OBJECTIVE: To report clinical application of a tibial plateau leveling and medial opening crescentic osteotomy (TPLMOCO) by a single blade cut to ameliorate lameness in dogs with cranial cruciate ligament (CCL) rupture (CCLR) and concurrent tibia vara. STUDY DESIGN: Case series. ANIMALS: Bullmastiff-type dogs (n=4; 5 stifles). METHODS: Dogs were evaluated clinically and radiographically and records retrospectively reviewed. Pins were driven through both cortices of the proximal and distal tibia and a multidirectional jig attached medially. Tibial plateau leveling osteotomy was performed with torsional realignment of the calcaneo-patellar axis. A rigid connecting bar applied to the pins laterally before distraction of the medial jig allowed medial opening of the osteotomy while maintaining contact on the lateral aspect of the osteotomy. A 3.5 mm plate was applied. RESULTS: Meniscal and articular cartilage pathology was identified in the medial joint compartment in 4 stifles, and in both medial and lateral compartments in 1 stifle. Postoperatively, subjectively assessed lameness resolved in 4/5 limbs and improved in 1 limb. All osteotomies healed uneventfully, with superficial wound infection being the only complication in 1 dog. CONCLUSIONS: TPLMOCO is a potential treatment methodology for dogs with CCLR and tibia vara with or without tibial torsion. Clinical lameness was successfully ameliorated. Intraoperative assessment and correction of sagittal and rotational malalignment was sufficient to achieve satisfactory clinical outcome in these 4 dogs. CLINICAL RELEVANCE: TPLMOCO offers a potential treatment option and warrants further investigation for use in selected cases.
OBJECTIVE: To report clinical application of a tibial plateau leveling and medial opening crescentic osteotomy (TPLMOCO) by a single blade cut to ameliorate lameness in dogs with cranial cruciate ligament (CCL) rupture (CCLR) and concurrent tibia vara. STUDY DESIGN: Case series. ANIMALS: Bullmastiff-type dogs (n=4; 5 stifles). METHODS:Dogs were evaluated clinically and radiographically and records retrospectively reviewed. Pins were driven through both cortices of the proximal and distal tibia and a multidirectional jig attached medially. Tibial plateau leveling osteotomy was performed with torsional realignment of the calcaneo-patellar axis. A rigid connecting bar applied to the pins laterally before distraction of the medial jig allowed medial opening of the osteotomy while maintaining contact on the lateral aspect of the osteotomy. A 3.5 mm plate was applied. RESULTS: Meniscal and articular cartilage pathology was identified in the medial joint compartment in 4 stifles, and in both medial and lateral compartments in 1 stifle. Postoperatively, subjectively assessed lameness resolved in 4/5 limbs and improved in 1 limb. All osteotomies healed uneventfully, with superficial wound infection being the only complication in 1 dog. CONCLUSIONS: TPLMOCO is a potential treatment methodology for dogs with CCLR and tibia vara with or without tibial torsion. Clinical lameness was successfully ameliorated. Intraoperative assessment and correction of sagittal and rotational malalignment was sufficient to achieve satisfactory clinical outcome in these 4 dogs. CLINICAL RELEVANCE: TPLMOCO offers a potential treatment option and warrants further investigation for use in selected cases.
Authors: Inês E Dias; Diogo F Cardoso; Carla S Soares; Luís C Barros; Carlos A Viegas; Pedro P Carvalho; Isabel R Dias Journal: Open Vet J Date: 2021-04-12