Case Report: A Modification to a TPLO Procedure to Simultaneously Correct for CCL Tear and Concurrent Medial Patellar Luxation

Abstract

To evaluate a modification in the tibial plateau leveling osteotomy (TPLO) procedure that can simultaneously adjust tibial plateau angle and align the patellar apparatus using simplified and repeatable technique.

A 4-year-old 28 kg mixed breed dog with bilateral medial patellar luxation grade II/IV and a right hind (RH) concurrent cranial cruciate ligament rupture (CCLR).

The patient presented with a nonweight-bearing lameness of the right pelvic limb (V/V lameness score). Diagnosis of a CCLR and MPL was made based on physical examination, and confirmed with orthogonal radiographs. Arthroscopic examination of the stifle showed synovitis and cartilage eburnation of the lateral articular surface of the patella and of the medial trochlear ridge of the femur. The CCL and MPL were repaired using a TPLO procedure and semi-cylindrical recession trochleoplasty (SCRT). The principal tibial fragment was laterally translated to improve the alignment of the patellar apparatus using a TPLO plate with offset spacers placed between the distal portion of the TPLO plate and the distal segment of the tibia. A medial fascial release and a lateral fascial imbrication was performed. The clinical outcome of the patient was recorded by the owner over 8 weeks. The patient had good function of the right pelvic limb and radiographic union of the osteotomy site at 8 weeks.

This report documents successful surgical treatment of CCLR with a concurrent MPL in a dog using TPLO technique combined with offset spacers.

Acknowledgements: Proprietary interest in the Patelign (patent pending) spacer. No financial support was provided in this study, Patelign spacers were provided for this case.

Publication History

Article published online:
16 September 2024