Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation

胫骨平台水平截骨术联合胫骨结节移位术治疗伴有内侧髌骨脱位的前十字韧带功能不全

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Abstract

OBJECTIVES: To describe the surgical technique and report short-term outcome for combined tibial plateau levelling osteotomy and tibial tuberosity transposition (TPLO-TTT) as an option in the treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation. METHODS: Medical records were reviewed (2011-2013) of dogs that underwent a standard tibial plateau levelling osteotomy followed by a tibial tuberosity transposition in the frontal plane and stabilized with pin and tension-band wire fixation as a component of surgical treatment for combined cranial cruciate ligament insufficiency and medial patellar luxation. Signalment, fixation method together with any ancillary procedures, function at the in-hospital follow-up examinations, and any complications were recorded. Healing was assessed retrospectively based on the grading criteria of the International Society Of Limb Salvage. RESULTS: Fifteen stifle joints in 11 dogs were identified; 13 stifles were available for in-hospital follow-up. All 13 achieved union (3 with grade III/IV and 10 with grade IV/IV radiographic healing scores); mean time to healing was 10.6 (± 2.9) weeks. Patellar ligament thickening was also identified radiographically in seven of the 13 of stifle joints. All dogs were reported to have mild or no lameness at their last follow-up examination. No catastrophic or major postoperative complications occurred that required additional surgery. Patellar re-luxation did not occur in any of the 13 stifles available for in-hospital follow-up. CLINICAL SIGNIFICANCE: The TPLO-TTT was found to be a reliable and effective technique when used as a part of the treatment of combined cranial cruciate ligament insufficiency with concomitant medial patellar luxation in this series of dogs.

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