Benefits of pre- and intraoperative planning for tibial plateau leveling osteotomy.
OBJECTIVE
To determine (1) if preoperative and intraoperative osteotomy planning increases the likelihood that a surgeon will achieve a centered osteotomy during tibial plateau leveling osteotomy (TPLO) and (2) if that centered osteotomy reduces the risk of tibial tuberosity (TT) fractures.


METHODS
Retrospective case series.


METHODS
Dogs (n = 406) with cranial cruciate ligament that had TPLO (n = 468).


METHODS
Medical records (2007-2010) and radiographs of dogs that had TPLO were reviewed. Osteotomies from Group A (pre and intra-operative planning) were compared to Group B (free-hand osteotomy only) investigating the influence of osteotomy planning as well as 21 other variables, looking for any other confounding variables that may also contribute to TT fractures. Data were analyzed with logistic regression and χ(2) analysis.


RESULTS
Actual osteotomies were closer to the centered-osteotomy position in Group A than in Group B (P ≤ .01). TT fractures occurred in 20 cases (4.3% overall). Group A had 0 fractures out of 172 surgeries and Group B had 20 fractures out of 296 surgeries (6.8%). Five variables were found to increase the risk of TT fractures: lack of osteotomy planning, bilateral same-session surgeries, osteotomy gap, anti-rotational pin location, and decreased tibial crest width at the insertion of the patellar ligament (P ≤ .05).


CONCLUSIONS
Dogs that had osteotomy planning had a more centered osteotomy position and a reduced risk of developing TT factures.
Ocean State Veterinary Specialists, East Greenwich, Rhode Island.
Josuha E
JE
Collins
Daniel A
DA
Degner
Joe G
JG
Hauptman
Charles E
CE
DeCamp
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D004283:Dog Diseases / Q000517:prevention & control* / Q000601:surgery; D004285:Dogs; D050723:Fractures, Bone / Q000209:etiology / Q000662:veterinary; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D011183:Postoperative Complications / Q000662:veterinary; D012189:Retrospective Studies; D012307:Risk Factors