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Vet Comp Orthop Traumatol 2007; 20(03): 159-168
DOI: 10.1160/VCOT-06-06-0054
Original Research
Schattauer GmbH

Evaluation of the Triple Tibial Osteotomy. A new technique for the management of the canine cruciate-deficient stifle

W. J. Bruce
1   Veterinary Specialist Orthopaedic Services, Adelaide, Australia
,
A. Rose
2   School of Veterinary Science, University of Queensland, Brisbane, Australia
,
J. Tuke
3   School of Mathematical Sciences, Adelaide University, Adelaide, Australia
,
G. M. Robins
4   Surgical Referral Service, Brisbane, Australia
› Author Affiliations
Further Information

Publication History

Received 29 June 2006

Accepted 20 July 2006

Publication Date:
21 December 2017 (online)

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Summary

The triple tibial osteotomy (TTO) is a technique which combines the features of tibial tuberosity advancement and wedge osteotomy for the treatment of complete and partial cruciate ligament injuries in dogs. In this paper, the technique is described and the results of a prospective study of 64 consecutive cases are presented. TTO provided a satisfactory clinical outcome in a very high percentage of cases. The technique is relatively easy to learn and has a low post-operative complication rate.

Keywords

Triple tibial osteotomy - tibial plateau leveling - cranial cruciate ligament - stifle - dog
 

