Comparison of techniques for osteotomy tibial tuberosity advancement (TTA) and leveling tibial plateau osteotomy (TPLO) to cranial cruciate ligament deficience in dogs through kinetic analysis

Author(s)

Márcio Poletto Ferreira

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina Veterinária e Zootecnia (FMVZ/SBD)
• Defense date: 2013-06-28

Examining board members

Cassio Ricardo Auada Ferrigno; Marcelo Meller Alievi; Julia Maria Matera; Marcos Ishimoto Della Nina; Kelly Cristiane Ito Yamauchi

• Advisor: Cassio Ricardo Auada Ferrigno

Abstract

Cranial cruciate ligament rupture is the major cause of lameness in dogs and can occur due to degenerative or traumatic causes. Despite the wide variety of surgical techniques available, the ideal treatment for this orthopedic condition remains undetermined. Currently techniques have been developed to prevent abnormal movement of the stifle. Dynamic stability is achieved by changing the bone geometry by techniques like tibial plateau leveling osteotomy (TPLO) and osteotomy to tibial tuberosity advancement (TTA). One of the main advantages of TPLO and TTA is the early weight-bearing in postoperative period, which can be evaluated subjectively. But the locomotion kinetic analysis in pressure platform is a more objective measurement in the use of the limb during walking. The objective of this study is to compare the techniques of tibial tuberosity advancement (TTA) and tibial plateau leveling osteotomy (TPLO) in stabilizing dogs stifles with cranial cruciate ligament deficiency in one limb. Evaluation will be done with subjective and objective assessment via analysis in pressure platform (baropodometry). We evaluated 27 adult dogs over 20 Kg with unilateral or bilateral cranial cruciate ligament rupture. They were underwent to TTA (12 dogs) and TPLO (15 dogs). These patients were evaluated in the preoperative period and at 14, 30, 60 and 90 days postoperatively focus on claudication (two veterinarians - grade scale), visual analysis scale (weightbearing - owner), radiographs (osteotomy healing), recovery degree of the function (owner) and on pressure platform (baropodometry). We evaluated 27 adult dogs with 20 kilos at least and unilateral cranial cruciate ligament deficience. They were subjected to procedures TTA (12 dogs) or TPLO (15 dogs). These patients were evaluated in the preoperative period and at 14, 30, 60 and 90 days after surgery, with postoperative lameness grading system (two veterinarians), scale of visual analysis (owner), radiographic exam (osteotomy healing), recovery grading system (owner) and pressure platform (baropodometry). The animals were divided into groups according to the the tibial plateau angle (TPA) and based on clinical recommendation we used TPLO in all patients and TTA in those patients that had TPA less than 27°. In both groups we observed statistically significant recovery, both in subjective evaluations and objective assessment. Due to the clinical recommendation for TTA, there was significant difference among groups in respect to the tibial plateau slope (28.13 for TPLO and 22.33 for TTA), but It was corrected with the covariance test. There was no difference between groups in recovery of the surgery. We conclude that TPLO and TTA were effective in promoting improved support in dogs with cranial cruciate ligament deficience. (AU)

• FAPESP's process: 10/19667-7 - EVALUATION OF TECHNIQUES FOR OSTEOTOMY TIBIAL TUBEROSITY ADVANCEMENT (TTA) AND LEVELING TIBIAL PLATEAU OSTEOTOMY (TPLO) TO CRANIAL CRUCIATE LIGAMENT DEFICIENCE IN DOGS THROUGH KINETIC ANALYSIS.
• Grantee: Márcio Poletto Ferreira
• Support Opportunities: Scholarships in Brazil - Doctorate