Combined center of rotation of angulation-based leveling osteotomy and tibial tuberosity transposition: An ex vivo mechanical study

Authors: 
W Tyler Clough, David L Dycus, Matthew D Barnhart, Don A Hulse, Alan S Litsky
Vet Surg. 2022 Mar 7. doi: 10.1111/vsu.13790.

Objective: To describe the technique of combined center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) with tibial tuberosity transposition (TTT) and to compare the load to failure between CBLO combined with TTT and CBLO or TTT alone.

Study design: Ex vivo study.

Sample population: Twelve pairs of cadaveric pelvic limbs.

Methods: Six pairs of cadaveric tibia were tested in each group (CBLO-TTT versus CBLO) and (CBLO-TTT versus TTT) with each limb randomly assigned to a treatment group. Construct stability was determined by applying a tensile force to each patellar tendon until failure occurred. Load at failure and mode of failure were recorded for each specimen.

Results: No difference in mean load to failure was identified between CBLO-TTT (897 N) and CBLO alone (943 N) (P = .81). There was also no difference in the mean load to failure between the CBLO-TTT (928 N) and TTT alone (1046 N) (P = .12).

Conclusion: Performing a TTT in combination with a CBLO does not weaken the construct failure to load when compared with each procedure performed alone.

Clinical significance: A combined CBLO and TTT could be considered a viable option for concurrent management of a cranial cruciate ligament deficient stifle and medial patella luxation.