The Clinical and Radiological Evaluation of Canine Cranial Cruciate Ligament Rupture Treatment with Tibial Plateau Leveling Osteotomy

Year 2016, Volume: 42 Issue: 1, 89 - 97, 04.01.2015

Didar Aydın Kaya , Kemal Altunatmaz

Abstract

Tibial plateau leveling osteotomy (TPLO) is one of the tibial osteotomy techniques for canine cranial cruciate ligament rupture. The purpose of this study is to evaluate the clinically and radiologically findings of the patients with cranial cruciate ligament rupture treated by tibial plateau leveling osteotomy. In our clinical study, treatment of cranial cruciate ligament rupture in 18 dogs with a total of 20 stifles was performed. Cases were diagnosed with cranial cruciate ligament rupture, technical measurements for the operations are determined and the cases were prepared for the operation during the preoperative period of the clinical and radiological examinations. Following the operation, postoperative clinical and radiological evaluations were performed on the 10^th, 30^th, 60^th, 90^th and 120^th days. At the end of the study, it was observed that the dogs retained stifle joint motion ability, early healing of the osteotomy side in the postoperative period, all stifle joint functions were retained after a period. It was determined that this method of operation can securely (in regards to joint stabilization) be performed on especially in large breed dogs.

Keywords

-

Köpeklerin Ön Çapraz Bağ Kopuklarının Sağaltımında Tibial Plato Düzeltme Osteotomisi-TPLO ile Sağaltımı, Sonuçlarının Klinik ve Radyografik Olarak Değerlendirilmesi

Abstract

Tibial plato düzeltme osteotomisi (TPDO), köpeklerin ön çapraz bağ kopuklarının sağaltımında kullanılan osteotomi tekniklerinden birisidir. Bu çalışmanın amacı, sağaltımı tibial plato düzeltme osteotomisi ile yapılan ön çapraz bağ kopuğu bulunan hastaların bulgularını klinik ve radyografik olarak değerlendirmektir. Çalışmanın materyalini; arka ekstremitesinde topallık şikayeti ile kliniğe getirilen 18 köpeğe ait 20 adet ekstremite oluşturdu. Olguların preoperatif dönemde klinik ve radyolojik muayeneleri sonucunda, ön çapraz bağ kopuğu tanısı konuldu, ameliyat tekniğinin gerektirdiği ölçümler yapıldı ve ameliyata hazır hale getirildi. Operasyonlarını takiben postoperatif 10., 30., 60., 90. ve 120. günlerde olguların klinik ve radyolojik değerlendirilmeleri yapıldı. Çalışmanın sonucunda diz ekleminin normal hareket yeteneğinin koruduğu, osteotomi hattının postoperatif erken dönemde kaynadığı, ekstremite fonksiyonlarını bir süre sonra tamamen kazandığı gözlemlendi ve özellikle iri ırk köpeklerde diz ekleminin stabilizasyonu açısından bu tekniğin güvenli bir şekilde uygulanabileceği sonucuna varıldı.

