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Modified cranial closing wedge osteotomy for treatment of cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angles: Technique and complications in 19 cases
Author(s) -
Frederick Steven W.,
Cross Alan R.
Publication year - 2017
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/vsu.12614
Subject(s) - medicine , cruciate ligament , osteotomy , surgery , fixation (population genetics) , radiography , implant , anterior cruciate ligament , population , environmental health
Abstract Objective To describe short‐term outcomes of a modified cranial closing wedge osteotomy (CCWO) for treatment of dogs with cranial cruciate ligament disease and excessive tibial plateau angle (eTPA). Study Design Retrospective clinical study. Animals 18 client‐owned dogs (19 stifles) with cranial cruciate ligament disease and eTPA (>34°). Methods A modified CCWO was performed with Kirschner wires as osteotomy alignment aids. A juxta‐articular neutral wedge osteotomy equal in angle to the preoperative TPA was performed. Fixation was achieved with a tibial plateau leveling osteotomy (TPLO) plate and tension band wire apparatus (89%) or a TPLO plate (11%). Preoperative and postoperative, and recheck TPA, cranial tibial long axis shift, and major and minor complications were recorded. Results The mean preoperative TPA (49.5° ± 6.7°) was reduced postoperatively (8.3° ± 4.8°). Four of 19 joints (21%) developed 2 major and 3 minor complications during the intraoperative and follow‐up period (577 day mean in‐hospital recheck). Two cases were diagnosed with surgical site infections requiring implant removal for resolution. Fixation failure or implant complications were not observed in any dog during the limited radiographic follow‐up period. All dogs were sound or recovering as expected, with 15/19 dogs (79%) showing complete radiographic osteotomy healing at their final in‐hospital follow‐up examination. Conclusion Modified CCWO should be considered for the treatment of cranial cruciate ligament disease in dogs with eTPA. In this case series, the described technique was associated with uneventful osteotomy healing without implant failures in all dogs, although radiographic follow‐up was limited in some cases.