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Peer-reviewed veterinary case report

Accuracy of fluoroscopy-guided bone cuts in dog knee surgery

By Wang, Rita Y et al.·Published in Veterinary surgery : VS·2025·Colorado Animal Specialty and Emergency (CASE), United States·View original on PubMed

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Original publication title: Accuracy of fluoroscopy-guided osteotomy placement in TPLO: Postoperative tibial plateau angle and preoperative planning evaluation.

Species:
dog

Plain-English summary

A group of 25 dogs undergoing a surgical procedure called tibial plateau leveling osteotomy (TPLO) had their surgery guided by fluoroscopy to ensure accurate placement of the bone cut. This technique helped achieve a precise angle in the knee joint after surgery, which is important for proper healing and function. The results showed that the fluoroscopy method led to minimal errors in the angle measurement, suggesting it could improve surgical outcomes. Overall, the use of fluoroscopy during TPLO surgery appears to enhance accuracy and may help dogs recover better.

People also search for: dog TPLO surgery recovery · fluoroscopy in dog surgery · knee surgery for dogs · TPLO angle measurement accuracy

Abstract

OBJECTIVE: To evaluate the accuracy of achieving a predetermined postoperative tibial plateau angle (TPA) using fluoroscopy-assisted osteotomy planning and positioning, and to assess the reproducibility of preoperative tibial plateau leveling osteotomy (TPLO) radiographic measurements intraoperatively. STUDY DESIGN: Prospective observational study. ANIMAL POPULATION: A total of 25 client owned dogs undergoing TPLO. METHODS: Dogs undergoing TPLO with 21 mm osteotomy blades were enrolled. Intraoperatively, fluoroscopy was used to identify the intercondylar eminence (intended center of rotation), which was marked with a 0.035-inch Kirschner wire. The osteotomy site was dynamically adjusted to maintain a 21 mm radius from the center of rotation before proceeding with the osteotomy. Preoperative radiographic measurements (D1 and D2) were compared to intraoperative fluoroscopic measurements (R1 and R2) to assess reproducibility. Postoperative TPA was measured on routine radiographs. RESULTS: A total of 30 TPLOs were performed. The median postoperative TPA based on fluoroscopic guidance was 3° (range: 0-4°). The median absolute difference between R1 and 21 mm was 0.5 mm (range: 0.0-3.0 mm), while the difference between R2 and 21 mm was 2.5 mm (range: 0.0-4.0 mm). D1 measurements demonstrated greater intraoperative reproducibility than D2. CONCLUSION: Fluoroscopy-assisted osteotomy placement resulted in precise postoperative TPA alignment with minimal deviation. Preoperative radiographic measurements were reproducible intraoperatively, with D1 showing higher accuracy than D2. CLINICAL SIGNIFICANCE: Intraoperative fluoroscopy improves the accuracy of osteotomy placement, leading to more precise postoperative TPA and potentially reducing surgical variability.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40528518/