title: Comparison of autogenous cancellous bone grafting and extracorporeal shock wave therapy on osteotomy healing in the tibial tuberosity advancement procedure in dogs. Radiographic densitometric evaluation.
abstract: OBJECTIVE
  To compare optical values in the osteotomy gap created after a tibial tuberosity advancement (TTA) treated with autogenous cancellous bone graft, extracorporeal shock wave therapy, a combination of autogenous cancellous bone graft and extracorporeal shock wave therapy, and absence of both autogenous cancellous bone graft and extracorporeal shock wave therapy using densitometry.
  
  
  METHODS
  Dogs that were presented for surgical repair of a cranial cruciate ligament rupture were randomly assigned to one of four groups: TTA with autogenous cancellous bone graft (TTA-G), TTA with autogenous cancellous bone graft and extracorporeal shock wave therapy (TTA-GS), TTA with extracorporeal shock wave therapy (TTA-S), and TTA with no additional therapy (TTA-O). Mediolateral radiographs at zero, four and eight weeks after surgery were evaluated to compare healing of the osteotomy gap via densitometry. An analysis of variance was used to compare the densitometric values between groups.
  
  
  RESULTS
  At four weeks after surgery, a significant difference in osteotomy gap density was noted between TTA-GS (8.4 millimetres of aluminium equivalent [mmAleq]) and TTA-S (6.1 mmAleq), and between TTA-GS (8.4 mmAleq) and TTA-O (6.4 mmAleq). There were no significant differences noted between any groups at the eight week re-evaluation.
  
  
  CONCLUSIONS
  There were no significant differences in the osteotomy gap density at eight weeks after surgery regardless of the treatment modality used. The combination of autogenous cancellous bone graft and extracorporeal shock wave therapy may lead to increased radiographic density of the osteotomy gap in the first four weeks after surgery. Densitometry using an aluminium step wedge is a feasible method for comparison of bone density after TTA in dogs.
authors.affiliation: Katherine Barnes, DVM, Virginia-Maryland Regional College of Veterinary Medicine, 205 Duck Pond Drive, Blacksburg, VA 24061, United States, Phone: +1 540 231 4621, Fax: +1 540 231 9354, E-mail: khbarnes@vt.edu.
authors.forename: K
authors.initials: K
authors.lastname: Barnes
authors.forename: O
authors.initials: O
authors.lastname: Lanz
authors.forename: S
authors.initials: S
authors.lastname: Werre
authors.forename: K
authors.initials: K
authors.lastname: Clapp
authors.forename: R
authors.initials: R
authors.lastname: Gilley
mesh_terms: D015502:Absorptiometry, Photon / Q000662:veterinary*; D000818:Animals; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D016025:Bone Transplantation / Q000379:methods / Q000662:veterinary*; D004285:Dogs / Q000293:injuries / Q000601:surgery*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D008297:Male; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing
keywords: TTA; Tibial tuberosity advancement; autogenous cancellous bone graft; cranial cruciate ligament rupture; extracorporeal shock wave therapy