  • References

  • 1 Ness MG, Abercromby RH, May C. et al. A survey of orthopaedic conditions in small animal practice in Britain. Vet Comp Orthop Traumatol 1996; 9: 43-52.
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Carlin I. Ruptur des ligamentum cruciatum ante- rius. In: Kniegelenk beim Hund. Arch Wissensch Prakt Tierhalk. 1926. 54 420-426.
    Search in Google Scholar
  • 3 Slocum Slocum, Devine TD. Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cruciate ligament repair. J Am Vet Med Assoc 1984; 184: 564-569.
    PubMedSearch in Google Scholar
  • 4 Slocum Slocum, 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: 777-795.
    CrossrefPubMedSearch in Google Scholar
  • 5 Henderson Henderson, Milton JL. The tibial compression mechanism: A diagnostic aid in stifle injuries. J Am Anim Hosp Assoc 1978; 14: 474-479.
    PubMedSearch in Google Scholar
  • 6 Tepic S, Damur D, Montavon PM. Biomechanics of the stifle. In: ESVOT-VOS: 1st World Veterinary Orthopaedic Congress. Munich, Germany: 5th-8th September 2002
    Search in Google Scholar
  • 7 Slocum Slocum, Devine TD. Cranial tibial thrust: A primary force in the canine stifle. J Am Vet Med Assoc 1983; 184: 456-459.
    PubMedSearch in Google Scholar
  • 8 Shahar Shahar, Milgram J. Biomechanics of tibial plateau levelling of the canine cruciate-deficient stifle joint: atheoreticalmodel. Vet Surg 2006; 35: 144-149.
    CrossrefPubMedSearch in Google Scholar
  • 9 Warzee CC, Dejardin LM, Arnoczky SP. et al. Effect of tibial plateau leveling on cranial and caudal tibial thrusts in canine cruciate-deficient stifles: an in vitro experimental study. Vet Surg 2001; 30: 278-286.
    CrossrefPubMedSearch in Google Scholar
  • 10 Montavon PM, Damur DM, Tepic S. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. In: ESVOT/VOS: 1st World Veterinary Orthopaedic Congress. 5th-8th September 2002. Munich, Germany.:
    Search in Google Scholar
  • 11 Vasseur Vasseur, Slatter D. Gait analysis and Orthopaedic examination. In: Textbook of Small Animal Surgery. Slatter D. (ed) Philadelphia: WB. Saunders Co; 1993: 1577-1586.
    Search in Google Scholar
  • 12 Johnson JM, Johnson AL, Pijanowski GJ. et al. Rehabilitation of dogs with surgically treated cranial cruciate ligament-deficient stifles by use of electrical stimulation of muscles. Am J Vet Res 1997; 58: 1473-1478.
    PubMedSearch in Google Scholar
  • 13 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.
    CrossrefPubMedSearch in Google Scholar
  • 14 Slocum Slocum, Slocum TD. Meniscal release. In: Current Techniques in Small Animal Surgery. Bojrab MJ. (ed) Philadelphia: Lea and Febiger; 1997: 1197-1199.
    Search in Google Scholar
  • 15 Vasseur Vasseur, Berry CR. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992; 28: 129-136.
    PubMedSearch in Google Scholar
  • 16 Wellek S. Methods for one-sided equivalence problems. In: Testing Statistical Hypotheses of Equivalence. Chapman & Hall/CRC, London: 2002: 15-28.
    Search in Google Scholar
  • 17 Flo GL. Classification of meniscal lesions in twenty-six consecutive canine meniscectomies. J Am Anim Hosp Assoc 1983; 19: 335-340.
    PubMedSearch in Google Scholar
  • 18 Baroni E, Matthias RR, Marcellin-Little DJ. et al. Comparison of radiographic assessments of the tibial plateau slope in dogs. Am J Vet Res 2003; 64: 586-589.
    CrossrefPubMedSearch in Google Scholar
  • 19 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.
    PubMedSearch in Google Scholar
  • 20 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.
    CrossrefPubMedSearch in Google Scholar
  • 21 Apelt D, Kowaleski MP, Boudrieau RJ. Effect of tibial tuberosity advancement on cranial tibial subluxation in canine cranial cruciate-deficient stifle joints: An in-vitro experimental study. In: WVOC/VOS: 2nd World Veterinary Orthopaedic Congress and the 33rd Annual Conference of the VOS. February 25tll-March 4th 2006. Keystone, CO, USA.:
    Search in Google Scholar
  • 22 Hoffman D, Miller J, Ober C. et al. Short-term results of TTA procedures performed in 57 dogs with cranial cruciate ruptures. In: WVOC-VOS: 2nd World Orthopaedic Veterinary Conference and the 33rd Annual Conference ofthe VOS. Keystone, CO, USA: February 25th-March 4th 2006
    Search in Google Scholar
  • 23 Kowaleski Kowaleski, McCarthy RJ. Geometric analysis evaluating the effect of tibial plateau levelling osteotomy position on postoperative tibial plateau slope. Vet Comp Orthop Traumatol 2004; 17: 30-34.
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Apelt D, Kowaleski MP, Pozzi Aetal. The effect of tibial closing wedge angle on cranial tibial subluxation. In: 32nd Veterinary Orthopaedic Society Congress. March 5th-12th 2005. Aspen, CO, USA.:
    Search in Google Scholar
  • 25 Damur DM, Tepic S, Montavon PM. Proximal tibial osteotomy for the repair of cranial cruciate- deficient stifle joints in dogs. Vet Comp Orthop Traumatol 2003; 16: 211-216.
    Thieme ConnectPubMedSearch in Google Scholar
  • 26 Jerram RM, Walker AM, Warman CGA. Proximal tibial intraarticular ostectomy for treatment of canine cranial cruciate ligament injury. Vet Surg 2005; 34: 196-205.
    CrossrefPubMedSearch in Google Scholar
  • 27 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.
    CrossrefPubMedSearch in Google Scholar
  • 28 Priddy NH, Tomlinson JL, Dodam JR. et al. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001). J Am Vet Med Assoc 2003; 222: 1726-1732.
    CrossrefPubMedSearch in Google Scholar
  • 29 Stauffer KD, Tuttle TA, Elkins AD. et al. Complications associated with 696 tibial plateau leveling osteotomies (2001-2003). J Am Anim Hosp Assoc 2006; 42: 44-50.
    CrossrefPubMedSearch in Google Scholar
  • 30 Kergosien DH, Barnhart MD, Kees CE. et al. Radiographic and clinical changes of the tibial tuberosity after tibial plateau leveling osteotomy. Vet Surg 2004; 33: 468-474.
    CrossrefPubMedSearch in Google Scholar
  • 31 Dernell WS, Straw RC, Withrow SJ. Tumors ofthe skeletal system. In: Small Animal Clinical Oncology. Withrow SJ, MacEwan EG. (eds) Philadelphia: WB. Saunders; 2001: 378-417.
    Search in Google Scholar
  • 32 Boudrieau RJ, McCarthy RJ, Sisson RD. Metallur- gic evaluation of the slocum TPLO plate. In: 32nd Veterinary Orthopaedic Society Congress. March 5th-12th 2005. Aspen, CO, USA.:
    Search in Google Scholar
  • 33 Slocum TD. Incidence of neoplasia with TPLO surgery and slocum implant. In: 32nd Veterinary Orthopaedic Society Congress. Aspen, CO, USA: March 5th-12th 2005
    Search in Google Scholar
  • 34 Kennedy SC, Dunning D, Bischoff MG. et al. The effect of axial and abaxial release on meniscal displacement in the dog. Vet Comp Orthop Traumatol 2005; 18: 227-34.
    Thieme ConnectPubMedSearch in Google Scholar
  • 35 Read Read, Robins GM. Deformity of the proximal tibia in dogs. Vet Record 1982; 111: 295-298.
    CrossrefPubMedSearch in Google Scholar
  • 36 Kawahara Y, Uetani M, Fuchi K. et al. MR assessment of meniscal movement during knee flexion: correlation with severity of cartilage abnormality in the femorotibial joint. J Comput Assist Tomogr 2001; 218: 1281-1284.
    PubMedSearch in Google Scholar
  • 37 Innes JF, Barr ARS. Clinical naturalhistoryofthe postsurgical cruciate deficient canine stifle joint; year 1. J Small Anim Pract 1998; 39: 325-332.
    CrossrefPubMedSearch in Google Scholar