• 1. Johnson JA, Austin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994;7:5669.

    • Search Google Scholar
    • Export Citation
  • 2. Wilke VL, Robinson DA, Evans RB, et al. Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States. J Am Vet Med Assoc 2005;227:16041607.

    • Search Google Scholar
    • Export Citation
  • 3. Wucherer KL, Conzemius MG, Evans R, et al. Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. J Am Vet Med Assoc 2013;242:13641372.

    • Search Google Scholar
    • Export Citation
  • 4. Duerr FM, Martin KW, Rishniw M, et al. Treatment of canine cranial cruciate ligament disease. A survey of ACVS diplomates and primary care veterinarians. Vet Comp Orthop Traumatol 2014;27:478483.

    • Search Google Scholar
    • Export Citation
  • 5. Vasseur PB. Clinical results following nonoperative management for rupture of the cranial cruciate ligament in dogs. Vet Surg 1984;13:243246.

    • Search Google Scholar
    • Export Citation
  • 6. Guénégo L, Zahra A, Madelénat A, et al. Cranial cruciate ligament rupture in large and giant dogs. A retrospective evaluation of a modified lateral extracapsular stabilization. Vet Comp Orthop Traumatol 2007;20:4350.

    • Search Google Scholar
    • Export Citation
  • 7. Christopher SA, Beetem J, Cook JL. Comparison of long-term outcomes associated with three surgical techniques for treatment of cranial cruciate ligament disease in dogs. Vet Surg 2013;42:329334.

    • Search Google Scholar
    • Export Citation
  • 8. Cook JL, Luther JK, Beetem J, et al. Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs. Vet Surg 2010;39:315323.

    • Search Google Scholar
    • Export Citation
  • 9. Krotscheck U, Nelson SA, Todhunter RJ, et al. Long term functional outcome of tibial tuberosity advancement vs. tibial plateau leveling osteotomy and extracapsular repair in a heterogeneous population of dogs. Vet Surg 2016;45:261268.

    • Search Google Scholar
    • Export Citation
  • 10. Gordon-Evans WJ, Griffon DJ, Bubb C, et al. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease (Erratum published in J Am Vet Med Assoc 2013;243:1297). J Am Vet Med Assoc 2013;243:675680.

    • Search Google Scholar
    • Export Citation
  • 11. Conzemius MG, Evans RB, Besancon MF, et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005;226:232236.

    • Search Google Scholar
    • Export Citation
  • 12. Mölsä SH, Hielm-Björkman AK, Laitinen-Vapaavuori OM. Use of an owner questionnaire to evaluate long-term surgical outcome and chronic pain after cranial cruciate ligament repair in dogs: 253 cases (2004–2006). J Am Vet Med Assoc 2013;243:689695.

    • Search Google Scholar
    • Export Citation
  • 13. DeAngelis M, Lau RE. A lateral retinacular imbrication technique for the surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970;157:7984.

    • Search Google Scholar
    • Export Citation
  • 14. Flo GL. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975;11:570576.

    • Search Google Scholar
    • Export Citation
  • 15. Casale SA, McCarthy RJ. Complications associated with lateral fabellotibial suture surgery for cranial cruciate ligament injury in dogs: 363 cases (1997–2005). J Am Vet Med Assoc 2009;234:229235.

    • Search Google Scholar
    • Export Citation
  • 16. 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.

    • Search Google Scholar
    • Export Citation
  • 17. Sah S, Fagerlin A, Ubel P. Effect of physician disclosure of specialty bias on patient trust and treatment choice. PNAS 2016;113:74657469.

    • Search Google Scholar
    • Export Citation
  • 18. Lam WW, Fielding R, Ho EY, et al. Surgeon's recommendation, perceived operative efficacy and age dictate treatment choice by Chinese women facing breast cancer surgery. Psychooncology 2005;14:585593.

    • Search Google Scholar
    • Export Citation
  • 19. Korvick DL, Johnson AL, Schaeffer DJ. Surgeons’ preferences in treating cranial cruciate ligament ruptures in dogs. J Am Vet Med Assoc 1994;205:13181324.

