胫骨平台水平化截骨术治疗犬前交叉韧带疾病的手术效果和并发症分析

doi:10.11843/j.issn.0366-6964.2023.09.034

Abstract

Abstract: This study aimed to evaluate the surgical effect and complications of tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament disease (CCLD) in dogs, and analyze factors that affect surgical effect and complications. The medical records of canine CCLD treated by TPLO in China Agricultural University Veterinary Teaching Hospital were reviewed and followed up. The inclusion criteria are:follow-up time more than 5 months; case information record is completed. Results were as follows:101 TPLO procedures in 85 dogs of 20 breeds were included, including crossbreed (n=17, 20.0%), poodle (n=15, 17.7%), bichon (n=11, 12.9%), golden retriever (n=10, 11.8%) and Labrador retriever (n=8, 9.4%). The median weight and age were 14.4 kg (range, 4-53 kg) and 7 years (range, 1-14 years old), respectively. The overall complication rate was 37.6% (38/101). Thirty-six cases (35.6%, 36/101) had minor complications (including wound-related complications and bandage-related complications), and 2 cases (2.0%) had major complications (including 1case of screw loosening and 1 case of tibial tuberosity fracture). Wound-related complications (23.8%, 24/101) were more likely to occur in dogs with wound licking (P<0.01), which were found in all the 15 dogs with wound licking. Related complications occurred in 18 (34.6%) of 52 dogs treated with bandage. Two major complications were treated by revision surgery with good results. Among the cases with follow-up results, 95.6% (86/90) cases had good functional recovery. Besides, postoperative bandage increased the risk of complications (P=0.047, OR=3.873, 95%CI:1.015-14.776). However, no risk factors associated with surgical outcomes were found. In summary, TPLO of dogs with CCLD has desirable results and a low proportion of major complications. Licking can cause wound-related complications, therefore licking wounds should be strictly prevented postoperatively. Moreover, the use of bandages should be reduced to decrease associated complications.

Key words: cranial cruciate ligament disease, tibial plateau leveling osteotomy, canine, surgical effect, complications

CLC Number:

S857.128

SHI Lei, MA Yihan, YUAN Zhankui, SUN Yihong, WANG Xiao, ZHANG Bin, QIAO Kangjia. Analysis of Surgical Effect and Complications of Tibial Plateau Leveling Osteotomy for the Treatment of Cranial Cruciate Ligament Disease in Dogs[J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(9): 3964-3976.

