Peer-reviewed veterinary case report
Mismatch between planned and actual tibial plateau angle after dog
By Banks, Charlotte et al.·Published in Veterinary surgery : VS·2024·Department of Clinical Science and Services, United Kingdom·View original on PubMed →
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Original publication title: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases.
- Species:
- dog
Plain-English summary
A study looked at 100 dogs that underwent a specific knee surgery called cranial closing wedge osteotomy (CCWO) to see if it could achieve a desired angle in the knee joint. Most dogs ended up with a knee angle greater than the target of 5 degrees, especially smaller dogs. The surgery's technique was found to sometimes lead to a position that was too far from the ideal, which could worsen the outcome. The researchers suggest that the current guidelines for this surgery need to be updated to help achieve better results for dogs.
People also search for: dog knee surgery outcome · cranial closing wedge osteotomy dogs · knee angle surgery for dogs
Abstract
OBJECTIVE: (1) To determine whether Oxley's modified cranial closing wedge osteotomy (CCWO) results in a tibial plateau angle (TPA) of 5° in silico, (2) compare in silico to clinical postoperative TPA and (3) determine the impact of ostectomy distalization in silico. STUDY DESIGN: Cross-sectional retrospective radiographic in silico study. SAMPLE POPULATION: A total of 100 stifle radiographs; 90 dogs (small ≤25 kg = 84; large >25 kg = 16). METHODS: Tibial plateau angles were measured preoperatively (TPA), after in silico planning (TPA), and postoperatively (TPA). Virtual ostectomies were evaluated for plate fit. Postoperative ostectomy position was measured. Virtual ostectomies were performed 5/7.5/10/15 mm from the patellar tendon insertion in 10 dogs from each preoperative TPA category (≤20°/21-25°/ 26-30°/31-35°/>35°). Comparisons for TPA, TPA, and TPAwere made between small and large dogs, and the outcome to the target 5° between TPA categories and ostectomy positions. RESULTS: Mean ± SD TPAwas 28.6 ± 6.2° and higher in small than large dogs. Mean TPAwas 7.6 ± 2.7°. Plate fit was appropriate in all. In silico, TPAs were greater than 5° except for cases with TPA > 35°. Median TPAwas 5.5° (-4-21) and was higher in small (7°) than large (4.5°) dogs. Postoperative ostectomy position was more distal than Oxley's guidelines. When distalized >7.5 mm in silico, the magnitude of under-correction increased. CONCLUSIONS: Oxley's modified CCWO did not result in TPA of 5° in most cases. Ostectomy distalization exacerbated under-correction. CLINICAL IMPACT: Current guidelines should be modified to achieve 5° TPA postoperatively.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37470173/