Peer-reviewed veterinary case report
How plate angle and cut position affect tibial surgery outcomes
By Mclean, Euan J et al.·Published in Veterinary and comparative orthopaedics and traumatology : V.C.O.T·2024·Southpaws Specialty Surgery for Animals, Australia·View original on PubMed →
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Original publication title: Effect of Plate Inclination and Osteotomy Positioning on Rock-back following Tibial Plateau Levelling Osteotomy in Dogs.
- Species:
- dog
Plain-English summary
A group of dogs that had a surgery called tibial plateau leveling osteotomy (TPLO) to fix knee problems were monitored for a complication known as rock-back, which is when the angle of the knee changes after surgery. In this study, about 21% of the dogs developed rock-back, with an average increase in knee angle of 3.2 degrees. The researchers looked at factors like the angle of the surgical plate and the position of the cut made during surgery but found no clear link between these factors and the occurrence of rock-back. This means that other reasons might be causing this complication after TPLO surgery.
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Abstract
OBJECTIVE:  Rock-back is a reported complication following tibial plateau levelling osteotomy (TPLO), whereby tibial plateau angle (TPA) increases postoperatively. The mechanism of rock-back is not fully understood, although a recentinvestigation demonstrated that osteotomy exit cut angle (ECA) and inclination of the plate in the sagittal plane might be risk factors. The purpose of this study was to explore these relationships in a clinical dog population. We hypothesized that dogs with rock-back would have a higher degree of plate inclination and downward ECA compared with those without rock-back. MATERIALS AND METHODS:  Medical records and radiographs of dogs that underwent TPLO between January 2021 and January 2022 were retrospectively reviewed. TPA was recorded preoperatively, postoperatively, and at follow-up. Plate inclination, ECA, and descriptive data were collected. Observers measuring TPA were blinded to other variables. Rock-back was defined as a change in TPA ≥ 2. RESULTS:  Ninety-five TPLO procedures met the inclusion criteria ( = 87 dogs). Rock-back was identified in 21% of TPLOs ( = 20/95). The mean increase in TPA in the rock-back group was 3.2 ± 2.6. Plate inclination and ECA were not correlated with the presence of rock-back. Descriptive variables did not have a significant correlation with rock-back. CONCLUSION:  Plate inclination and ECA did not have a relationship with rock-back when defined as a postoperative TPA change ≥2 degrees, in this clinical retrospective study.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38843820/