    • Search Google Scholar
    • Export Citation
  • 20. mudpuppy. TPLO? TTA? Tightrope? Fishline? What does my dog need? Available at: www.infobarrel.com/TPLO_TTA_Tightrope_Fishline_What_Does_My_Dog_Need. Accessed Dec 16, 2017.

    • Search Google Scholar
    • Export Citation
  • 21. tiggerpoz website. Dog ACL / CCL ligament injury. TPLO / TTA—not good choices for most dogs with ligament injury. Available at: www.tiggerpoz.com/id8.html. Accessed Dec 16, 2017.

    • Search Google Scholar
    • Export Citation
  • 22. Farber J, Harris JD, Kolstad K, et al. Treatment of anterior cruciate ligament injuries by Major League Soccer team physicians. Orthop J Sports Med 2014;2: 2325967114559892.

    • Search Google Scholar
    • Export Citation
  • 23. Comerford E, Forster K, Gorton K, et al. Management of cranial cruciate ligament rupture in small dogs: a questionnaire study. Vet Comp Orthop Traumatol 2013;26:493497.

    • Search Google Scholar
    • Export Citation
  • 24. Leighton RL. Preferred method of repair of cranial cruciate ligament rupture in dogs: a survey of ACVS diplomates specializing in canine orthopedics. American College of Veterinary Surgery. Vet Surg 1999;28:194.

    • Search Google Scholar
    • Export Citation
  • 25. Ritzo ME, Ritzo BA, Siddens AD, et al. Incidence and type of meniscal injury and associated long-term clinical outcomes in dogs treated surgically for cranial cruciate ligament disease. Vet Surg 2014;43:952958.

    • Search Google Scholar
    • Export Citation
  • 26. Choate CJ, Lewis DD, Conrad BP, et al. Assessment of the craniocaudal stability of four extracapsular stabilization techniques during two cyclic loading protocols: a cadaver study. Vet Surg 2013;42:853859.

    • Search Google Scholar
    • Export Citation
  • 27. Rose ND, Goerke D, Evans RB, et al. Mechanical testing of orthopedic suture material used for extra-articular stabilization of canine cruciate ligament-deficient stifles. Vet Surg 2012;41:266272.

    • Search Google Scholar
    • Export Citation
  • 28. Vaughan LC. The history of canine cruciate ligament surgery from 1952–2005. Vet Comp Orthop Traumatol 2010;23:379384.

  • 29. Cook JL. Extracapsular stabilization In: Muir P, ed. Advances in the canine cranial cruciate ligament. Hoboken, NJ: Wiley-Blackwell: ACVS Foundation, 2010;163.

    • Search Google Scholar
    • Export Citation
  • 30. Duval JM, Budsberg SC, Flo GL, et al. Breed, sex, and body weight as risk factors for rupture of the cranial cruciate ligament in young dogs. J Am Vet Med Assoc 1999;215:811814.

    • Search Google Scholar
    • Export Citation
  • 31. Aragon CL, Budsberg SC. Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog. Vet Surg 2005;34:9398.

    • Search Google Scholar
    • Export Citation
  • 32. Nelson SA, Krotscheck U, Rawlinson J, et al. Long-term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs. Vet Surg 2013;42:3850.

    • Search Google Scholar
    • Export Citation
  • 33. Voss K, Damur DM, Guerrero T, et al. Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008;21:243249.

    • Search Google Scholar
    • Export Citation
  • 34. Gatineau M, Dupuis J, Plante J, et al. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Rate of subsequent ‘pivot shift', meniscal tear and other complications. Vet Comp Orthop Traumatol 2011;24:333341.

    • Search Google Scholar
    • Export Citation
  • 35. Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010;39:460474.

    • Search Google Scholar
    • Export Citation
  • 36. Coletti TJ, Anderson M, Gorse MJ, et al. Complications associated with tibial plateau leveling osteotomy: a retrospective of 1519 procedures. Can Vet J 2014;55:249254.

    • Search Google Scholar
    • Export Citation
  • 37. Kowaleski MP, Boudrieau RJ, Beale BS, et al. Radiographic outcome and complications of tibial plateau leveling osteotomy stabilized with an anatomically contoured locking bone plate. Vet Surg 2013;42:847852.

