Abstract
ObjectiveCranial cruciate ligament (CCL) rupture is a common cause of pelvic limb lameness in dogs. The tibial plateau leveling osteotomy (TPLO) is a well-described surgical procedure that treats CCL ruptures. The objective of this study was to compare the risk of tibial tuberosity fractures from TPLO procedures using a TPLO reduction pin in situ versus patients with a TPLO reduction pin removed at the time of surgery. Our hypothesis is that patients with a TPLO reduction pin left in situ will have a decreased incidence of tibial tuberosity fractures.ResultsA total of 400 dogs that fitted the criteria of 200 consecutive TPLO surgeries performed with each group were included in the study. The Student’s t-test revealed a statistically significant difference in fractures observed in group 1 (in situ pin) and group 2 (no pin). In univariate logistic regression analysis, only the covariate for the presence of the reduction pin was associated with a statistically significant reduction in the likelihood of tibial tuberosity fracture. In the multivariate model, the presence of the reduction pin was associated with an approximate 92% reduction in the likelihood of tibial tuberosity fracture.
Highlights
Cranial cruciate ligament (CCL) rupture is one of the most common causes of pelvic limb lameness in dogs [1]
It has been hypothesized that the cranial positioning of the osteotomy, large tibial plateau angle (TPA) corrections, inaccurate reduction of the osteotomy gap, oversized saw blade, relative placement of the antirotational tibial plateau leveling osteotomy (TPLO) reduction pin, and simultaneous bilateral TPLO surgeries are all risk factors for tibial tuberosity fractures [11–13]
The mean absolute tibial tuberosity width was 0.76 cm and relative tibial tuberosity width was 0.18. To our knowledge this is the only study of TPLO procedures that evaluates the incidence of tibial tuberosity avulsion fractures in relation to the presence of an in situ TPLO reduction pin
Summary
A total of 400 dogs were included in the study that fit the criteria of 200 consecutive TPLO surgeries performed with each group were included in the study. Pin (ref = 0) Sex (ref = male) Age (years) Weight (kg) Post/pre angle difference (degrees). In univariate logistic regression analysis, only the covariate for the presence of the reduction pin was associated with a statistically significant reduction in the likelihood of tibial tuberosity avulsion [OR: 0.138 (95% CI 0.007–0.789)]. In the multivariate model, adjusting for potentially confounding covariates, the presence of the reduction pin was associated with an approximate 92% reduction in the likelihood of tibial tuberosity avulsion [OR: 0.075 (95% CI 0.003–0.549, p = 0.03732)]. In group 1, one fracture was observed in 200 consecutive TPLO surgeries (0.5%). Age (years) Sex (% female) Weight (kg) Pre TPA angle Post TPA angle Post/pre angle difference Tibial tuberosity width (cm) Tibial width (cm) Tibial tuberosity avulsion. In group 2 seven fractures were observed in 200 TPLO surgeries (3.5%). The mean absolute tibial tuberosity width was 0.76 cm and relative tibial tuberosity width was 0.18
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