Keywords

Köpek, kraniyal, çapraz, bağ, TPDO

References

• Ballagas, A.J., Montgomery, R.D., Henderson, R.A., Gilette, R., 2004. Pre and postoperative force plate analysis of dogs with experimentally transected cranial cruciate ligaments treated using tibial plateau leveling osteotomy. Veterinary Surgery 33, 187-190.
• Barnhart, M.D., 2003. Results of single-session bilateral tibial plateau leveling osteotomies as a treatment for bilaterally ruptured cranial cruciate ligaments in dogs: 25 cases (2000-2001). Journal of the American Animal Hospital Association 39, 573-578.
• Bell, J.C., Ness, M.G., 2007. Does use of a jig influence the precision of tibial plateau leveling surgery? Veterinary Surgery 36, 228-233.
• Bennett, D., Tennant, B., Lewis, D.G., Baughan, J., May, C., Carter, S. 1988. A reappraisal of anterior cruciate ligament disease in the dog. Journal of Small Animal Practice, 275-297.
• Chauvet, A.E., Johnson, A.L., Pijanowski, G.J., 1996. Evaluation of fibular head transposition, lateral fabellar suture, and conservative treatment of cranial cruciate rupture in large dogs: A retrospective study. Journal of American Hospital Association 32, 247-255.
• Corr, C.A., Brown, C.A., 2007. Comparison of outcomes following tibial plateau leveling osteotomy and cranial tibial wedge osteotomy procedures. Veterinary Comparative Orthopedic Traumatology 20, 313-319.
• Dejardin, M.L., 2003. Tibial plateau leveling osteotomy. In Slatter, D. (3rdEd.), Textbook of Small Animal Surgery, Philadelphia, W.B. Saunders Company, Vol: II, 2133- 2170.
• Doom, M., de Bruin T., de Rooster, H., van Bree, H., Cox, E., 2008. Immunopathological mechanism in dogs with rupture of the cranial cruciate ligament. Veterinary Immunology and Immunopathology 125, 143-161.
• Duerr, F.M., Duncan, G.C., Savicky, R.S., Park, R.D., Egger, E.L., Palmer, R.H., 2008. Comparison of surgical treatment options for cranial cruciate ligament disease in large breed dogs with excessive tibial plateau angle. Veterinary Surgery 37, 49-62.
• Harasen, G., 2002. Diagnosing rupture of the cranial cruciate ligament. Canadian Veterinary Journal 43, 475-476.
• Harasen, G., 2003. Canine cranial cruciate ligament rupture in profile. Canadian Veterinary Journal 44, 845-846.
• Hayashi, K., Manley, P.A., Muir, P., 2004. Cranial cruciate ligament pathophysiology in dogs with cruciate disease: a review. Journal of American Animal Hospital Association 40, 385-390.
• Henderson, R.A., Milton, J.L., 1978. The tibial compression mechanism: a diagnostic aid in stifle injuries. Journal of American Animal Hospital Association 14, 474-479.
• Jerram, R.M., Walker, A.M., Warman, C.G.A., 2003. Cranial Cruciate Ligament Injuries in the Dog: Pathophysiology, Diagnosis and Treatment. New Zealand Veterinary Journal 51, 149-158.
• Johnson, J.M., Johnson, A.L., 1993. Cranial cruciate ligament rupture. Pathogenesis, diagnosis and postoperative rehabilitation. Veterinary Clinics of North America: Small Animal Practice 23, 717-733.
• Kennedy, S.C., Dunning, D., Bichroff, M.G., Kuriashkin, I.V., Pijanowski, G.J., Schaffer, D.J., 2005. The effect of axial and abaxial release on meniscal displacement in the dog. Veterinary Comparative Orthopedic Traumatology 18, 227-234.
• Kim, S.E., Pozzi, A. Kowaleski, M.P., Lewis, D.D., 2008. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Veterinary Surgery 37, 111-125.
• Lazar, T.P., Berry, C.R., De Haan, J.J., Peck, J.N., Correa, M., 2005. Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog. Veterinary Surgery 34, 133-141.
• Leitner, M., Pearce, S.G., Windolf, M., Schwieger, K., Zeiter, S., Schwalder, P., Johnson, K.A., 2008. Comparison of locking and conventional screws for maintenance of tibial plateau positioning and biomechanical stability after locking tibial plateau leveling osteotomy plate fixation. Veterinary Surgery 37, 357-365.
• Luther, J.K., Cook, C.R., Cook, C.L., 2009. Meniscal release in cruciate ligament intact stifles causes lameness and medial compartment cartilage pathology in dogs 12 weeks postoperatively. Veterinary Surgery 38, 520-529.
• Moeller, E.M., Cross, A.R., Rapoff, A.J., 2006. Change in tibial plateau angle after tibial plateau leveling osteotomy in dogs. Veterinary Surgery 35, 460-464.
• Morris E., Lipowitz, A.J., 2001. Comparison of tibial plateau angles in dogs with and without cranial cruciate ligament injuries. Journal of the American Veterinary Medical Association 218, 363-366.
• Piermattei, D.L., Flo, G.L., De Camp, C.E., 2006. Small Animal Orthopedics and Fracture Repair. (4th Ed.), USA: Saunders, 562-632.
• Pozzi, A, Kowaleski, M.P., Apelt, D., Meadows, C., Andrews, C.M., Johnson, K.A., 2006. Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy. Veterinary Surgery 35, 486-494.
• Pozzi, A., Litsky, A.S., Field J.R, Apelt, D., Meadows, C., Johnson, K.A., 2008. Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau leveling osteotomy in dogs. Veterinary Comparative Orthopaedics Traumatology 21, 8-14.
• Pozzi, A., Litsky, A.S., Field, J.R., 2005. Meniscal release impairs load transmission and joint stability in the canine stifle. Veterinary Comparative Orthopedic Traumatology 2005 (2), A36.
• Priddy, N.H., Tomlison, J.L., Dodam, J.R., Hornbostel J.E., 2003. 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). Journal of the American Veterinary Medical Association 222, 1726-1732.
• Reif, U., Hulse, D.A., Hulse, J.G., Hauptmann, J.G., 2002. Effect of tibial plateau leveling on stability of the canine cranial cruciate deficient stifle joint: an in vitro study. Veterinary Surgery 31, 147-154.
• Rooster, H., Bruin, T., Van Bree, H., 2006. Morphologic and functional features of the canine cruciate ligaments. Veterinary Surgery 35, 769-780.
• Schmerbach, K.I., Boeltzig, C.K., Reif, U., Wieze, J.C., Keller, T., Grevel, V., 2007. In vitro comparison of tibial plateau leveling osteotomy with and without use of a tibial plateau leveling jig. Veterinary Surgery 36, 156-163.
• Slocum, B., Slocum, T.D., 1993. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Veterinary Clinics of North America: Small Animal Practice 23, 777-795.
• Slocum, B., Slocum, T.D., 1998. Diagnostic tests. In: Bojrab, M.J. (4th Ed.), Current Techniques in Small Animal Surgery. Lea&Febiger, USA, pp. 1187-1193.
• Vasseur, P.B., 2003. Stifle Joint In: D. Slatter, (3rd Ed.), Textbook of Small Animal Surgery, Vol: II, Saunders, USA, pp. 2090-2133.
• Warzee, C.C., Dejardin, M.L., Arnoczky, P.S., Perry, L.E., 2001. Effect on tibial plateau leveling on cranial and caudal tibial thrusts in canine cranial cruciate deficient stifles: an in vitro experimental study. Veterinary Surgery 30, 278-286.