority of the studies ( 32 , 36 , 48 , 51 , 61 , 62 , 67 , 69 , 84 , 91 ) focused on short- and mid-term outcome, whereas only three authors ( 49 ) considered long-term outcomes.…”

“…Long-term outcome was not successful in any of the evaluated studies (49,61,62), since all the osteoarthritis scores showed at least mild osteoarthritis and a progression of more than 10 % compared with preoperative levels. The mean OA score was 1.57 (median 1.5) for TPLO and 1.55 (median 1.55) for TTA.…”

“…Studies with subjective lameness assessment by a veterinarian, however, did not show differences between their outcome ( 48 , 69 ), confirmed by the current study. There were also studies included that could not be evaluated within the systematic analysis as they lacked detailed data on lameness scores or scores were expressed in combination with other criteria ( 31 , 39 , 43 , 49 , 62 , 65 , 96 , 97 ). Still, these studies confirm the assumption that both procedures can result in decreased lameness scores over time.…”

Long‐term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

“…11,12,[19][20][21] Treatment outcome in dogs with CCLD has been evaluated in several ways, for example, by using force plate gait analysis, visual gait observation, orthopaedic and physiotherapeutic examination, radiography for evaluation of OA progression and owner questionnaires. 8,17,[22][23][24][25][26][27][28][29] Owner questionnaires based on behaviour are considered one of the most reliable tools for assessment of chronic pain in dogs. [30][31][32] There are several questionnaires available, such as the canine orthopaedic index (COI), the Helsinki chronic pain index (HCPI), the Liverpool osteoarthritis in dogs, the canine brief pain inventory (CBPI) and the Bologna healing stifle injury index (BHSII).…”