Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs

C. J. Bailey; B. A. Smith; A. P. Black

doi:10.1160/VCOT-06-02-0012

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2007; 20(03): 169-174
DOI: 10.1160/VCOT-06-02-0012

Original Research

Schattauer GmbH

Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs

C. J. Bailey

¹North Shore Veterinary Specialist Centre, Crows Nest, New South Wales, Australia

,

B. A. Smith

²Northern Sydney Veterinary Specialist Centre, North Turramurra, New South Wales, Australia

,

A. P. Black

²Northern Sydney Veterinary Specialist Centre, North Turramurra, New South Wales, Australia

› Author Affiliations

Abstract

Summary

The tibial wedge osteotomy (TWO), a procedure that reduces the tibial plateau slope, has become an established surgical technique for the treatment of cranial cruciate ligament injuries in dogs, yet variation from the desired postoperative tibial plateau slope of 6° has been noted. The objectives of this study were to investigate the geometric implications of this procedure and to identify factors that affect the postoperative angles. The records of 35 consecutive cases that had a TWO performed were reviewed and comparisons were made between the alignment of the cortices and level of the osteotomy using duplicated tracings of a preoperative radiograph. The existing method for calculating the size of wedge to be removed was found to result in a postoperative slope greater than the expected 6°. Our results indicate that the desired postoperative angle is more likely to be achieved if the cranial cortices are aligned and the osteotomy is performed proximally.

Keywords

Tibial wedge osteotomy - cranial cruciate ligament - tibial plateau slope - tibial long axis

Full Text

References

References
1 Piermattei Piermattei, Flo GL. In: Handbook of small animal orthopedics and fracture repair. Philadelphia: W.B. Saunders Company; 1997
2 Elkins AD, Pechman R, Kearney MT. et al. A retrospective study evaluating the degree of degenerative joint disease in the stifle joint of dogs following surgical repair of anterior cruciate ligament rupture. J Am Anim Hosp Assoc 1991; 27: 533-540.
3 Slocum Slocum, Devine T. Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair. J Am Vet MedAssoc 1984; 184: 564-569.
4 Warzee CC, Dejardin LM, Arnoczky SP. et al. Effect of tibial plateau leveling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: an in vitro experimental study. Vet Surg 2001; 30: 278-286.
5 Reif U, Hulse DA, Hauptman JG. Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study. Vet Surg 2002; 31: 147-154.
6 Slocum B, Devine-Slocum T. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777-795.
7 Watt P. Tibial plateau levelling. Aust Vet J 2000; 78: 385-386.
8 Caylor KB, Zumpano CA, Evans LM. et al. Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. JAmAnimHosp Assoc 2001; 37: 263-268.
9 Fettig AA, Rand WM, Sato AF. et al. Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints. Vet Surg 2003; 32: 471-478.
10 Pacchiana PD, Morris E, Gillings SL. et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001). J Am Vet Med Assoc 2003; 222: 184-193.
11 Whitehair JG, Vasseur PB, Willits NH. Epidemiology of cranial cruciate ligament rupture in dogs. JAmVet Med Assoc 1993; 203: 1016-1019.
12 Morris Morris, Lipowitz AJ. Comparison of tibial plateau angles in dogs with and without cranial cruciate ligament injuries. JAmVet MedAssoc 2001; 218: 363-366.
13 Wilke VW, Conzemius MG, Besancon MF. et al. Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament. J Am Vet Med Assoc 2002; 221: 1426-1429.
14 Reif U, Dejardin LM, Probst CW. et al. Influence of limb positioning and measurement method on the magnitude of the tibial plateau angle. Vet Surg 2004; 33: 368-375.
15 Kowaleski Kowaleski, McCarthy RJ. Geometric analysis evaluating the effect of tibial plateau leveling osteotomy position on postoperative tibial plateau slope. Vet Comp Orthop Traumatol 2004; 17: 30-34.
16 Robinson DA, Mason DR, Evans R. et al. The effect of tibial plateau angle on ground reaction forces 4-17 months after tibial plateau leveling osteotomy in Labrador Retrievers. Vet Surg 2006; 35: 294-299.
17 Zachos TA, Arnoczky SP, Lavagnino M. et al. The effect of cranial cruciate ligament insufficiency on caudal cruciate ligament morphology: an experimental study in dogs. Vet Surg 2002; 31: 596-603.