References

[1] MOSSMAN H, VON PFEIL D J, NICHOLSON M, et al. Accuracy of three pre-and intra-operative measurement techniques for osteotomy positioning in the tibial plateau levelling procedure[J]. Vet Comp Orthop Traumatol, 2015, 28(4):250-255.
[2] WITSBERGER T H, VILLAMIL J A, SCHULTZ L G, et al. Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs[J]. J Am Vet Med Assoc, 2008, 232(12):1818-1824.
[3] COOK J L. Cranial cruciate ligament disease in dogs:biology versus biomechanics[J]. Vet Surg, 2010, 39(3):270-277.
[4] DUERR F M, MARTIN K W, RISHNIW M, et al. Treatment of canine cranial cruciate ligament disease. A survey of ACVS Diplomates and primary care veterinarians[J]. Vet Comp Orthop Traumatol, 2014, 27(6):478-483.
[5] SLOCUM B, SLOCUM T D. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine[J]. Vet Clin North Am Small Anim Pract, 1993, 23(4):777-795.
[6] HOOTS E A, PETERSEN S W. Tibial plateau leveling osteotomy and cranial closing wedge ostectomy in a cat with cranial cruciate ligament rupture[J]. J Am Anim Hosp Assoc, 2005, 41(6):395-399.
[7] RAY W M, GUSTAFSON S B, HUBER M J. Tibial plateau leveling osteotomy in a llama with a ruptured cranial cruciate ligament[J]. J Am Vet Med Assoc, 2004, 225(11):1739-1742, 1702.
[8] WITTE P G, SCOTT H W. Tibial plateau leveling osteotomy in small breed dogs with high tibial plateau angles using a 4-hole 1. 9/2. 5 mm locking T-plate[J]. Vet Surg, 2014, 43(5):549-557.
[9] COSENZA G, REIF U, MARTINI F M. Tibial plateau levelling osteotomy in 69 small breed dogs using conically coupled 1. 9/2. 5 mm locking plates. A clinical and radiographic retrospective assessment[J]. Vet Comp Orthop Traumatol, 2015, 28(5):347-354.
[10] AMIMOTO H, KOREEDA T, OCHI Y, et al. Force plate gait analysis and clinical results after Tibial Plateau levelling osteotomy for cranial cruciate ligament rupture in small breed dogs[J]. Vet Comp Orthop Traumatol, 2020, 33(3):183-188.
[11] BERGER B, KNEBEL J, STEIGMEIER-RAITH S, et al. Long-term outcome after surgical treatment of cranial cruciate ligament rupture in small breed dogs. Comparison of tibial plateau leveling osteotomy and extra-articular stifle stabilization[J]. Tierarztl Prax Ausg K Kleintiere Heimtiere, 2015, 43(6):373-380.
[12] 王虓, 吴楚琳, 袁占奎, 等. 31例犬前十字韧带断裂手术治疗的调查报告[J]. 黑龙江畜牧兽医, 2022(10):68-72, 75.
WANG X, WU C L, YUAN Z K, et al. Investigation report on surgical treatment of 31 cases of canine cranial cruciate ligament rupture[J]. Heilongjiang Animal Science and Veterinary Medicine, 2022(10):68-72, 75.
[13] 吴楚琳, 王佳尧, 张晗, 等. 前十字韧带断裂犬胫骨平台角的X线和CT测量[J]. 中国畜牧兽医, 2021, 48(10):3896-3904.
WU C L, WANG J Y, ZHANG H, et al. Radiographic and CT measurements of tibial plateau angle in dogs with cranial cruciate ligament rupture[J]. China Animal Husbandry & Veterinary Medicine, 2021, 48(10):3896-3904.
[14] IMPELLIZERI J A, TETRICK M A, MUIR P. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis[J]. J Am Vet Med Assoc, 2000, 216(7):1089-1091.
[15] QUINN M M, KEULER N S, LU Y, et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs[J]. Vet Surg, 2007, 36(4):360-367.
[16] COOK J L, EVANS R, CONZEMIUS M G, et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine[J]. Vet Surg, 2010, 39(8):905-908.
[17] GATINEAU M, DUPUIS J, PLANTÉ J, et al. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Rate of subsequent 'pivot shift', meniscal tear and other complications[J]. Vet Comp Orthop Traumatol, 2011, 24(5):333-341.
[18] COLLINS J E, DEGNER D A, HAUPTMAN J G, et al. Benefits of pre-and intraoperative planning for tibial plateau leveling osteotomy[J]. Vet Surg, 2014, 43(2):142-149.
[19] AULAKH K S, HARPER T A M, LANZ O I, et al. Effect of stifle angle on the magnitude of the tibial plateau angle measurement in dogs with intact and transected cranial cruciate ligament. A cadaveric study[J]. Vet Comp Orthop Traumatol, 2011, 24(4):272-278.
[20] REIF U, DEJARDIN L M, PROBST C W, et al. Influence of limb positioning and measurement method on the magnitude of the tibial plateau angle[J]. Vet Surg, 2004, 33(4):368-375.
[21] UNIS M D, JOHNSON A L, GRIFFON D J, et al. Evaluation of intra-and interobserver variability and repeatability of tibial plateau angle measurements with digital radiography using a novel digital radiographic program[J]. Vet Surg, 2010, 39(2):187-194.
[22] BELL J C, NESS M G. Does use of a jig influence the precision of tibial plateau leveling osteotomy surgery?[J]. Vet Surg, 2007, 36(3):228-233.
[23] SCHMERBACH K I, BOELTZIG C K M, REIF U, et al. In vitro comparison of tibial plateau leveling osteotomy with and without use of a tibial plateau leveling jig[J]. Vet Surg, 2007, 36(2):156-163.
[24] LEE S, KANG J S, KIM N, et al. Evaluation of a customized 3D-printed saw guide for tibial plateau leveling osteotomy:An ex vivo study[J]. Vet Surg, 2022, 51(6):963-973.