    • Search Google Scholar
    • Export Citation
  • 38. Helliker K. This joint problem makes dogs, owners, weak in the knees: a human jock's ailment also plagues pooches; an $80 pet's $6,000 bill. Wall Street Journal 2006;Apr 11:A1. Available at: www.wsj.com/articles/SB114472326147922581. Accessed Dec 16, 2017.

    • Search Google Scholar
    • Export Citation
  • 39. Blyskal J. Veterinary care without the bite. Consumer Reports 2003;68(7):1217.

  • 40. Bergh MS, Peirone B. Complications of tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2012;25:349358.

  • 41. 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.

    • Search Google Scholar
    • Export Citation
  • 42. 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.

    • Search Google Scholar
    • Export Citation
  • 43. 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.

    • Search Google Scholar
    • Export Citation
  • 44. Jandi AS, Schulman AJ. Incidence of motion loss of the stifle joint in dogs with naturally occurring cranial cruciate ligament rupture surgically treated with tibial plateau leveling osteotomy: longitudinal clinical study of 412 cases. Vet Surg 2007;36:114121.

    • Search Google Scholar
    • Export Citation
  • 45. Hirshenson MS, Krotscheck U, Thompson MS, et al. Evaluation of complications and short-term outcome after unilateral or single-session bilateral tibial tuberosity advancement for cranial cruciate rupture in dogs. Vet Comp Orthop Traumatol 2012;25:402409.

    • Search Google Scholar
    • Export Citation
  • 46. Wolf RE, Scavelli TD, Hoelzler MG, et al. Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007–2009). J Am Vet Med Assoc 2012;240:14811487.

    • Search Google Scholar
    • Export Citation
  • 47. Dulisch ML. Suture reaction following extra-articular stifle stabilization in the dog—part 1: a retrospective study of 161 stifles. J Am Anim Hosp Assoc 1981;17:569571.

    • Search Google Scholar
    • Export Citation
  • 48. Franklin SP, Gilley RS, Palmer RH. Meniscal injury in dogs with cranial cruciate ligament rupture. Compend Contin Educ Vet 2010;32:E1E11.

    • Search Google Scholar
    • Export Citation
  • 49. Pozzi A, Litsky AS, Field J, et al. Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2008;21:814.

    • Search Google Scholar
    • Export Citation
  • 50. Pozzi A, Kim SE, Lewis DD. Effect of transection of the caudal menisco-tibial ligament on medial femorotibial contact mechanics. Vet Surg 2010;39:489495.

    • Search Google Scholar
    • Export Citation
  • 51. Luther JK, Cook CR, Cook JL. Meniscal release in cruciate ligament intact stifles causes lameness and medial compartment cartilage pathology in dogs 12 weeks postoperatively. Vet Surg 2009;38:520529.

    • Search Google Scholar
    • Export Citation
  • 52. Steinberg EJ, Prata RG, Palazzini K, et al. Tibial tuberosity advancement for treatment of CrCL injury: complications and owner satisfaction. J Am Anim Hosp Assoc 2011;47:250257.

    • Search Google Scholar
    • Export Citation
  • 53. Stein S, Schmoekel H. Short-term and eight to 12 months results of a tibial tuberosity advancement as treatment of canine cranial cruciate ligament damage. J Small Anim Pract 2008;49:398404.

    • Search Google Scholar
    • Export Citation
  • 54. Hoffmann DE, Miller JM, Ober CP, et al. Tibial tuberosity advancement in 65 canine stifles. Vet Comp Orthop Traumatol 2006;19:219227.

    • Search Google Scholar
    • Export Citation
  • 55. 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.

    • Search Google Scholar
    • Export Citation
  • 56. Dymond NL, Goldsmid SE, Simpson DJ. Tibial tuberosity advancement in 92 canine stifles: initial results, clinical outcome and owner evaluation. Aust Vet J 2010;88:381385.

    • Search Google Scholar
    • Export Citation
  • 57. Edwards GA, Hosgood G, Hancock RB, et al. Major complications associated with fork-based and screw-based tibial tuberosity advancement implants: 438 cases. Can Vet J 2016;57:415420.

    • Search Google Scholar
    • Export Citation
  • 58. Costa M, Craig D, Cambridge T, et al. Major complications of tibial tuberosity advancement in 1613 dogs. Vet Surg 2017;46:494500.

