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- Title
Femorotibial kinematics in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament insufficiency: An in vivo fluoroscopic analysis during walking.
- Authors
Tinga, Selena; Kim, Stanley E.; Banks, Scott A.; Jones, Stephen C.; Park, Brian H.; Burtch, Matthew; Pozzi, Antonio; Lewis, Daniel D.
- 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.
- Subjects
CRUCIATE ligaments; KINEMATICS; PLATEAUS; IMAGE registration; SUBLUXATION; FLUOROSCOPY
- Publication
Veterinary Surgery, 2020, Vol 49, Issue 1, p187
- ISSN
0161-3499
- Publication type
Article
- DOI
10.1111/vsu.13356