In vitro evaluation of five canine tibial plateau leveling methods.
OBJECTIVE
To compare application time, accuracy of tibial plateau slope (TPS) correction, presence and magnitude of rotational and angular deformities, and mechanical properties of 5 canine tibial plateau leveling methods.


METHODS
27 canine tibial replicas created by rapid prototyping methods.


METHODS
The application time, accuracy of TPS correction, presence and magnitude of rotational and angular deformation, and construct axial stiffness of 3 internal fixation methods (tibial plateau leveling osteotomy, tibial wedge osteotomy, and chevron wedge osteotomy [CWO]) and 2 external skeletal fixation (ESF) methods (hinged hybrid circular external fixation and wedge osteotomy linear fixation [WOLF]) were assessed.


RESULTS
Mean bone model axial stiffness did not differ among methods. Mean application time was more rapid for WOLF than for other methods. Mean TPSs did not differ from our 5 degrees target and were lower for ESF methods, compared with internal fixation methods. Mean postoperative rotational malalignment did not differ from our target or among groups. Mean postoperative medio-lateral angulation did not differ from our target, except for CWO. Internal fixation methods lead to axially stiffer constructs than ESF methods. Reuse of ESF frames did not lead to a decrease in axial stiffness.


CONCLUSIONS
The 5 tibial plateau leveling methods had acceptable geometric and mechanical properties. External skeletal fixation methods were more accurate as a result of precise data available for determining the exact magnitude of correction required to achieve a 5 degrees TPS.
Hildreth
Blake Eason
BE
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
Marcellin-Little
Denis J
DJ
Roe
Simon C
SC
Harrysson
Ola L A
OL
D000818:Animals; D001696:Biomechanical Phenomena; D001864:Bone Wires; D004195:Disease Models, Animal; D004285:Dogs; D016267:External Fixators; D008422:Materials Testing; D013977:Tibia / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery*