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Effect of Tibial Plateau Leveling Osteotomy on Femorotibial Subluxation: In Vivo Analysis during Standing
Author(s) -
Kim Stanley E.,
Lewis Daniel D.,
Pozzi Antonio
Publication year - 2012
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.2012.00973.x
Subject(s) - medicine , subluxation , cruciate ligament , weight bearing , radiography , stifle joint , osteoarthritis , osteotomy , orthodontics , surgery , anterior cruciate ligament , alternative medicine , pathology
Objective To assess the effect of tibial plateau leveling osteotomy ( TPLO ) on femorotibial subluxation during standing in dogs with cranial cruciate ligament ( C r CL ) insufficiency. Study Design Prospective clinical study. Animals Fifteen dogs weighing 20–45 kg with unilateral complete C r CL insufficiency. Methods Force‐platform analysis, and lateral weight‐bearing radiographs of the affected stifle were acquired preoperatively, 1, 3, and 6 months postoperatively. The distance between the origin and insertion of the C r CL ( C r CL d ) was measured on each radiograph and compared between time points using ANOVA . Lateral radiographs of the non‐weight‐bearing affected stifle and weight‐bearing contralateral normal stifle were acquired preoperatively, and C r CL d was compared with a paired t‐test. Dogs were grouped according to medial meniscal status (intact or hemimeniscectomy) and C r CL d was compared within each group using ANOVA . Results No difference was observed in C r CL d between the non‐weight‐bearing affected stifle and the contralateral stifle ( P = .994). That is, femorotibial joint alignment in the affected stifle when non‐weight‐bearing was considered normal. Preoperatively in the affected stifle, C r CL d during weight‐bearing was 6.3 ± 2.4 mm longer than normal ( P < .001). Postoperative weight‐bearing C r CL d in dogs with intact menisci at all time points was not statistically different from normal; C r CL d at 1 ( P = .014) and 6 months ( P = .005) postoperatively was longer than normal in dogs with hemimeniscectomy. Conclusions TPLO does not consistently resolve femorotibial subluxation during standing in dogs with C r CL insufficiency. The medial meniscus appears to be an important contributor to stability in stifles treated by TPLO .