Long Term Functional Outcome of Tibial Tuberosity Advancement vs. Tibial Plateau Leveling Osteotomy and Extracapsular Repair in a Heterogeneous Population of Dogs

Krotscheck, Ursula; Nelson, Samantha A.; Todhunter, Rory J.; Stone, Marisa J.; Zhang, Zhiwu

doi:10.1111/vsu.12445

Cited by 94 publications

(104 citation statements)

References 40 publications

(102 reference statements)

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“…Authors of previous studies have reported that ground reaction forces were restored 6‐12 months after TPLO in dogs tested at the walk and trot. However, dogs treated with TTA produced normal ground reaction forces only at the walk at this time point . The average pet likely spends more hours in a day walking than trotting, and this level of activity may normalize CTOAM values; even joints with TTA behave differently at the trot.…”

Section: Discussionmentioning

confidence: 86%

“…TPLO restores limb function at the walk and trot by 6‐12 months, according to gait kinematics. TTA achieves comparable function at the walk by 12 months but fails to match normal ground reaction forces at the trot . These functional metrics serve as indicators of the clinical performance of the procedure, but they do not test joint response to the biomechanical alterations induced by TPLO and TTA.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs

et al. 2018

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Long‐term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs

et al. 2018

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“…Usually the CrCL rupture occurs without major trauma and is thought to result from progressive degenerative changes in the substance of the CrCL 14. TPLO is the preferred technique of many orthopaedic surgeons internationally,15 16 and the long-term outcomes have been reported to be superior for TPLO versus Tibial Tuberosity Advancement (TTA) and extracapsular suture 17. This technique had resulted in an excellent outcome in this patient for contralateral CrCL rupture approximately two years previously.…”

Section: Discussionmentioning

confidence: 83%

Extracapsular articulating implant to treat cranial cruciate ligament disease in a dog with multiple myeloma

Lhuillery¹,

Witte

2019

Vet Record Case Reports

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An 11-year-old Border collie was presented for left hindlimb lameness associated with cranial cruciate ligament disease. The history included right tibial plateau levelling osteotomy performed approximately two years previously, with a subjectively good outcome. Multiple myeloma had been diagnosed approximately two months before presentation of the left hindlimb lameness. Medical treatment of multiple myeloma included glucocorticoids (prednisolone) and melphalan. Stabilisation of the left stifle was performed with the Simitri Stable in Stride extracapsular articulating implant. The dog demonstrated weightbearing on the operated limb within 24 hours following surgery. Re-examination six weeks following surgery revealed mild left hindlimb lameness, no resentment to manipulation of the left stifle, no cranial tibial thrust and a mild reduction in the range of motion. Hindlimb function was affected by various neurological events considered secondary to the malignant neoplasia; however, left stifle function was good until euthanasia 11 months following surgery.

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“…Surgical procedures that actively stabilize the cruciate ligament deficient stifle can be divided into those that eliminate the cranial tibiofemoral shear force by decreasing the angle of the tibial plateau, by advancing the insertion of the quadriceps, or by a combination of both procedures . No single procedure has yet been established as vastly superior to another, and a favourable long‐term clinical outcome can be expected regardless of the technique chosen …”

Section: Introductionmentioning

confidence: 99%

Influence of tibial plateau leveling osteotomy and tibial tuberosity advancement on passive laxity of the cranial cruciate deficient stifle in dogs

Ober

Factor²,

Meiner³

et al. 2019

Veterinary Surgery

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Objective: To evaluate the effect of tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTA) on craniocaudal stability of the cranial cruciate ligament (CCL) deficient stifle at 3 joint angles. Study design: Ex vivo biomechanical study. Sample population: Eight stifles from 4 dogs. Methods: One of the hind limbs was randomly assigned to undergo TPLO or TTA, with the contralateral limb assigned to the alternate procedure. Each specimen was tested with the stifle at 150 , 135 , and 120 of flexion. Cranial translation of the tibia relative to the femur was measured under cranial loads ranging from 0.2 to 2.0 kg with a single motion tracking sensor (Nest of Birds) fixed to the tibia. Each stifle was tested before and after transection of the CCL and after performing the assigned procedure. Results: Tibial plateau leveling osteotomy and TTA caused a decrease in the cranial translation of the tibia relative to the femur, especially at greater angles of flexion. Tibial plateau leveling osteotomy caused a greater decrease in tibial cranial translation and was associated with a degree of translation that did not differ from joints with intact CCL, regardless of the degree of stifle flexion. Conclusion: Tibial plateau leveling osteotomy and TTA caused an angle dependent decrease in craniocaudal translation of the tibia in the CCL deficient stifle. Only TPLO restored translations similar to those of the intact joint at all angles tested. Clinical impact: Tibial plateau leveling osteotomy and TTA provide passive stability to the stifle. Tibial plateau leveling osteotomy seems more effective than TTA at restoring craniocaudal stability of the stifle.

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Long Term Functional Outcome of Tibial Tuberosity Advancement vs. Tibial Plateau Leveling Osteotomy and Extracapsular Repair in a Heterogeneous Population of Dogs

Abstract: At the walk, TTA achieves normal function by 12 months; however, at the trot TTA is indistinguishable from ECR. TPLO resulted in operated limb function that was similar to the control population by 6-12 months postoperatively at the walk and the trot.

Cited by 94 publications

References 40 publications

Long‐term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs

Long‐term effects of tibial plateau leveling osteotomy and tibial tuberosity advancement on tibial plateau subchondral bone density in dogs

Extracapsular articulating implant to treat cranial cruciate ligament disease in a dog with multiple myeloma

Influence of tibial plateau leveling osteotomy and tibial tuberosity advancement on passive laxity of the cranial cruciate deficient stifle in dogs

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