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DOI: 10.3415/VCOT-14-02-0033
Assessment of the medial collateral ligament as an intra-operative anatomical landmark for tibial plateau levelling osteotomy
Publikationsverlauf
Received:
26. Februar 2014
Accepted:
26. Mai 2014
Publikationsdatum:
20. Dezember 2017 (online)
Summary
Objectives: To determine whether the medial collateral ligament can be a reliable intra-operative anatomical landmark for rotation of the tibial plateau in the tibial plateau levelling osteotomy (TPLO) procedure, thus providing a tibial plateau rotation equal to that obtained using standard preoperative measurements.
Methods: Tibial plateau levelling osteotomy procedures were performed on pelvic limbs (n = 42) from canine cadavers with or without a history of cranial cruciate ligament deficiency. The rotation of the proximal fragment was performed such that the orientation of the fibres of the medial collateral ligament were aligned parallel to the caudal tibial cortex at the location of the osteotomy. Statistical analysis was performed to evaluate the difference between calculated rotation to achieve a postoperative tibial plateau angle of five degrees and the actual rotation achieved by aligning the medial collateral ligament and caudal tibial cortex.
Results: The rotation performed by alignment of the medial collateral ligament fibres with the caudal tibial cortex resulted in a significantly greater rotation than the calculated movement required to achieve a postoperative angle of five degrees. The mean over-rotation was 2.1 ± 1.73 mm.
Clinical significance: Use of the medial collateral ligament alignment with the caudal tibial cortex will reliably result in over-rotation of the tibial plateau and should not be used as an intra-operative guideline for tibial plateau rotation during TPLO procedures.
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References
- 1 Duval JM, Budsberg SC, Flo GL. et al. Breed, sex, and body weight as risk factors for rupture of the cranial cruciate ligament in young dogs. J Am Vet Med Assoc 1999; 215: 811-814.
- 2 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am 1993; 23: 777-795.
- 3 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for cranial cruciate ligament. In: Bojrab MJ. editor. Current Techniques in Small Animal Surgery. Baltimore, MD: Williams and Wilkins; 1998. pg. 1998-1209.
- 4 Slocum Enterprises Inc. Tibial Plateau Leveling Osteotomy Course. 2004. May Eugene, OR, USA: Slocum Enterprises Inc;
- 5 Warzee CC, Dejardin LM, Amoczky SP. et al. Effect of tibial plateau leveling osteotomy on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: an in vitro experimental study. J Vet Surg 2001; 30: 278-286.
- 6 Reif U, Hulse DA, Hauptman JG. Effect of tibial plateau leveling on stability of the canine cruciate-deficient stifle joint: an in vitro study. J Vet Surg 2002; 31: 147-154.
- 7 Abel SB, Hammer DL, Shott S. Use of the proximal portion of the tibia for measurement of the tibial plateau angle in dogs. Am J Vet Res 2003; 64: 1117-1123.
- 8 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.
- 9 Grierson J, Sanders M, Guitan J. et al. Comparison of anatomical tibial plateau angle versus observer measurement from lateral radiographs in dogs. Vet Comp Orthop Traumatol 2005; 18: 215-219.
- 10 Reif U, Dejardin LM, Probst CW. et al. Influence of limb positioning and measurement method on the magnitude of the tibial plateau angle. J Vet Surg 2004; 33: 368-375.
- 11 Sabanci SS, Ocal MK. Lateral and medial tibial plateau angles in normal dogs. Vet Comp Orthop Traumatol 2014; 27: 135-140.
- 12 Kowaleski MP, 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.
- 13 Unis MD, Johnson AL, Griffon DJ. et al. Evaluation of intra- and inter-observer variability and repeatability of tibial plateau angle measurements with digital radiography using a novel digital radiographic program. Vet Surg 2010; 39: 187-194.
- 14 Serwa D, Lorinson K, Lorinson D. et al. Comparison of conventional and digital measurements of tibial plateau angle in dogs. J Am Vet Med Assoc 2009; 234: 622-624.
- 15 Lister SA, Roush JK, Renberg WC. Digital measurement of radiographic tibial plateau angle. A comparison to measurement on printed digital images. Vet Comp Orthop Traumatol 2008; 21: 129-132.
- 16 Ocal MK, Sabanci SS. Effect of anatomic variation in caudal tibial plateau on the tibial plateau angle in dogs: a cadaveric study. J Small Anim Pract 2013; 54: 537-540.
- 17 Caylor KB, Zumpano CA, Evans LM. et al. Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. J Am Anim Hosp Assoc 2001; 37: 263-268.
- 18 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. J Vet Surg 2003; 32: 471-478.