title: Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation.
abstract: OBJECTIVE
  To describe the surgical technique and report short-term outcome for combined tibial plateau levelling osteotomy and tibial tuberosity transposition (TPLO-TTT) as an option in the treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation.
  
  
  METHODS
  Medical records were reviewed (2011-2013) of dogs that underwent a standard tibial plateau levelling osteotomy followed by a tibial tuberosity transposition in the frontal plane and stabilized with pin and tension-band wire fixation as a component of surgical treatment for combined cranial cruciate ligament insufficiency and medial patellar luxation. Signalment, fixation method together with any ancillary procedures, function at the in-hospital follow-up examinations, and any complications were recorded. Healing was assessed retrospectively based on the grading criteria of the International Society Of Limb Salvage.
  
  
  RESULTS
  Fifteen stifle joints in 11 dogs were identified; 13 stifles were available for in-hospital follow-up. All 13 achieved union (3 with grade III/IV and 10 with grade IV/IV radiographic healing scores); mean time to healing was 10.6 (± 2.9) weeks. Patellar ligament thickening was also identified radiographically in seven of the 13 of stifle joints. All dogs were reported to have mild or no lameness at their last follow-up examination. No catastrophic or major postoperative complications occurred that required additional surgery. Patellar re-luxation did not occur in any of the 13 stifles available for in-hospital follow-up.
  
  
  CONCLUSIONS
  The TPLO-TTT was found to be a reliable and effective technique when used as a part of the treatment of combined cranial cruciate ligament insufficiency with concomitant medial patellar luxation in this series of dogs.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Leonard
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kowaleski
authors.forename: William B
authors.initials: WB
authors.lastname: Saunders
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McCarthy
authors.affiliation: Randy J. Boudrieau, DVM, Diplomate ACVS & ECVS, Cummings School of Veterinary Medicine at Tufts University, Department of Clinical Sciences, 200 Westboro Road, N. Grafton, MA 01536, United States, E-mail: randy.boudrieau@tufts.edu.
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Boudrieau
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D003131:Combined Modality Therapy; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D008297:Male; D010027:Osteotomy / Q000662:veterinary*; D031222:Patellar Dislocation / Q000150:complications / Q000601:surgery / Q000662:veterinary*; D012189:Retrospective Studies; D013264:Stifle / Q000601:surgery; D013977:Tibia / Q000601:surgery*
keywords: TPLO; Tibial tuberosity transposition; cranial cruciate ligament insufficiency; medial patellar luxation; patellar luxation; tibial plateau levelling osteotomy