Abstract
BackgroundCranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients. This cadaveric and radiographic study was performed with the aim of determining the effect of proximal translation of the tibial tuberosity during tibial tuberosity advancement (TTA) on patellar position (PP) and patellar ligament angle (PLA).ResultsDisarticulated left hind limb specimens harvested from medium to large breed canine cadavers (n = 6) were used for this study. Limbs were mounted to Plexiglass sheets with the stifle joint fixed in 135° of extension. The quadriceps mechanism was mimicked using an elastic band. Medio-lateral radiographs were obtained pre-osteotomy, after performing TTA without proximal translation of the tibial tuberosity, and after proximal translation of the tibial tuberosity by 3mm and 6mm. Radiographs were blinded to the observer for distance of tibial tuberosity proximalization following radiograph acquisition. Three independent observers recorded PP and PLA (tibial plateau method and common tangent method). Comparisons were made between the stages of proximalization using repeated measures ANOVA. Patellar position was found to be significantly more distal than pre-osteotomy, if the tibial tuberosity was not translated proximally (P = 0.001) and if it was translated proximally by 3mm (P = 0.005). The difference between pre-osteotomy PP and 6mm proximalization was not significant. The PLA was significantly larger if the tibial tuberosity was not translated proximally compared to tibial tuberosity proximalization of 6mm using the tibial plateau and the common tangent methods (P = 0.006 and P = 0.015 respectively).ConclusionsProximalizing the tibial tuberosity during TTA helps in maintaining vertical position of the patella in the patellar groove. Proximalization of the tibial tuberosity reduces PLA when compared to TTA without tibial tuberosity proximalization.
Highlights
Cranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients
Radiographic assessment of the 3mm and 6mm tibial tuberosity proximalizations showed that the 3mm stage had a mean proximalization of 3.17 (± 0.55mm) and the 6mm stage a mean of 5.90 (± 0.46mm) respectively
Mean pre-osteotomy patellar position (PP) measurement was 28.0mm (± 0.32). This distance was reduced post-osteotomy to 24.3mm (±0.34) if the tibial tuberosity was not proximally translated, 25.4mm (±0.29) if it was proximally translated by 3mm, and 26.8mm (±0.33) if it was proximally translated by 6mm (Fig. 1)
Summary
Cranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients. This cadaveric and radiographic study was performed with the aim of determining the effect of proximal translation of the tibial tuberosity during tibial tuberosity advancement (TTA) on patellar position (PP) and patellar ligament angle (PLA). Given the prevalence of disease, development of treatment techniques, including various tibial osteotomies have been described over the past 25 years [5,6,7,8,9] These procedures are intended to change stifle dynamic joint biomechanics rather than directly repair the cranial cruciate ligament and include the cranial. With the original TTA technique, the advanced tibial tuberosity is stabilized
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
