Resident in Small Animal Surgery University of Florida College of Veterinary Medicine Gainesville, Florida
Radiographic Comparison of Virtual Surgical Corrective Options for Excessive Tibial Plateau Angle in the Dog. Worden NJ1, Oxley B2, Naiman J3, Peycke L4, Karlin WM5, Hetzel SJ6, Chen TM1, Bleedorn J1. 1University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI; 2Vet3D, Coventry, United Kingdom; 3VCA ASEC Animal Specialty & Emergency Center, Department of Small Animal Surgery, Los Angeles, CA, United States; 4Texas A&M University, College of Veterinary Medicine, College Station, TX; 5Tufts University, North Grafton, MA; 6University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI.
Dogs with excessive tibial plateau angles (eTPA), defined as a tibial plateau angle (TPA) > 34°, present a unique challenge in the surgical treatment of cranial cruciate ligament disease. While many surgical options have been proposed for correcting eTPA, there lacks consensus of which method is superior to mitigate the reported increased complication rate in these dogs. The objective of this study was to compare the impact of six proximal tibial osteotomies (PTOs) on the geometry and alignment of tibias with a range of TPAs. Our null hypothesis was that there would be no differences in changes to tibial geometry and alignment between corrective procedures. Mediolateral radiographs of 30 canine tibias with TPAs ranging from 29° to 56° were used for analysis. Six virtual PTOs were simulated on the radiographs via orthopedic planning software, reducing the TPA to the intended, procedure-specific target. Pre- and postoperative tibial measurements were recorded for each virtual correction and compared using a two-way mixed effects ANOVA with post-hoc Tukey comparisons. The TPLO/CCWO had the lowest tibial long axis shift (TLAS) and distal tibial tuberosity shift (dTTS). The coplanar CBLO had the largest TLAS and cranial TT shift (cTTS). The CCWO had the largest dTTS. Study limitations included the radiographic nature of the study, small sample size, and variability of proximal tibial deformities. The findings in this study may help to guide decision-making when selecting a procedure for correction of eTPA in dogs.