title: Sagittal accuracy of tibial osteotomy position during in vivo tibial plateau levelling osteotomy performed without an alignment jig and cutting guide.
abstract: OBJECTIVE
  To assess the accuracy of tibial osteotomy location for tibial plateau levelling osteotomy (TPLO) in the sagittal plane and its effect on the postoperative tibial plateau angle (TPA), when performed without an alignment jig and saw guide. Also, to document the improvement gained with experience.
  
  
  METHODS
  Medical records and stifle radiographs of dogs undergoing TPLO, without the use of an alignment jig and saw guide, by one surgeon were reviewed (2010-2014). Postoperative radiographs were reviewed to record the distance and direction of eccentricity. Postoperative TPA was also recorded.
  
  
  RESULTS
  In a series of 401 TPLO procedures, 231 met the inclusion criteria. The absolute distance of eccentricity (DOE) for all dogs was 3.0 ± 1.6 mm. When evaluating surgical experience, the DOE for the final 77 cases (2.72 ± 1.43 mm), the middle 77 cases (3.18 ± 1.49 mm), and the first 77 cases (3.24 ± 1.7 mm) were not significantly different (p = 0.07157). There was a very weak correlation between DOE and postoperative TPA (R = 0.029).
  
  
  CONCLUSIONS
  The location of the tibial osteotomy when performing TPLO without an alignment jig and saw guide compared favourably with previously documented use of an alignment jig and saw guide. Whilst the location of the tibial osteotomy has a theoretical impact on the postoperative TPA, other factors appear to be of greater importance. Surgeon experience did not result in significant improvement in accuracy up to 231 procedures.
authors.affiliation: Andrew Craig, Southern Counties Veterinary Specialists, 6 Forest Corner Farm, Hangersley, Ringwood, Hampshire, BH24 3JW, United Kingdom, Telephone: +44 1425 485615, E-mail: Andrew.craig@scvetspecialists.co.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Craig
authors.forename: Philip Georg
authors.initials: PG
authors.lastname: Witte
authors.forename: Harry William
authors.initials: HW
authors.lastname: Scott
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004285:Dogs; D005260:Female; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D008297:Male; D010027:Osteotomy / Q000295:instrumentation / Q000662:veterinary*; D011182:Postoperative Care; D011859:Radiography / Q000662:veterinary; D013264:Stifle / Q000000981:diagnostic imaging / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Cranial cruciate ligament; dog; free-hand osteotomy; stifle; tibial plateau levelling osteotomy (TPLO)