Combination of closing-wedge distal femoral osteotomy and modified tibial plateau levelling osteotomy for the treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in dogs
Jose Sergio Costa Junior a, Eloy Henrique Pares Curuci b, Rafael Kretzer Carneiro c, Matheus Nobile a, Rog´erio Giufrida d, Luís Gustavo Gosuen Gonçalves Dias a, Alefe Luiz Caliani Carrera a,*, Bruno Watanabe Minto a
a. Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, “Júlio de Mesquita Filho” São Paulo State University — UNESP,
Jaboticabal, State of São Paulo, Brazil
b. OrtopediaVet Veterinary Clinic, Dr. Eloy Curuci and Team, São Paulo, State of São Paulo, Brazil
c. Department of Veterinary Medicine, Center for Agroveterinary Sciences, Santa Catarina State University — UDESC, Lages, State of Santa Catarina, Brazil
d. Department of Graduate Studies in Animal Science, Western São Paulo State University — UNOESTE, Presidente Prudente, State of São Paulo, Brazil
Abstract: Considering the prevalence of cranial cruciate ligament disease (CCLD) and concurrent medial patellar luxation (MPL) among dogs, and the concomitant bone deviations routinely identified, the aim of this study is to evaluate the efficacy of the combination between distal femoral osteotomy (DFO) and modified tibial plateau levelling osteotomy (mTPLO) for the treatment of MPL with distal femoral varus, tibial torsion, and CCLD. Dogs with concurrent MPL and CCLD that underwent DFO and mTPLO procedures were included. Subjective clinical evaluations of gait and pre-operative and immediate post-operative radiographic examinations were performed. Surgical data were documented.
The anatomical lateral distal femoral angle (aLDFA), femoral varus angle, mechanical medial proximal tibial angle, and tibial plateau angle (TPA) were compared between the pre- and post-operative periods. A total of 12 dogs were included in this study. Closing-wedge DFO and mTPLO procedures were performed on 14 limbs. The mean pre-operative and post-operative aLDFA values were 104.8 ± 3.9◦ and 95.4 ± 2.4◦, respectively. TPA values were 26.2 ± 3.7◦ pre-operatively and 6.3 ± 3.2◦ post-operatively.
Bone healing was observed in 7.1 %, 71.3 %, and 85.5 % of patients at the first, second, and third follow-up, respectively. Lameness was resolved in 28.5 %, 78.5 %, and 100 % at 30, 60, and 90 days, respectively. No major peri- or post-operative complications were reported. The combination of mTPLO and DFO aligns the stifle extensor mechanism, promoting dynamic stabilization. It can be
considered for the treatment of concurrent MPL and CCLD in dogs, performed as a single procedure, and is associated with favorable short-term outcomes.
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KEYWORDS: Dog, Stifle, Osteotomy, Femoral varus
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