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Risk Factors for Tibial Tuberosity Fracture After Tibial Plateau Leveling Osteotomy in Dogs
Author(s) -
BERGH MARY SARAH,
RAJALASCHULTZ PÄIVI,
JOHNSON KENNETH A.
Publication year - 2008
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2008.00391.x
Subject(s) - medicine , cruciate ligament , surgery , osteotomy , radiography , anterior cruciate ligament
Objective— To evaluate factors that predispose to tibial tuberosity (TT) fracture after tibial plateau leveling osteotomy (TPLO) in dogs. Study Design— Retrospective study. Animals— Dogs (n=182) with cranial cruciate ligament (CCL) rupture undergoing 213 TPLO surgeries. Methods— Medical records and radiographs of 2 groups of dogs that had TPLO surgery (2000–2001, 2004–2005) were evaluated to determine the effect of operative technique and surgeon experience on TT fracture. Results— TT fracture was diagnosed in 8 dogs (9 TPLO, 4.2% of surgical procedures). Four fractures occurred after unilateral TPLO in 167 dogs (2.4%), 4 fractures occurred after simultaneous bilateral TPLO in 5 dogs (40%), and 1 fracture occurred after staged bilateral TPLO in 36 dogs (2.8%). Simultaneous bilateral TPLO resulted in a 12.4 times higher odds of TT fracture versus unilateral TPLO ( P =.046). The mean absolute thickness of the TT after TPLO was less in dogs sustaining TT fractures (7.2 ± 2.2 mm) than those that did not (10.8 ± 2.7 mm, P <.0001). The odds of fracture decreased by 37% when the absolute TT width postosteotomy increased by 1 mm ( P <.0001). An increase in tibial plateau angle at follow‐up versus immediately postoperative was associated with TT fracture ( P =.025). Surgeon experience was not associated with TT fracture. Conclusion— A combination of surgical decision‐making and surgical technique play a role in the occurrence of TT fracture after TPLO. Simultaneous bilateral TPLO was associated with a high percentage of TT fracture. Clinical Relevance— Careful planning of osteotomy positioning is advised while performing TPLO surgery.