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Femorotibial kinematics in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament insufficiency: an in vivo fluoroscopic analysis during walking


Tinga, Selena; Kim, Stanley E; Banks, Scott A; Jones, Stephen C; Park, Brian H; Burtch, Matthew; Pozzi, Antonio; Lewis, Daniel D (2020). Femorotibial kinematics in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament insufficiency: an in vivo fluoroscopic analysis during walking. Veterinary Surgery, 49(1):187-199.

Abstract

OBJECTIVE: To determine the ability of tibial plateau leveling osteotomy (TPLO) to address abnormal femorotibial kinematics caused by cranial cruciate ligament (CCL) rupture during walking in dogs.
STUDY DESIGN: Prospective, clinical.
ANIMALS: Sixteen dogs (20-40 kg) with unilateral complete CCL rupture.
METHODS: Lateral view fluoroscopy was performed during treadmill walking preoperatively and 6 months after TPLO. Digital three-dimensional (3D) models of the femora and tibiae were created from computed tomographic (CT) images. Gait cycles were analyzed by using a 3D-to-2D image registration process. Craniocaudal translation, internal/external rotation, and flexion/extension of the femorotibial joint were compared between preoperative and 6-month postoperative time points for the affected stifle and 6-month postoperative unaffected contralateral (control) stifles.
RESULTS: In the overall population, CCL rupture resulted in 10 ± 2.2 mm (mean ± SD) cranial tibial translation at midstance phase, which was converted to 2.1 ± 4.3 mm caudal tibial translation after TPLO. However, five of 16 TPLO-treated stifles had 4.1 ± 0.3 mm of cranial tibial subluxation during mid-to-late stance phase, whereas 10 of 16 TPLO-treated stifles had 4.3 ± 0.4 mm of caudal tibial subluxation throughout the gait cycle. Overall, postoperative axial rotational and flexion/extension patterns were not different from control, but stifles with caudal tibial subluxation had more external tibial rotation during mid-to-late stance phase compared with stifles with cranial tibial subluxation.
CONCLUSION: TPLO mitigated abnormal femorotibial kinematics but did not restore kinematics to control values in 15 of 16 dogs during walking.
CLINICAL SIGNIFICANCE: Tibial plateau leveling osteotomy reduces cranial tibial subluxation during walking, but persistent instability is common.

Abstract

OBJECTIVE: To determine the ability of tibial plateau leveling osteotomy (TPLO) to address abnormal femorotibial kinematics caused by cranial cruciate ligament (CCL) rupture during walking in dogs.
STUDY DESIGN: Prospective, clinical.
ANIMALS: Sixteen dogs (20-40 kg) with unilateral complete CCL rupture.
METHODS: Lateral view fluoroscopy was performed during treadmill walking preoperatively and 6 months after TPLO. Digital three-dimensional (3D) models of the femora and tibiae were created from computed tomographic (CT) images. Gait cycles were analyzed by using a 3D-to-2D image registration process. Craniocaudal translation, internal/external rotation, and flexion/extension of the femorotibial joint were compared between preoperative and 6-month postoperative time points for the affected stifle and 6-month postoperative unaffected contralateral (control) stifles.
RESULTS: In the overall population, CCL rupture resulted in 10 ± 2.2 mm (mean ± SD) cranial tibial translation at midstance phase, which was converted to 2.1 ± 4.3 mm caudal tibial translation after TPLO. However, five of 16 TPLO-treated stifles had 4.1 ± 0.3 mm of cranial tibial subluxation during mid-to-late stance phase, whereas 10 of 16 TPLO-treated stifles had 4.3 ± 0.4 mm of caudal tibial subluxation throughout the gait cycle. Overall, postoperative axial rotational and flexion/extension patterns were not different from control, but stifles with caudal tibial subluxation had more external tibial rotation during mid-to-late stance phase compared with stifles with cranial tibial subluxation.
CONCLUSION: TPLO mitigated abnormal femorotibial kinematics but did not restore kinematics to control values in 15 of 16 dogs during walking.
CLINICAL SIGNIFICANCE: Tibial plateau leveling osteotomy reduces cranial tibial subluxation during walking, but persistent instability is common.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Language:English
Date:1 January 2020
Deposited On:09 Dec 2019 18:24
Last Modified:27 Dec 2019 02:05
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0161-3499
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/vsu.13356
PubMed ID:31777975

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