Abstract
PICO question
 In dogs over 15 kg, with cranial cruciate ligament rupture is there evidence of improved outcome following tibial plateau levelling osteotomy or lateral fabellotibial suture?
 Clinical bottom line
 Although the evidence is not conclusive, the literature reviewed here suggests that tibial plateau levelling osteotomy (TPLO) results in superior limb function and owner satisfaction compared to placement of a lateral fabellotibial suture (LFS).
 There is currently insufficient evidence to determine if there is a difference in complication rates or osteoarthritis (OA) development following TPLO or LFS.
Highlights
Orthopaedic examination o The severity of stifle joint crepitation was significantly lower in the osteotomy group than in the LFS group. o The amount of periarticular swelling was significantly lower in the osteotomy than in the LFS group. o No significant differences were found between surgical techniques in pain response to stifle joint flexion/extension
Gait analysis o There was no significant difference in peak vertical force (PVF) between groups at any time point
Radiography o Mediolateral and either caudocranial or craniocaudal radiographic projections were obtained at preoperative and final examinations question): There was no significant difference in OA scores between treatment groups at defined time periods; dogs with greater than six point change in pre and postoperative scores were 5.78 times more likely to have been treated with a lateral fabellotibial suture placement
Summary
PICO question In dogs over 15 kg, with cranial cruciate ligament rupture is there evidence of improved outcome following tibial plateau levelling osteotomy or lateral fabellotibial suture?. Clinical bottom line the evidence is not conclusive, the literature reviewed here suggests that tibial plateau levelling osteotomy (TPLO) results in superior limb function and owner satisfaction compared to placement of a lateral fabellotibial suture (LFS). You discuss surgical treatment options with the client Both TPLO and LFS placement are performed locally and are financially feasible, other techniques are not available within a distance that the client is willing to travel and so are not considered. When considering postoperative limb function, owner satisfaction and complication rates, what evidence is there to suggest a TPLO technique is superior to LFS placement (or vice versa)?
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