  • 59. Skinner OT, Kim SE, Lewis DD, et al. In vivo femorotibial subluxation during weight-bearing and clinical outcome following tibial tuberosity advancement for cranial cruciate ligament insufficiency in dogs. Vet J 2013;196:8691.

    • Search Google Scholar
    • Export Citation
  • 60. Calvo I, Aisa J, Chase D, et al. Tibial tuberosity fracture as a complication of tibial tuberosity advancement. Vet Comp Orthop Traumatol 2014;27:148154.

    • Search Google Scholar
    • Export Citation
  • 61. Arthurs GI, Langley-Hobbs SJ. Patellar luxation as a complication of surgical intervention for the management of cranial cruciate ligament rupture in dogs. A retrospective study of 32 cases. Vet Comp Orthop Traumatol 2007;20:204210.

    • Search Google Scholar
    • Export Citation
  • 62. de Lima Dantas B, Sul R, Parkin T, et al. Incidence of complications associated with tibial tuberosity advancement in Boxer dogs. Vet Comp Orthop Traumatol 2016;29:3945.

    • Search Google Scholar
    • Export Citation
  • 63. 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.

    • Search Google Scholar
    • Export Citation
  • 64. Nutt AE, Garcia-Fernandez P, San Roman F, et al. Risk factors for tibial tuberosity fracture after tibial tuberosity advancement in dogs. Vet Comp Orthop Traumatol 2015;28:116123.

    • Search Google Scholar
    • Export Citation
  • 65. Hans EC, Barnhart MD, Kennedy SC, et al. Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight. Vet Comp Orthop Traumatol 2017;30:299305.

    • Search Google Scholar
    • Export Citation
  • 66. Solano MA, Danielski A, Kovach K, et al. Locking plate and screw fixation after tibial plateau leveling osteotomy reduces postoperative infection rate in dogs over 50 kg. Vet Surg 2015;44:5964.

    • Search Google Scholar
    • Export Citation
  • 67. Johansson A, Lindgren JU, Nord CE, et al. Material and design in haematogenous implant-associated infections in a rabbit model. Injury 1999;30:651657.

    • Search Google Scholar
    • Export Citation
  • 68. Arenas MA, Perez-Jorge C, Conde A, et al. Doped Tio2 anodic layers of enhanced antibacterial properties. Colloids Surf B Biointerfaces 2013;105:106112.

    • Search Google Scholar
    • Export Citation
  • 69. Rochford ET, Richards RG, Moriarty TF. Influence of material on the development of device-associated infections. Clin Microbiol Infect 2012;18:11621167.

    • Search Google Scholar
    • Export Citation
  • 70. Arthrex Vet Systems. TightRope CCL. Surgical technique. Available at: www.arthrexvetsystems.com/resources/surgical-technique-guide/e7NuVsRg-UKBBwFchDt91w/tightrope-ccl. Accessed Dec 16, 2017.

    • Search Google Scholar
    • Export Citation
  • 71. Biskup JJ, Griffon DJ. Technical difficulties during the training phase for Tightrope(R) and percutaneous lateral fabellar suture techniques for cranial cruciate ligament repair. Vet Surg 2014;43:347354.

    • Search Google Scholar
    • Export Citation
  • 72. Anand A, Wei R, Patel A, et al. Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series. Eur J Orthop Surg Traumatol 2017;27:461467.

    • Search Google Scholar
    • Export Citation
  • 73. Hsu AR, Jones CP, Cohen BE, et al. Clinical outcomes and complications of percutaneous Achilles repair system versus open technique for acute Achilles tendon ruptures. Foot Ankle Int 2015;36:12791286.

    • Search Google Scholar
    • Export Citation
  • 74. Bockmann B, Buecking B, Eschbach DA, et al. Fixation of the greater tuberosity in proximal humeral fractures: FiberWire(R) or wire cerclage? Acta Orthop Belg 2015;81:916.

    • Search Google Scholar
    • Export Citation
  • 75. Rigby RB, Cottom JM. Does the Arthrex TightRope(R) provide maintenance of the distal tibiofibular syndesmosis? A 2-year follow-up of 64 TightRopes(R) in 37 patients. J Foot Ankle Surg 2013;52:563567.

