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Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007–2009)

Rebecca E. WolfGarden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Thomas D. ScavelliGarden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Michael G. HoelzlerGarden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Ryan P. FulcherGarden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Richard P. BastianGarden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Abstract

Objective—To describe the surgical and postoperative complications encountered with tibial tuberosity advancement (TTA) performed in dogs with cranial cruciate ligament–deficient stifle joints.

Design—Retrospective case series.

Animals—458 dogs (TTA performed on 501 stifle joints).

Procedures—During the 2-year period, 624 TTA procedures had been performed in dogs for correction of cranial cruciate ligament deficiency. Five hundred one stifle joints in 458 dogs fit the criteria for inclusion; 43 dogs had had TTAs performed on both stifle joints. Historical data and complications reported were analyzed.

Results—Following 501 TTA surgeries, there were 95 instances of complications reported. In 7 stifle joints, 2 complications occurred. The most common complication was incisional infection and inflammation. Stifle joints with medial menisci that did not undergo medial meniscal release had a high incidence of subsequent injury, and meniscal tear was the most common complication treated by a second surgery. A partially torn cranial cruciate ligament left in situ at the time of TTA did not protect against subsequent injury of an intact, unreleased medial meniscus. Most fractures were identified on routine follow-up radiography and were rarely treated. In terms of preoperative factors, high body weight (> 40 kg [88 lb]) and a high preoperative patellar tendon angle were significantly associated with complications.

Conclusions and Clinical Relevance—High body weight and preoperative patellar tendon angle were significantly associated with complications following TTA in dogs. Subsequent meniscal tear was the most common reason for second surgery, suggesting that medial meniscal release of intact menisci should be considered when performing TTA in dogs.

Abstract

Objective—To describe the surgical and postoperative complications encountered with tibial tuberosity advancement (TTA) performed in dogs with cranial cruciate ligament–deficient stifle joints.

Design—Retrospective case series.

Animals—458 dogs (TTA performed on 501 stifle joints).

Procedures—During the 2-year period, 624 TTA procedures had been performed in dogs for correction of cranial cruciate ligament deficiency. Five hundred one stifle joints in 458 dogs fit the criteria for inclusion; 43 dogs had had TTAs performed on both stifle joints. Historical data and complications reported were analyzed.

Results—Following 501 TTA surgeries, there were 95 instances of complications reported. In 7 stifle joints, 2 complications occurred. The most common complication was incisional infection and inflammation. Stifle joints with medial menisci that did not undergo medial meniscal release had a high incidence of subsequent injury, and meniscal tear was the most common complication treated by a second surgery. A partially torn cranial cruciate ligament left in situ at the time of TTA did not protect against subsequent injury of an intact, unreleased medial meniscus. Most fractures were identified on routine follow-up radiography and were rarely treated. In terms of preoperative factors, high body weight (> 40 kg [88 lb]) and a high preoperative patellar tendon angle were significantly associated with complications.

Conclusions and Clinical Relevance—High body weight and preoperative patellar tendon angle were significantly associated with complications following TTA in dogs. Subsequent meniscal tear was the most common reason for second surgery, suggesting that medial meniscal release of intact menisci should be considered when performing TTA in dogs.

Contributor Notes

Dr. Wolf's present address is Animal Emergency and Treatment Center, 3927 W Belmont Ave, Chicago, IL 60618.

Address correspondence to Dr. Wolf (rewolf@gmail.com).