Accuracy of three pre- and intra-operative measurement techniques for osteotomy positioning in the tibial plateau levelling procedure.

Abstract

To prospectively compare the accuracy of three preoperative measurement techniques in tibial plateau levelling osteotomy (TPLO) planning. Fifty-nine dogs were randomly assigned to one of three measurement techniques; A, B or C. Surgeons measured the intended osteotomy location on preoperative radiographs according to the assigned technique. Measurements were used intra-operatively during osteotomy placement. Postoperative measurements were made by a single blinded observer and compared to preoperative measurements. Fifty-one dogs were included for final statistical analysis. The mean absolute differences between pre- and postoperative measurements was 1.72 mm ± 0.958, 1.79 mm ± 1.010, and 3.56 mm ± 1.839, for techniques A, B and C, respectively. No significant differences were identified for patient age, gender, limb or surgeon. Techniques A and B were not significantly different (p = 0.8799). Techniques A and B were significantly more accurate than C (p = 0.0001 and p = 0.0003, respectively). Weight was significantly different among the groups (p = 0.047) but the statistical results did not change when an adjustment was made for bodyweight (p = 0.4971, p <0.001 and p = 0.0007, respectively). Preoperative measuring for planning a TPLO osteotomy is recommended. Techniques A and B in the current study were clinically practical and significantly more accurate compared to technique C.