Peer-reviewed veterinary case report
New TPLO surgery method with anti-rotational suture to prevent knee
By von Pfeil, Dirsko J F & House, Parker N·Published in Frontiers in veterinary science·2025·Small Animal Surgery Locum PLLC, United States·View original on PubMed →
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Original publication title: Monofilament anti-rotational suture combined with TPLO to prevent pivot shift: surgical technique and novel TPLO plate design.
- Species:
- dog
Plain-English summary
A group of dogs undergoing surgery for knee problems were tested to see if a new anti-rotational suture (ARS) could help prevent complications after a common procedure called tibial plateau leveling osteotomy (TPLO). In this study, 85 dogs were split into two groups: one received the standard TPLO, while the other had the TPLO along with the ARS. The results showed that none of the dogs with the ARS developed post-surgery pivot shift problems, compared to two dogs in the standard group. The ARS group also had longer surgery times, but overall, it seemed to help improve outcomes.
People also search for: dog knee surgery recovery · TPLO surgery complications · anti-rotational suture for dogs
Abstract
OBJECTIVES: To identify dogs at risk of developing pivot-shift (PS) following tibial-plateau-leveling-osteotomy (TPLO) using a rotational-instability-test (RI-test), describe a combination of a monofilament anti-rotational suture (ARS) with TPLO and assess this technique for feasibility, compare post-operative PS-incidence in dogs receiving a standard TPLO (TPLO-only) or a TPLO with ARS (TPLO+ARS), and design a novel TPLO-plate facilitating ARS-anchoring (TPLO/ARS-plate). STUDY DESIGN: In this clinical pilot trial on 85 client-owned dogs and instrumentation design study, the RI-test and ARS-placement-technique were described and performed. Reporting included: anesthesia and surgery times, bone-healing, post-TPLO-PS-incidence, follow-up and complications. Significance was set as ≤ 0.05. Comprehensive engineering of a novel TPLO plate was performed. RESULTS: Between TPLO-only ( = 57) and TPLO+ARS ( = 28) groups, significant differences were found for surgery time ( = 0.01), anesthesia time (<0.001) and bone healing scores ( = 0.03), all being longer/higher for TPLO+ARS. PS-incidence was 2/57 (TPLO-only) and 0/28 (TPLO+ARS) within the first 8 weeks post-surgery ( = 1.00). Medium follow-up was 642 days. Major complications during that time occurred in 2/57 (TPLO-only; infection and implant removal) and 1/28 (TPLO+ARS; infection, PS-development and implant removal) dogs ( = 1.00). A novel TPLO/ARS-plate was designed. CONCLUSION: Post-TPLO-PS might be reduced following ARS placement. Additional studies are indicated to validate and refine the RI-test and assess the novel TPLO/ARS-plate in the clinical setting.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/41049150/