Proximal tibial intraarticular ostectomy for treatment of canine cranial cruciate ligament injury.
OBJECTIVE
To report a technique for surgical alteration of the slope of the tibial plateau by a proximal tibial intraarticular ostectomy (PTIO) after injury to the canine cranial cruciate ligament (CCL) and to determine the outcome.


METHODS
Prospective clinical study.


METHODS
Dogs (n=52) with CCL injury in 60 stifle joints.


METHODS
CCL injury was treated by lateral stifle arthrotomy, removal of CCL remnants, and appropriate meniscal surgery. PTIO was performed to remove a wedge of bone from the proximal aspect of the tibia. The ostectomy site was reduced and stabilized using a bone plate and screws applied to the medial surface of the tibia as well as a craniocaudal positional screw. Dogs were evaluated at 6 weeks, 6, and 12 months by complication assessment, lameness scores, stifle range of motion (ROM), thigh circumference, radiographic assessment, degenerative joint disease (DJD) scores, and surgeon and owner evaluation of function.


RESULTS
Lameness scores improved by 6 and 12 months in all but 1 dog. Thigh circumference and DJD were increased at 6 and 12 months. Complications occurred in 20% of dogs with all but 1 occurring perioperatively or within 6 weeks; most common were injury to the long digital extensor tendon (4 dogs) and plate failure (3); 2 other dogs required surgery to treat complications. Most owners (98%) reported that lameness had improved by 12 months; 90% were extremely or very satisfied with the procedure and 90% would have the same procedure performed on another dog.


CONCLUSIONS
PTIO to level the tibial plateau provided a satisfactory clinical outcome in dogs >20 kg with CCL injury and the complication rate was similar to tibial plateau levelling osteotomy (TPLO). Stifle osteoarthritis continued to progress radiographically.


CONCLUSIONS
PTIO represents an alternative to TPLO that does not require specialized surgical equipment.
Jerram
Richard M
RM
Veterinary Specialist Group at UNITEC, 97 Carrington Road, Mt. Albert, Auckland, New Zealand. surgeryrj@vsg.co.nz
Walker
Alex M
AM
Warman
Chris G A
CG
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001860:Bone Plates / Q000662:veterinary; D001863:Bone Screws / Q000662:veterinary; D004285:Dogs / Q000293:injuries / Q000601:surgery*; D005260:Female; D007794:Lameness, Animal; D008297:Male; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013264:Stifle / Q000293:injuries / Q000601:surgery*; D013977:Tibia / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome