Use of a Modified TPLO with Double Cut and Medial Crescentic Closing Wedge Osteotomy to Treat Dogs with Cranial Cruciate Ligament Rupture and Tibial Valgus Deformity

Authors: 
Vezzoni L, Bazzo S, Boiocchi S, Vezzoni A.
Vet Comp Orthop Traumatol. 2019 Nov 22. doi: 10.1055/s-0039-1700565.

OBJECTIVE: The aim of this study was to report efficacy of a modified tibial plateau levelling osteotomy (TPLO) with double cut and medial crescentic closing wedge osteotomy (TPLO/MCCWO) to treat dogs with cranial cruciate ligament rupture and concurrent tibial valgus.

STUDY DESIGN: This study was a cases series.

MATERIALS AND METHODS: Medical records of dogs that had TPLO with medial crescentic closing wedge osteotomy were reviewed. Data collected included signalment, body weight, pre- and postoperative tibial valgus angle, tibial plateau angle (TPA), surgical planning, corrective osteotomy technique, method of fixation, complications, and length of time to radiographic healing.

RESULTS: Fifty-two surgical procedures performed in 45 dogs (7 bilateral) were included in the study. Mean age at surgery was 54 months, and body weight ranged from 5 to 63 kg (mean: 36.5 kg). Mean pre- and postoperative mechanical medial proximal tibial angle were 101° (98°-107°) and 92.80° (88°-97°) respectively. The mean pre- and postoperative TPA were 27.80° (16-35°) and 6.50° (3-11°) respectively. Intraoperative complications occurred in two stifles: in one stifle over-rotation of the proximal tibial segment resulted in a TPA of -8°, with immediate revision to a 5° TPA; in the second stifle a fissure of the lateral tibial cortex developed during insertion of a screw and required adjunctive fixation. No postoperative complications were recorded and all osteotomies healed uneventfully.

CONCLUSIONS: Tibial plateau levelling osteotomy/medial crescentic closing wedge osteotomy is an effective treatment for dogs with cranial cruciate ligament rupture and tibial valgus allowing accurate correction of the tibial deformity with a low complication rate.