[25] BURTON N J, FITZPATRICK N, WALLACE A M. Evaluation of cut accuracy and cis cortical damage for tibial plateau leveling osteotomy performed with and without aid of a novel saw guide:an in vitro study[J]. Vet Surg, 2013, 42(1):28-37.
[26] TAN C J, BERGH M S, SCHEMBRI M A, et al. Accuracy of tibial osteotomy placement using 2 different tibial plateau leveling osteotomy jigs[J]. Vet Surg, 2014, 43(5):525-533.
[27] CONKLING A L, FAGIN B, DAYE R M. Comparison of tibial plateau angle changes after tibial plateau leveling osteotomy fixation with conventional or locking screw technology[J]. Vet Surg, 2010, 39(4):475-481.
[28] KOWALESKI M P, BOUDRIEAU R J, BEALE B S, et al. Radiographic outcome and complications of tibial plateau leveling osteotomy stabilized with an anatomically contoured locking bone plate[J]. Vet Surg, 2013, 42(7):847-852.
[29] SOLANO M A, DANIELSKI A, KOVACH K, et al. Locking plate and screw fixation after tibial plateau leveling osteotomy reduces postoperative infection rate in dogs over 50 kg[J]. Vet Surg, 2015, 44(1):59-64.
[30] PACCHIANA P D, MORRIS E, GILLINGS S L, et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture:397 cases (1998-2001)[J]. J Am Vet Med Assoc, 2003, 222(2):184-193.
[31] PRIDDY II N H, TOMLINSON J L, DODAM J R, et al. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs:193 cases (1997-2001)[J]. J Am Vet Med Assoc, 2003, 222(12):1726-1732.
[32] STAUFFER K D, TUTTLE T A, ELKINS A D, et al. Complications associated with 696 tibial plateau leveling osteotomies (2001-2003)[J]. J Am Anim Hosp Assoc, 2006, 42(1):44-50.
[33] FITZPATRICK N, SOLANO M A. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs[J]. Vet Surg, 2010, 39(4):460-474.
[34] COLETTI T J, ANDERSON M, GORSE M J, et al. Complications associated with tibial plateau leveling osteotomy:a retrospective of 1519 procedures[J]. Can Vet J, 2014, 55(3):249-254.
[35] NAZARALI A, SINGH A, WEESE J S. Perioperative administration of antimicrobials during tibial plateau leveling osteotomy[J]. Vet Surg, 2014, 43(8):966-971.
[36] NAZARALI A, SINGH A, MOENS N M, et al. Association between methicillin-resistant Staphylococcus pseudintermedius carriage and the development of surgical site infections following tibial plateau leveling osteotomy in dogs[J]. J Am Vet Med Assoc, 2015, 247(8):909-916.
[37] HANS E C, BARNHART M D, KENNEDY S C, et al. Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight[J]. Vet Comp Orthop Traumatol, 2017, 30(4):299-305.
[38] BROWN G, MADDOX T, SILES M M B. Client-assessed long-term outcome in dogs with surgical site infection following tibial plateau levelling osteotomy[J]. Vet Rec, 2016, 179(16):409.
[39] TUTTLE T A, MANLEY P A. Risk factors associated with fibular fracture after tibial plateau leveling osteotomy[J]. Vet Surg, 2009, 38(3):355-360.
[40] TAYLOR J, LANGENBACH A, MARCELLIN-LITTLE D J. Risk factors for fibular fracture after TPLO[J]. Vet Surg, 2011, 40(6):687-693.
[41] KERGOSIEN D H, BARNHART M D, KEES C E, et al. Radiographic and clinical changes of the tibial tuberosity after tibial plateau leveling osteotomy[J]. Vet Surg, 2004, 33(5):468-474.
[42] BERGH M S, RAJALA-SCHULTZ P, JOHNSON K A. Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs[J]. Vet Surg, 2008, 37(4):374-382.
[43] BOUDRIEAU R J, MCCARTHY R J, SISSON R D, Jr. Sarcoma of the proximal portion of the tibia in a dog 5.5 years after tibial plateau leveling osteotomy[J]. J Am Vet Med Assoc, 2005, 227(10):1613-1617.
[44] MEESON R L, DAVIDSON C, ARTHURS G I. Soft-tissue injuries associated with cast application for distal limb orthopaedic conditions[J]. Vet Comp Orthop Traumatol, 2011, 24(2):126-131.
[45] BERGH M S, SULLIVAN C, FERRELL C L, et al. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs[J]. J Am Anim Hosp Assoc, 2014, 50(5):315-321.
[46] THIEMAN K M, TOMLINSON J L, FOX D B, et al. Effect of meniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau leveling osteotomy[J]. Vet Surg, 2006, 35(8):705-710.
[47] CHRISTOPHER S A, BEETEM J, COOK J L. Comparison of long-term outcomes associated with three surgical techniques for treatment of cranial cruciate ligament disease in dogs[J]. Vet Surg, 2013, 42(3):329-334.
[48] DE MEDEIROS M, BUSTINDUY M S, RADKE H, et al. Early kinematic outcome after treatment of cranial cruciate ligament rupture by tibial plateau levelling osteotomy in the dog[J]. Vet Comp Orthop Traumatol, 2011, 24(3):178-184.
[49] BÖDDEKER J, DRÜEN S, MEYER-LINDENBERG A, et al. Computer-assisted gait analysis of the dog:comparison of two surgical techniques for the ruptured cranial cruciate ligament[J]. Vet Comp Orthop Traumatol, 2012, 25(1):11-21.
[50] INNES J F, BARR A R S. Can owners assess outcome following treatment of canine cruciate ligament deficiency?[J]. J Small Anim Pract, 1998, 39(8):373-378.

