PDF herunterladen
Vet Comp Orthop Traumatol 2019; 32(04): 314-323
DOI: 10.1055/s-0039-1684050
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Comparison of Outcomes Associated with Tibial Plateau Levelling Osteotomy and a Modified Technique for Tibial Tuberosity Advancement for the Treatment of Cranial Cruciate Ligament Disease in Dogs: A Randomized Clinical Study

Véronique Livet
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Arnaud Baldinger
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Éric Viguier
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Mathieu Taroni
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Mathieu Harel
3   Small Animal Imaging Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Claude Carozzo
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
,
Thibaut Cachon
1   Small Animal Surgery Department, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
2   Research Unit ICE, UPSP 2016-A104, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
› Institutsangaben Funding The authors received no financial support for the research, authorship and/or publication of this article.
Weitere Informationen

Publikationsverlauf

23. April 2018

23. Februar 2019

Publikationsdatum:
03. April 2019 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Objectives This study aimed to compare outcomes between the tibial plateau levelling osteotomy (TPLO) procedure and a modified tibial tuberosity advancement (TTA Rapid) in dogs with cranial cruciate ligament rupture.

Materials and Methods Twenty-six dogs were prospectively randomized into two groups: a TPLO group (n = 13) and a TTA Rapid group (n = 13). A lameness score evaluation, gait analysis and radiographical examination were performed before surgery, the 3 days after surgery, and then at 1, 3 and 6 months postoperatively. Finally, owners were asked to subjectively rate their level of satisfaction.

Results The duration of surgery was significantly shorter for the TTA Rapid procedure (p < 0.0001). There was no significant difference in the occurrence of complications between groups. Lameness scores were significantly higher during the first 3 days after surgery for the TPLO group (p = 0.01 at day 1, p = 0.01 at day 2 and p = 0.003 at day 3). One month after surgery, the symmetry index between healthy and affected limbs for the relative stance time during the gait cycle (symmetry index/%) was significantly higher for the TTA Rapid group (p < 0.01). No gait parameters were significantly different between the two groups 6 months after surgery. All of the owners of dogs in the TPLO group were completely satisfied, whereas only 11/13 owners of dogs in the TTA rapid group were completely satisfied.

Clinical Significance Tibial plateau levelling osteotomy and TTA Rapid were associated with high long-term success rates in dogs. The immediate postoperative recovery seemed faster with TTA Rapid, but thereafter there was no difference.

Keywords

dogs - cruciate ligament disease - tibial plateau levelling osteotomy - tibial tuberosity advancement - lameness score

Author Contribution

Véronique Livet and Thibaut Cachon contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Arnaud Baldinger and Éric Viguier contributed to study design, acquisition of data and data analysis and interpretation. Mathieu Harel contributed to acquisition of data and data analysis and interpretation. Mathieu Taroni and Claude Carozzo contributed to data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.


 

