Download PDF
Vet Comp Orthop Traumatol 2011; 24(01): 27-31
DOI: 10.3415/VCOT-10-01-0013
Original Research
Schattauer GmbH

Theoretical discrepancy between cage size and efficient tibial tuberosity advancement in dogs treated for cranial cruciate ligament rupture

S. Etchepareborde
1   School of Veterinary Medicine, University of Liège – Department of Clinical Sciences, Liège, Belgium
,
J. Mills
2   Scarsdale Veterinary Practice, Derby, Derbyshire, United Kingdom
,
V. Busoni
3   School of Veterinary Medicine, University of Liège, Department of Clinical Sciences: Diagnostic Imaging, Liège, Belgium
,
L. Brunel
1   School of Veterinary Medicine, University of Liège – Department of Clinical Sciences, Liège, Belgium
,
M. Balligand
1   School of Veterinary Medicine, University of Liège – Department of Clinical Sciences, Liège, Belgium
› Author Affiliations
Further Information

Publication History

Received: 27 January 2010

Accepted: 16 August 2010

Publication Date:
19 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Objectives: To calculate the difference between the desired tibial tuberosity advancement (TTA) along the tibial plateau axis and the advancement truly achieved in that direction when cage size has been determined using the method of Montavon and colleagues. To measure the effect of this difference on the final patellar tendon-tibial plateau angle (PTA) in relation to the ideal 90°.

Methods: Trigonometry was used to calculate the theoretical actual advancement of the tibial tuberosity in a direction parallel to the tibial plateau that would be achieved by the placement of a cage at the level of the tibial tuberosity in the osteotomy plane of the tibial crest. The same principle was used to calculate the size of the cage that would have been required to achieve the desired advancement. The effect of the difference between the desired advancement and the actual advancement achieved on the final PTA was calculated.

Results: For a given desired advancement, the greater the tibial plateau angle (TPA), the greater the difference between the desired advancement and the actual advancement achieved. The maximum discrepancy calculated was 5.8 mm for a 12 mm advancement in a case of extreme TPA (59°). When the TPA was less than 31°, the PTA was in the range of 90° to 95°.

Clinical significance: A discrepancy does exist between the desired tibial tuberosity advancement and the actual advancement in a direction parallel to the TPA, when the tibial tuberosity is not translated proximally. Although this has an influence on the final PTA, further studies are warranted to evaluate whether this is clinically significant.

Keywords

Maquet - TTA - tibial tuberosity advancement - trigonometry

 

  • References

  • 1 Tepic S, Damur DM, Montavon PM. Biomechanics of the stifle joint. In: Tepic S, Damur DM, Montavon PM. editors. Proceedings of the 1st World Orthopaedic Veterinary Congress 2002. September 5-8 Munich; Germany: 189-190.
    Google Scholar
  • 2 Montavon PM, Damur DM, Tepic S. Advancement of the tibial tuberosity for the treatment of cranial cruciate deficient canine stifle. Montavon PM, Damur DM, Tepic S, editors. Proceedings of the 1st World Orthopedic Veterinary Congress 2002. September 5-8 Munich; Germany: 152
    Google Scholar
  • 3 Hottinger HA, DeCamp CE, Olivier NB. et al. Noninvasive kinematic analysis of the walk in healthy large-breed dogs. Am J Vet Res 1996; 57: 381-388.
    PubMedGoogle Scholar
  • 4 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. Vet Surg 2007; 36: 170-177.
    CrossrefPubMedGoogle Scholar
  • 5 Lafaver S, Miller NA, Stubbs WP. et al. Tibial tube-rosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007; 36: 573-586.
    CrossrefPubMedGoogle Scholar
  • 6 Reif U, Probst CW. Comparison of tibial plateau angles in normal and cranial cruciate deficient stifles of Labrador retrievers. Vet Surg 2003; 32: 385-389.
    CrossrefPubMedGoogle Scholar
  • 7 Duerr FM, Duncan CG, Savicky RS. et al. Comparison of surgical treatment options for cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle. Vet Surg 2008; 37: 49-62.
    CrossrefPubMedGoogle Scholar
  • 8 Buote N, Fusco J, Radasch R. Age, tibial plateau angle, sex, and weight as risk factors for contralateral rupture of the cranial cruciate ligament in Labradors. Vet Surg 2009; 38: 481-489.
    CrossrefPubMedGoogle Scholar
  • 9 Talaat MB, Kowaleski MP, Boudrieau RJ. Combination tibial plateau leveling osteotomy and cranial closing wedge osteotomy of the tibia for the treatment of cranial cruciate ligament-deficient stifles with excessive tibial plateau angle. Vet Surg 2006; 35: 729-739.
    CrossrefPubMedGoogle Scholar
  • 10 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.
    CrossrefPubMedGoogle Scholar
  • 11 Boudrieau RJ. Tibial plateau levelling osteotomy or tibial tuberosity advancement?. Vet Surg 2009; 38: 1-22.
    CrossrefPubMedGoogle Scholar
  • 12 Hoffmann DE, Miller JM, Ober CP. et al. Tibial tuberosity advancement in 65 canine stifles. Vet Comp Orthop Traumatol 2006; 19: 219-227.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Voss K, Damur DM, Guerrero T. et al. Force plate gait analysis to assess limb function after tibial tube-rosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008; 21: 243-249.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Stein S, Schmoekel H. Short-term and eight to 12 months results of a tibial tuberosity advancement as treatment of canine cranial cruciate ligament damage. J Small Anim Pract 2008; 49: 398-404.
    CrossrefPubMedGoogle Scholar
  • 15 Burns CG, Boudrieau RJ. Modified tibial tuberosity advancement procedure with tuberosity advancement in excess of 12 mm in four large breed dogs with cranial cruciate ligament-deficient joints. Vet Comp Orthop Traumatol 2008; 21: 250-255.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 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.
    CrossrefPubMedGoogle Scholar
  • 17 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.
    CrossrefPubMedGoogle Scholar
  • 18 Caylor KB, Zumpano CA, Evans LM. et al. Intraand interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. J Am Anim Hosp Assoc 2001; 37: 263-268.
    CrossrefPubMedGoogle Scholar