An in silico comparison of a novel CORA-based cranial closing wedge ostectomy methodology with three other techniques

通过计算机模拟比较一种基于CORA的新型颅骨闭合楔形截骨术方法与其他三种技术

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Abstract

OBJECTIVE: To describe a CORA-based cranial closing wedge ostectomy methodology (CCWO(CORA)) and to determine whether the CCWO(CORA) achieves a more accurate and precise postoperative tibial plateau angle (TPA(POST)) than three previously described methods. STUDY DESIGN: In silico study. SAMPLE POPULATION: Thirteen client-owned dogs. METHODS: Computed tomography (CT) scans of six Labrador retriever, six German shepherd, six Rottweiler, and six small-breed dog (<10 kg) tibiae, originally acquired for unrelated purposes, were used for in silico planning and execution of the CCWO(CORA) and previously described procedures. The TPA(POST), tibial long axis shift, change in tibial length and wedge angle were recorded and a linear mixed-effects model was used to compare differences amongst techniques. RESULTS: The median TPA(POST) for the CCWO(CORA) method was 5.00° (range: 5.00-5.00°) across a variety of tibial morphologies, whereas all other methods showed greater variability. Differences in TPA(POST) were evident amongst methods (p < .001) and breeds (p < .001). CONCLUSIONS: In silico, CCWO(CORA) methodology always achieved the target TPA(POST) due to its intrinsic geometric principles. As such, CCWO(CORA) surgeries achieved a more accurate TPA(POST) than previously described CCWO techniques. CLINICAL SIGNIFICANCE: The CCWO(CORA) provides clinicians with a cranial closing-wedge ostectomy methodology with entirely predictable TPA(POST).

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