Relationship between the stage of osteoarthritis before and six months after tibial tuberosity advancement procedure in dogs

Abstract

The present retrospective study evaluated the progression of osteoarthritis in stifle joints based on the radiographic grade of osteoarthritis (OA) scored in dogs with cranial cruciate ligament rupture. The aim of the study was to search for a correlation between the stage of radiographic osteoarthritis prior to surgery and the osteoarthritis progression occurring after the tibial tuberosity advancement (TTA) procedure. It was hypothesized that the procedure carried out in dogs in the early stages of OA could reduce the OA changes. A total of 190 X-ray images obtained from the medical records of 38 dogs were evaluated. The radiographic signs of osteoarthritis of 38 stifle joints were scored from 0 to 3 in 10 specific anatomic locations. The radiographs were divided into 4 groups based on the global scores: A) no-OA, B) mild-OA, C) moderate-OA, D) severe-OA; they were assessed prior to surgery, and 1, 2, 3 and 6 months post-operatively (T0, T1, T2, T3 and T6). There were no differences in osteoarthritis progression in Groups A and C at any time. Osteoarthritis changes from T0 to T6 were statistically significant in Group B. The OA changes in the anatomic locations were investigated. The most common anatomic sites for OA changes were the patella apex, the proximal and distal trochlear ridges, and the caudal aspect of the tibial plateau assessed before surgery. After surgery, the score increased in the first three locations in 10, 9 and 11 joints, respectively; instead, the progression of osteoarthritis in the caudal aspect of the tibial plateau occurred in 23 out of 38 stifle joints. The results indicated that the TTA procedure could be effective in slowing down the OA progression when carried out in the absence of or in the early stages of disease. Therefore, an early intervention may be suggested in clinical practice to obtain minimal or no progression 6 months postoperatively.

Bologna Healing Stifle Injury Index: A Comparison of Three Surgical Techniques for the Treatment of Cranial Cruciate Ligament Rupture in Dogs

“…Another limitation of the study was that the radiographic examination of the affected joint was not included and possible correlations between radiographic findings and the results of utilizing the tool were not studied. As explained in a previous article, the radiographic assessment of osteoarthritis was not included in the BHSII tool because the signs of osteoarthritis, and their respective radiographic scores, only worsen or stabilize, but not improve, over time (12,15). It would be interesting to relate the BHSII results to osteoarthritis radiographic findings, despite the fact that the functional and the radiographic appearances of the limb do not always correlate (15,16); therefore, other studies from this perspective are suggested.…”

Role of Tibial Tuberosity Fracture/Fissure through the Maquet Hole in Stifle Osteoarthritis after Porous Tibial Tuberosity Advancement in Dogs at Mid-Term Follow-Up

“…Interestingly, both groups showed significant progression compared to OA at 3 months after surgery, in accordance with the bibliographic data. In fact, it was found that 55% of the treated stifle joints presented progressive OA within 4-16 months of TTA intervention [3,7,21,22].…”

“…To assess the OA stage, we used a scoring system already validated and described previously [3,20] but modified for this specific study. In particular, we removed the anatomical points relative to the tibial tuberosity from the evaluation, because during TTA it is affected by the osteotomy, and during healing it presents radiographic changes as a function of bone repair of the osteotomy line and integration of the titanium cage.…”

“…This confirms that OA progression in subjects undergoing TTA was not significantly influenced by the fracture/fissure of the tibial tuberosity through the Maquet hole. Studying the cause of OA progression in the stifle joint in the course of TTA was not the objective of this study, although other studies have considered the potential risk factors for the development of OA in an affected stifle joint [3,21,22].…”

“…Tibial tuberosity advancement (TTA) has been added to the set of surgical procedures used to treat cranial cruciate ligament (CCL) rupture of the stifle joint in dogs. Although the modification of the stifle joint geometry obtained with the TTA procedure has the aim of neutralizing cranial tibial subluxation, it does not restore the position of the tibia in relation to the femur, resulting in progression of osteoarthritis (OA) [1][2][3].…”