Veterinary and comparative orthopaedics and traumatology : V.C.O.T · 2025
Feasibility of Combined Tibial Plateau Levelling Osteotomy and Tibial Tuberosity Transposition for Treatment of Ipsilateral Cranial Cruciate Ligament Insufficiency and Medial Patellar Luxation in Small-Breed Dogs Weighing up to 15 kg.
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Bietzk Edward, Sesana Alberto, Moores Alison L, Liu Paydor, Kakuta Simon, Craig Andy, Janovec Jan
Аннотация
OBJECTIVE: The aim of this study was to investigate the short-term outcomes of tibial plateau levelling osteotomy (TPLO) and tibial tuberosity transposition (TTT) for the combined treatment of cranial cruciate ligament rupture and medial patellar luxation (MPL) in small-breed dogs weighing up to 15 kg.
STUDY DESIGN: Retrospective case series of dogs treated with a single session TPLO-TTT from five referral centres between 2015 and 2023. Intraoperative and postoperative complications were assessed. Osteotomy healing, lameness and presence of patellar luxation or tibial thrust were assessed at a 6- to 12-week follow-up.
RESULTS: A total of 37 stifles in 35 dogs. At the time of follow-up, the tibial compression test was negative in all stifles. The MPL grade improved from a median of 3/4 preoperatively to a median of 0/4 (p = 0.0001) postoperatively. Lameness grade improved from a median of 3/5 to 1/5. There were seven minor complications and seven major complications. No catastrophic complications occurred. Osteotomy healing was appropriate in all dogs. Three intraoperative complications related to a TPLO screw near the joint required replacement. Postoperative MPL was noted in three stifle joints (grade 1/4, 3/4 and 4/4). One distal tibial tuberosity fracture and one patella fracture were managed conservatively. Patella ligament desmitis was managed conservatively in five stifles.
CONCLUSION: Combined TPLO-TTT is an effective treatment of cranial cruciate ligament rupture and MPL in small-breed dogs, but surgical accuracy is needed to minimize complications. High-grade patellar luxation may require alternative methods of stabilization.
STUDY DESIGN: Retrospective case series of dogs treated with a single session TPLO-TTT from five referral centres between 2015 and 2023. Intraoperative and postoperative complications were assessed. Osteotomy healing, lameness and presence of patellar luxation or tibial thrust were assessed at a 6- to 12-week follow-up.
RESULTS: A total of 37 stifles in 35 dogs. At the time of follow-up, the tibial compression test was negative in all stifles. The MPL grade improved from a median of 3/4 preoperatively to a median of 0/4 (p = 0.0001) postoperatively. Lameness grade improved from a median of 3/5 to 1/5. There were seven minor complications and seven major complications. No catastrophic complications occurred. Osteotomy healing was appropriate in all dogs. Three intraoperative complications related to a TPLO screw near the joint required replacement. Postoperative MPL was noted in three stifle joints (grade 1/4, 3/4 and 4/4). One distal tibial tuberosity fracture and one patella fracture were managed conservatively. Patella ligament desmitis was managed conservatively in five stifles.
CONCLUSION: Combined TPLO-TTT is an effective treatment of cranial cruciate ligament rupture and MPL in small-breed dogs, but surgical accuracy is needed to minimize complications. High-grade patellar luxation may require alternative methods of stabilization.