Best surgery methods for cruciate ligament tears in dogs over 33

Abstract

OBJECTIVE To determine which method (lateral fabellotibial suture [LFS], tibial plateau leveling osteotomy [TPLO], tibial tuberosity advancement [TTA], or tightrope-like braided multifilament suture secured with metallic buttons [TR]) Veterinary Orthopedic Society (VOS) members preferred for treating cranial cruciate ligament rupture (CCLR) in dogs weighing > 15 kg (33 lb), identify factors associated with this preference, and assess concerns related to surgical implant material used. DESIGN Cross-sectional study. SAMPLE 187 VOS members. PROCEDURES All registered VOS members received an online survey from June to July 2016. Responses were compiled and evaluated for associations with method preferences and perceived complications. RESULTS Overall response rate was 38.4% (221/575). Respondents had graduated from veterinary school a mean of 23 years prior to survey completion, and collectively they performed approximately 30,000 CCLR surgeries annually. The most commonly preferred method was TPLO (147 [78.6%]), followed by TTA (26 [13.9%]), the LFS procedure (11 [5.9%]), and the TR procedure (3 [1.6%]). The preference for TPLO was independent of board certification or college of training (American, European, or other College of Veterinary Surgeons). Non-board-certified surgeons, including general practitioners, also favored TPLO. The most common perceptions were that titanium implants (used for TTA) were associated with the lowest incidence of major complications, whereas braided multifilament suture (used for the TR procedure) was associated with the highest incidence of major complications. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that TPLO was preferred for treating CCLR in dogs weighing > 15 kg and that the TR procedure was perceived as having the highest complication rate. With results of this survey in mind, use of the TR procedure should be considered cautiously when treating CCLR.