    • Search Google Scholar
    • Export Citation
  • 76. Willmott HJ, Singh B, David LA. Outcome and complications of treatment of ankle diastasis with tightrope fixation. Injury 2009;40:12041206.

    • Search Google Scholar
    • Export Citation
  • 77. Dayton P, Sedberry S, Feilmeier M. Complications of metatarsal suture techniques for bunion correction: a systematic review of the literature. J Foot Ankle Surg 2015;54:230232.

    • Search Google Scholar
    • Export Citation
  • 78. Shin SJ, Kim NK. Complications after arthroscopic coracoclavicular reconstruction using a single adjustable-loop-length suspensory fixation device in acute acromioclavicular joint dislocation. Arthroscopy 2015;31:816824.

    • Search Google Scholar
    • Export Citation
  • 79. Mack AW, Freedman BA, Shawen SB, et al. Wound complications following the use of FiberWire in lower-extremity traumatic amputations. A case series. J Bone Joint Surg Am 2009;91:680685.

    • Search Google Scholar
    • Export Citation
  • 80. Storey P, Gadd RJ, Blundell C, et al. Complications of suture button ankle syndesmosis stabilization with modifications of surgical technique. Foot Ankle Int 2012;33:717721.

    • Search Google Scholar
    • Export Citation
  • 81. Hong CC, Lee WT, Tan KJ. Osteomyelitis after TightRope fixation of the ankle syndesmosis: a case report and review of the literature. J Foot Ankle Surg 2015;54:130134.

    • Search Google Scholar
    • Export Citation
  • 82. Fantry AJ, O'Donnell SW, Born CT, et al. Deep infections after syndesmotic fixation with a suture button device. Orthopedics 2017;40:e541e545.

    • Search Google Scholar
    • Export Citation
  • 83. Bindra J, VanDenBogaerde J, Hunter JC. Coracoid fracture with recurrent AC joint separation after Tightrope repair of AC joint dislocation. Radiol Case Rep 2011;6:624.

    • Search Google Scholar
    • Export Citation
  • 84. Khalid M, Jones ML. Index metacarpal fracture after tightrope suspension following trapeziectomy: case report. J Hand Surg Am 2012;37:418422.

    • Search Google Scholar
    • Export Citation
  • 85. Welck MJ, Ray P. Tibialis anterior tendon entrapment after ankle tightrope insertion for acute syndesmosis injury. Foot Ankle Spec 2013;6:242246.

    • Search Google Scholar
    • Export Citation
  • 86. Hurwit D, Fanton G, Tella M, et al. Viscoelastic properties of common suture material used for rotator cuff repair and arthroscopic procedures. Arthroscopy 2014;30:14061412.

    • Search Google Scholar
    • Export Citation
  • 87. Lo IK, Burkhart SS, Athanasiou K. Abrasion resistance of two types of nonabsorbable braided suture. Arthroscopy 2004;20:407413.

  • 88. Lambrechts M, Nazari B, Dini A, et al. Comparison of the cheese-wiring effects among three sutures used in rotator cuff repair. Int J Shoulder Surg 2014;8:8185.

    • Search Google Scholar
    • Export Citation
  • 89. Deranlot J, Maurel N, Diop A, et al. Abrasive properties of braided polyblend sutures in cuff tendon repair: an in vitro biomechanical study exploring regular and tape sutures. Arthroscopy 2014;30:15691573.

    • Search Google Scholar
    • Export Citation
  • 90. Arnoczky SP, Torzilli PA, Marshall JL. Biomechanical evaluation of anterior cruciate ligament repair in the dog: an analysis of the instant center of motion. J Am Anim Hosp Assoc 1977;13:553558.

    • Search Google Scholar
    • Export Citation
  • 91. D'Amico LL, Lanz OI, Aulakh KS, et al. The effects of a novel lateral extracapsular suture system on the kinematics of the cranial cruciate deficient canine stifle. Vet Comp Orthop Traumatol 2013;26:271279.

    • Search Google Scholar
    • Export Citation
  • 92. Roe SC, Kue J, Gemma J. Isometry of potential suture attachment sites for the cranial cruciate ligament deficient canine stifle. Vet Comp Orthop Traumatol 2008;21:215220.