  • References

  • 1 Kim SE, Pozzi A, Kowaleski MP, Lewis DD. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37 (02) 111-125
    CrossrefPubMedSuche in Google Scholar
  • 2 Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38 (01) 1-22
    CrossrefPubMedSuche in Google Scholar
  • 3 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23 (04) 777-795
    CrossrefPubMedSuche in Google Scholar
  • 4 Montavon PM, Damur DM, Tepic S. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. In Proceedings of the 1st World Orthopaedic Veterinary Congress; Munich, Germany; September 5–8; 2002 : 152
    PubMedSuche in Google Scholar
  • 5 Christopher SA, Beetem J, Cook JL. Comparison of long-term outcomes associated with three surgical techniques for treatment of cranial cruciate ligament disease in dogs. Vet Surg 2013; 42 (03) 329-334
    CrossrefPubMedSuche in Google Scholar
  • 6 Krotscheck U, Nelson SA, Todhunter RJ, Stone M, Zhang Z. Long term functional outcome of tibial tuberosity advancement vs. tibial plateau leveling osteotomy and extracapsular repair in a heterogeneous population of dogs. Vet Surg 2016; 45 (02) 261-268
    CrossrefPubMedSuche in Google Scholar
  • 7 Lafaver S, Miller NA, Stubbs WP, Taylor RA, Boudrieau RJ. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007; 36 (06) 573-586
    CrossrefPubMedSuche in Google Scholar
  • 8 Lazar TP, Berry CR, deHaan JJ, Peck JN, Correa M. Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog. Vet Surg 2005; 34 (02) 133-141
    CrossrefPubMedSuche in Google Scholar
  • 9 Rayward RM, Thomson DG, Davies JV, Innes JF, Whitelock RG. Progression of osteoarthritis following TPLO surgery: a prospective radiographic study of 40 dogs. J Small Anim Pract 2004; 45 (02) 92-97
    CrossrefPubMedSuche in Google Scholar
  • 10 Morgan JP, Voss K, Damur DM, Guerrero T, Haessig M, Montavon PM. Correlation of radiographic changes after tibial tuberosity advancement in dogs with cranial cruciate-deficient stifles with functional outcome. Vet Surg 2010; 39 (04) 425-432
    CrossrefPubMedSuche in Google Scholar
  • 11 Ferreira MP, Ferrigno CR, de Souza AN, Caquias DF, de Figueiredo AV. Short-term comparison of tibial tuberosity advancement and tibial plateau levelling osteotomy in dogs with cranial cruciate ligament disease using kinetic analysis. Vet Comp Orthop Traumatol 2016; 29 (03) 209-213
    Thieme ConnectPubMedSuche in Google Scholar
  • 12 Samoy Y, Verhoeven G, Bosmans T. , et al. TTA Rapid: description of the technique and short term clinical trial results of the first 50 cases. Vet Surg 2015; 44 (04) 474-484
    CrossrefPubMedSuche in Google Scholar
  • 13 Butterworth SJ, Kydd DM. TTA-Rapid in the treatment of the canine cruciate deficient stifle: short- and medium-term outcome. J Small Anim Pract 2017; 58 (01) 35-41
    CrossrefPubMedSuche in Google Scholar
  • 14 Dyall B, Schmökel H. Tibial tuberosity advancement in small-breed dogs using TTA Rapid implants: complications and outcome. J Small Anim Pract 2017; 58 (06) 314-322
    CrossrefPubMedSuche in Google Scholar
  • 15 Viguier E, Lequang T, Maitre P. , et al. The validity and reliability of the GAITRite system's measurement of the walking dog. Comput Methods Biomech Biomed Engin 2007; 10: 113-114
    CrossrefPubMedSuche in Google Scholar
  • 16 Light VA, Steiss JE, Montgomery RD, Rumph PF, Wright JC. Temporal-spatial gait analysis by use of a portable walkway system in healthy Labrador Retrievers at a walk. Am J Vet Res 2010; 71 (09) 997-1002
    CrossrefPubMedSuche in Google Scholar
  • 17 Taroni M, Cabon Q, Fèbre M. , et al. Evaluation of the effect of a single intra-articular injection of allogeneic neonatal mesenchymal stromal cells compared to oral non-steroidal anti-inflammatory treatment on the postoperative musculoskeletal status and gait of dogs over a 6-month period after tibial plateau leveling osteotomy: a pilot study. Front Vet Sci 2017; 4: 83
    CrossrefPubMedSuche in Google Scholar
  • 18 Bielecki MJ, Schwandt CS, Scharvogel S. Effect of tibial subluxation on the measurements for tibial tuberosity advancement in dogs with cranial cruciate ligament deficiency. An ex vivo study. Vet Comp Orthop Traumatol 2014; 27 (06) 470-477
    Thieme ConnectPubMedSuche in Google Scholar
  • 19 D'Anjou MA, Moreau M, Troncy E. , et al. Osteophytosis, subchondral bone sclerosis, joint effusion and soft tissue thickening in canine experimental stifle osteoarthritis: comparison between 1.5 T magnetic resonance imaging and computed radiography. Vet Surg 2008; 37 (02) 166-177
    CrossrefPubMedSuche in Google Scholar
  • 20 Kowaleski MP, Boudrieau RJ, Beale BS, Piras A, Hulse D, Johnson KA. Radiographic outcome and complications of tibial plateau leveling osteotomy stabilized with an anatomically contoured locking bone plate. Vet Surg 2013; 42 (07) 847-852
    PubMedSuche in Google Scholar
  • 21 Cook JL, Evans R, Conzemius MG. , et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
    CrossrefPubMedSuche in Google Scholar
  • 22 Singh A, Weese JS. Wound infections and antimicrobial use. In Johnson SA, Tobias KM. , eds: Veterinary surgery small animal, Vol. 1 (ed. 2). St. Louis, MO: Elsevier; 2017: 148-155
    Suche in Google Scholar
  • 23 Hans EC, Barnhart MD, Kennedy SC, Naber SJ. Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight. Vet Comp Orthop Traumatol 2017; 30 (04) 299-305
    Thieme ConnectPubMedSuche in Google Scholar
  • 24 Brown DC, Conzemius MG, Shofer F, Swann H. Epidemiologic evaluation of postoperative wound infections in dogs and cats. J Am Vet Med Assoc 1997; 210 (09) 1302-1306
    Suche in Google Scholar
  • 25 Shires PK, Lanz O, Martin RA. , et al. Early post-operative outcomes in unilateral cranial cruciate ligament deficient dogs treated with tibial tuberosity advancement or tibial plateau levelling osteotomy. Vet Surg 2007; 36: E24
    PubMedSuche in Google Scholar
  • 26 Kim SE, Pozzi A, Banks SA, Conrad BP, Lewis DD. Effect of cranial cruciate ligament deficiency, tibial plateau leveling osteotomy, and tibial tuberosity advancement on contact mechanics and alignment of the stifle in flexion. Vet Surg 2010; 39 (03) 363-370
    CrossrefPubMedSuche in Google Scholar
  • 27 Cox JS, Nye CE, Schaefer WW, Woodstein IJ. The degenerative effects of partial and total resection of the medial meniscus in dogs' knees. Clin Orthop Relat Res 1975; (109) 178-183
    PubMedSuche in Google Scholar
  • 28 Kim SE, Pozzi A, Banks SA, Conrad BP, Lewis DD. Effect of tibial tuberosity advancement on femorotibial contact mechanics and stifle kinematics. Vet Surg 2009; 38 (01) 33-39
    CrossrefPubMedSuche in Google Scholar