Analysis of Surgical Effect and Complications of Tibial Plateau Leveling Osteotomy for the Treatment of Cranial Cruciate Ligament Disease in Dogs

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	ZHANG Bin, ZHANG Han, SHI Lei, YUAN Zhankui. Clinical Application of 3D-Printed Model for Surgical Planning and Treatment of Grade Ⅳ Medial Patellar Luxation and Cranial Cruciate Ligament Rupture in a Dog [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(9): 3977-3984.
[2]	ZHONG Hua, SONG Shanshan, SHAO Huanting, ZHAO Yu, KANG Jinwen, WU Yao, SU Renwei. Transcriptome Sequencing Analysis on Canine Pyometra Uterine Tissue [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(8): 3383-3392.
[3]	WANG Jiali, ZHOU Ning, CHEN Xi, YUE Hua, TANG Cheng. Isolation, Identification and Pathogenicity of Canine Adenovirus Type 2 Strain with Natural Deletion in E3 Gene [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(7): 2982-2990.
[4]	MA Tianwen, WANG Yingxue, WANG Minghe, CHI Xinyu, WANG Shu, GAO Li, WEI Chengwei. Clinical Diagnosis, Treatment and Prognosis of Intestinal Lymphadenopathy in Canine [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(7): 3102-3107.
[5]	ZHANG Yan, LIU Jiayue, WU Meijin, ZHOU Jiahao, DIAO Hongxiu. Research Progress of Non-coding RNA as A Potential Biomarker for Canine Tumors [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(6): 2264-2271.
[6]	REN Xiaoli, FAN Yuying, HUANGFU Heping, LIU Yun, SHI Dongmei. Effect of GSK126 on Epithelial-mesenchymal Transition of Canine Mammary Tumor Cells [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(4): 1721-1729.
[7]	XU Huihao, LIU Jiangyu, LI Qijuan, ZHENG Xiaobo, LIN Jiahao, JIN Yipeng, LIN Degui. Expression and Prognosis of Hexokinase 2 in Canine Mammary Tumors [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(3): 1310-1324.
[8]	ZHANG Jiabin, XU Zhao, ZHOU Guangyu, ZHANG Mengdi, FU Yang, LIU Jiaqi, ZHOU Donghai. Effects of Electroacupuncture Therapy on Renal Function, Calcium and Phosphorus Metabolism, Antioxidant Capacity and NRF2 Signaling Pathway in AKI Dogs [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(2): 803-815.
[9]	YUAN Yue, HE Chuqiao, SHU Zongtao, SHI Chaoying, LI Xiaokun, YANG Deji, YAO Dawei. Imaging Manifestations of Multi-Sequence Scanning and Enhanced Magnetic Resonance Imaging in Acute Edematous Pancreatitis in Canines [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(11): 4777-4785.
[10]	XU Haojie, LIAN Shicun, DAI Pengxiu, ZHANG Xinke. Application of Immediate Implant Placement Technique in Repairing Molar Defects of Dogs [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(11): 4798-4804.
[11]	REN Xiaoli, FAN Yuying, HUANGFU Heping, WANG Jun, JIN Shuangxing, LIU Yun, SHI Dongmei. Mechanism of miR-502 Regulating Proliferation, Migration, Invasion and EMT of Canine Mammary Tumor Cells [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(10): 4379-4388.
[12]	XU Huihao, JIAO Yien, ZHENG Xiaobo, ZHANG Zhipeng, YANG Lihui, LIN Jinzhou, WANG Libo, TANG Jing, LI Qijuan, LIU Jiangyu, CHEN Ziyang, HU Xiaoyan, PIAO Xueling, ZHANG Hui, GAN Ling. A Large Retrospective Study on the Treatment of Corneal Diseases in Dogs and Cats with a New Type of Bioengineered Cornea Transplantation [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(10): 4389-4402.
[13]	LI Shun, LI Guizhen, YUAN Yaoxian, LI Kangjian, MA Chunquan, LI Shoujun, HUANG Liangzong, MA Jun. Effect of the Length of PA-X Gene on Replication and Pathogenicity of H3N2 Canine Influenza Virus [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(1): 272-280.
[14]	ZHOU Shuilian, BAI Yuman, XIE Wenting, HUANG Jianjia, QIU Wenyue, PANG Xiaoyue, ZHANG Xinting, TANG Zhaoxin, SU Rongsheng. Effect of N-acetyl-L-cysteine on Oxidative Damage of Lens Epithelium in Beagle Dogs with Type 1 Diabetes Mellitus [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(1): 361-370.
[15]	WANG Jingxuan, XU Yao, WANG Haoran, LIU Zhiyuan, ZHAO Qida, LIU Ruifang, WANG Xinyu, LIU Tao, SONG Xudong, XIAO Jianhua. A New Classification of Canine Endometritis: An Anatomical and Histopathological Perspective [J]. Acta Veterinaria et Zootechnica Sinica, 2022, 53(4): 1259-1269.