title: Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog.
abstract: OBJECTIVE
  Comparison of 2 methods of surgical management of cranial cruciate ligament (CCL) injury in large-breed dogs using a radiographic osteoarthrosis (OA) scoring system.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Client-owned dogs (n=66).
  
  
  METHODS
  Radiographs were evaluated from dogs weighing >/=22.7 kg, with surgical management of CCL rupture using extracapsular repair (ECR) or tibial plateau leveling osteotomy (TPLO). Radiographs were taken immediately before surgery and >/=12 months later. An OA score was assigned to each set of radiographs taken at the preoperative and final examinations by evaluating 32 specific features of stifle OA. The difference between preoperative and final OA scores were subtracted and 2 final score categories of a change </=5 or >5 were created. A logistic regression model was used to evaluate the effect of right versus left pelvic limb, age, preoperative weight, postoperative weight, days from surgery until final radiographic recheck, cranial cruciate status at surgery, medial meniscus status at surgery, and ECR versus TPLO.
  
  
  RESULTS
  The ECR group had 27 stifles (22 dogs) and the TPLO group had 52 stifles (44 dogs). ECR dogs had a preoperative weight of 33.4+/-9.3 kg (range 22.7-54.1 kg) and a preoperative OA score of 13.0+/-8.4 (range 1-34) compared with TPLO dogs that had a preoperative weight of 38.9+/-9.1 kg (range 25-63.9 kg) and preoperative OA score of 15.9+/-8.4 (range 4-44). Postoperative weights for ECR and TPLO dogs were 33.6+/-9 kg (range 21.8-54.6 kg) and 39.4+/-10.1 kg (range 24-72 kg), respectively. Final OA scores were: ECR dogs, 26.3+/-10.8 (range, 10-54); TPLO dogs, 23.3+/-9.5 (range, 12-50). Dogs with a final change in OA score of >/=6 were 5.78 times more likely to have had ECR compared with those that had TPLO as stabilization procedure (odds ratio=5.78; Log-likelihood test P-value=.025). Other dependent variables were not significant.
  
  
  CONCLUSIONS
  Based on logistic regression analysis, dogs with larger OA score differences were 5.78 times more likely to have had ECR than TPLO.
  
  
  CONCLUSIONS
  Prospective, randomized surgical trials with pre-defined objective measures would be required to further evaluate the clinical importance of these preliminary findings which suggest that TPLO may help stabilize the cranial tibial thrust as originally proposed.
authors.affiliation: Affiliated Veterinary Specialists, Maitland, FL 32751, USA.
authors.forename: Tibor P
authors.initials: TP
authors.lastname: Lazar
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Berry
authors.forename: Jacek J
authors.initials: JJ
authors.lastname: deHaan
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Peck
authors.forename: Maria
authors.initials: M
authors.lastname: Correa
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001835:Body Weight / Q000502:physiology; D001860:Bone Plates / Q000662:veterinary; D001863:Bone Screws / Q000662:veterinary; D004283:Dog Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004285:Dogs / Q000293:injuries / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D016015:Logistic Models; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D011859:Radiography; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery / Q000662:veterinary; D013264:Stifle / Q000000981:diagnostic imaging; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*