Radiographic evaluation and comparison of the patellar ligament following tibial plateau leveling osteotomy and tibial tuberosity advancement in dogs: 106 cases (2009–2012)

Dana M. DeSandre-RobinsonDepartment of Surgery, Affiliated Veterinary Specialists, 9905 S US Hwy 17-92, Maitland, FL 32751.

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Cheryl A. TanoDepartment of Surgery, Affiliated Veterinary Specialists, 9905 S US Hwy 17-92, Maitland, FL 32751.

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Kara L. FioreDepartment of Surgery, Affiliated Veterinary Specialists, 9905 S US Hwy 17-92, Maitland, FL 32751.

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Ben PrytherchDepartment of Statistics, College of Natural Sciences, Colorado State University, Fort Collins, CO 80523.

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Abstract

OBJECTIVE To radiographically evaluate and compare changes in the patellar ligament of dogs following tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA).

DESIGN Retrospective case series.

ANIMALS 106 dogs that underwent TPLO (n = 59) or TTA (n = 47) for unilateral rupture of the cranial cruciate ligament at a private veterinary hospital from August 2009 through September 2012.

PROCEDURES Medical records were reviewed to collect information on dog signalment, surgical procedure, whether arthrotomy had been performed, pre- and postoperative measurements of patellar ligament angle (PLA) and tibial plateau angle (TPA), and preoperative and follow-up measurements of patellar ligament thickness.

RESULTS For dogs that underwent TTA, thickening of the distal portion of the patellar ligament was identified radiographically in 43 (92%) dogs at the first follow-up examination and 36 (77%) at the second follow-up examination. For dogs that underwent TPLO, these numbers were 57 (97%) and 54 (92%), respectively. A significant decrease in patellar ligament thickness was identified between the first and second follow-up examinations for TTA but not TPLO. Mean ± SD PLA following TTA was 89.46 ± 5.54°, representing a mean difference from the preoperative PLA of 11.86 ± 5.3°; following TPLO, mean TPA was 12.61 ± 4.03°, representing a mean difference from the preoperative TPA of 16.74 ± 7.13°.

CONCLUSIONS AND CLINICAL RELEVANCE Patellar ligament thickening occurred following TPLO and TTA in dogs. The clinical relevance of this thickening remains unknown.

Abstract

OBJECTIVE To radiographically evaluate and compare changes in the patellar ligament of dogs following tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA).

DESIGN Retrospective case series.

ANIMALS 106 dogs that underwent TPLO (n = 59) or TTA (n = 47) for unilateral rupture of the cranial cruciate ligament at a private veterinary hospital from August 2009 through September 2012.

PROCEDURES Medical records were reviewed to collect information on dog signalment, surgical procedure, whether arthrotomy had been performed, pre- and postoperative measurements of patellar ligament angle (PLA) and tibial plateau angle (TPA), and preoperative and follow-up measurements of patellar ligament thickness.

RESULTS For dogs that underwent TTA, thickening of the distal portion of the patellar ligament was identified radiographically in 43 (92%) dogs at the first follow-up examination and 36 (77%) at the second follow-up examination. For dogs that underwent TPLO, these numbers were 57 (97%) and 54 (92%), respectively. A significant decrease in patellar ligament thickness was identified between the first and second follow-up examinations for TTA but not TPLO. Mean ± SD PLA following TTA was 89.46 ± 5.54°, representing a mean difference from the preoperative PLA of 11.86 ± 5.3°; following TPLO, mean TPA was 12.61 ± 4.03°, representing a mean difference from the preoperative TPA of 16.74 ± 7.13°.

CONCLUSIONS AND CLINICAL RELEVANCE Patellar ligament thickening occurred following TPLO and TTA in dogs. The clinical relevance of this thickening remains unknown.

Contributor Notes

Dr. DeSandre-Robinson's present address is California Veterinary Specialists, 2310 Faraday Ave, Carlsbad, CA 92008.

Address correspondence to Dr. DeSandre-Robinson (danadesandre@gmail.com).
  • 1. Pacchiana PD, Morris E, Gillings SL, et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998–2001). J Am Vet Med Assoc 2003; 222: 184193.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2. Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777795.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Kim SE, Pozzi A, Kowaleski MP, et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111125.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Bergh MS, Sullivan C, Ferrell CL, et al. Systematic review of surgical techniques for cranial cruciate ligament disease in dogs. J Am Anim Hosp Assoc 2014; 50: 315321.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement? Vet Surg 2009; 38: 122.

  • 6. Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1,000 consecutive dogs. Vet Surg 2010; 39: 460474.

    • Search Google Scholar
    • Export Citation
  • 7. Mattern KL, Berry CR, Peck JN, et al. Radiographic and ultrasonographic evaluation of the patellar ligament following tibial plateau leveling osteotomy. Vet Radiol Ultrasound 2006; 47: 185191.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Priddy NH II, Tomlinson JL, Dodam JR, et al. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997–2001). J Am Vet Med Assoc 2003; 222: 17261732.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Stauffer KD, Tuttle TA, Elkins AD, et al. Complications associated with 696 tibial plateau leveling osteotomies (2001–2003). J Am Anim Hosp Assoc 2006; 42: 4450.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Das S, Thorne R, Lorenz ND, et al. Patellar ligament rupture in the dog: repair methods and patient outcomes in 43 cases. Vet Rec 2014; 175: 370.

  • 11. Kuhn K, Ohlerth S, Markara M, et al. Radiographic and ultrasonographic evaluation of the patellar ligament following tibial tuberosity advancement. Vet Radiol Ultrasound 2011; 52: 466471.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Carey K, Aiken SW, DiResta GR, et al. Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy. Vet Comp Orthop Traumatol 2005; 18: 235242.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Pettitt R, Cripps P, Baker M, et al. Radiographic and ultrasonographic changes of the patellar ligament following tibial tuberosity advancement in 25 dogs. Vet Comp Orthop Traumatol 2014; 27: 216221.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Lafaver S, Miller NA, Stubbs WP, et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007; 36: 573586.

    • Crossref
    • Search Google Scholar
    • Export Citation

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