    • Search Google Scholar
    • Export Citation
  • 93. Roe SC. The challenge of isometry for extracapsular devices (lett). Vet Comp Orthop Traumatol 2013;26:VII.

  • 94. Hulse D, Hyman W, Beale B, et al. Determination of isometric points for placement of a lateral suture in treatment of the cranial cruciate ligament deficient stifle (Erratum published in Vet Comp Orthop Traumatol 2010;23:293). Vet Comp Orthop Traumatol 2010;23:163167.

    • Search Google Scholar
    • Export Citation
  • 95. Fischer C, Cherres M, Grevel V, et al. Effects of attachment sites and joint angle at the time of lateral suture fixation on tension in the suture for stabilization of the cranial cruciate ligament deficient stifle in dogs. Vet Surg 2010;39:334342.

    • Search Google Scholar
    • Export Citation
  • 96. Biskup JJ, Griffon DJ, Socie M, et al. Ability of the Tightrope and percutaneous lateral fabellar suture techniques to control cranial tibial translation. Vet Surg 2014;43:959965.

    • Search Google Scholar
    • Export Citation
  • 97. Gatineau M, El-Warrak AO, Bolliger C, et al. Effects of sterilization with hydrogen peroxide gas plasma, ethylene oxide, and steam on bioadhesive properties of nylon and polyethylene lines used for stabilization of canine stifle joints. Am J Vet Res 2012;73:16651669.

    • Search Google Scholar
    • Export Citation
  • 98. Masini BD, Stinner DJ, Waterman SM, et al. Bacterial adherence to high-tensile strength sutures. Arthroscopy 2011;27:834838.

  • 99. Alexander JW, Kaplan JZ, Altemeier WA. Role of suture materials in the development of wound infection. Ann Surg 1967;165:192199.

  • 100. Dulisch ML. Suture reaction following extra-articular stabilization in the dog. Part II: a prospective study of 66 stifles. J Am Anim Hosp Assoc 1981;17:572574.

    • Search Google Scholar
    • Export Citation
  • 101. Diamond DW, Besso J, Boudrieau RJ. Evaluation of joint stabilization for treatment of shearing injuries of the tarsus in 20 dogs. J Am Anim Hosp Assoc 1999;35:147153.

    • Search Google Scholar
    • Export Citation
  • 102. Fox SM, Guerin SR, Burbidge HM, et al. Reconstruction of the medial collateral ligament for tarsocrural luxation in the dog: a preliminary study. J Am Anim Hosp Assoc 1997;33:268274.

    • Search Google Scholar
    • Export Citation
  • 103. Martinez A, Han Y, Sardar ZM, et al. Risk of glove perforation with arthroscopic knot tying using different surgical gloves and high-tensile strength sutures. Arthroscopy 2013;29:15521558.

    • Search Google Scholar
    • Export Citation
  • 104. Rey J, Fischer MS, Böttcher P. Sagittal joint instability in the cranial cruciate ligament insufficient canine stifle. Caudal slippage of the femur and not cranial tibial subluxation. Tierarztl Prax Ausg K Kleintiere Heimtiere 2014;42:151156.

    • Search Google Scholar
    • Export Citation
  • 105. Kelley K, Clark B, Brown V, et al. Good practice in the conduct and reporting of survey research. Int J Qual Health Care 2003;15:261266.

    • Search Google Scholar
    • Export Citation
  • 106. Fowler FJJ. Survey research methods (applied social research methods). 5th ed. Los Angeles: Sage, 2014.

  • 107. Boudrieau RJ. Tibial plateau leveling osteotomy or tibial tuberosity advancement? Vet Surg 2009;38:122.

  • 108. Foy AJ, Filippone EJ. The case for intervention bias in the practice of medicine. Yale J Biol Med 2013;86:271280.

Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds)

View More View Less
  • 1 Friendship Surgical Specialists of the Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC 20016.
  • | 2 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.
  • | 3 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 4 Friendship Surgical Specialists of the Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC 20016.
  • | 5 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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.

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.

Supplementary Materials

    • Supplementary Appendix S1 (PDF 190 kb)

Contributor Notes

Address correspondence to Dr. von Pfeil (dvpfeil@yahoo.com).