Laurie's Blogs.

This month when reviewing what has come out in the literature, I found a cluster of recent information on cruciates in dogs.  The research articles touched on surgical techniques, complications, arthritis, and more. So, I figured that for this week’s blog, I would just put together some quick snippets of information pertaining to the canine stifle.  

1. Jeong, J, Jeong, SM, Kim, SE, Lewis, DD, Lee, H. Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study. Veterinary Surgery. 2021; 50: 966– 974.

In an experimental model, using 15 purpose-bred beagles, dogs had their cruciate ligaments transected.  They then each received a TPLO on one leg and a TTA on the other leg.  Dogs were then followed for 32 weeks post-operatively.  

Findings:  Medial meniscal tears and cartilage injury was more prevalent following TTA when compared to TPLO in this study group.

2. Geier, CM, Frederick, SW, Cross, AR.  Evaluation of the risk of patella fracture as the result of decreasing tibial plateau angle following tibial plateau leveling osteotomy. Veterinary Surgery. 2021; 50: 984– 989.

In this retrospective study, 20 patellar fractures were identified in 65 stifles that had undergone a TPLO.  

Results: Patellar fractures were diagnosed at a median of 69 days (range 31–189) after surgery.  The risk of patella fractures increased as Tibial Plateau Angle after TPLOs decreased.

Clinical Significance: Care should be taken to avoid excessive rotation during TPLO to decrease the likelihood of postoperative patellar fractures.

3. Kraeutler MJ, Aliberti GM, Scillia AJ, McCarty EC, Mulcahey MK. A Systematic Review of Basic Science and Animal Studies on the Use of Doxycycline to Reduce the Risk of Posttraumatic Osteoarthritis After Anterior Cruciate Ligament Rupture/Transection. Am J Sports Med. 2021 Jul;49(8):2255-2261.

Doxycycline, administered after CCL transection or rupture seems to have a beneficial effect on preventing post-traumatic osteoarthritis based on a review of 7 studies that met inclusion criterion.

4. Peress R, Mejia S, Unis M, Sotgiu G, Dore S, Bruecker K. Comparison of Intra- and Postoperative Complications between Bilateral Simultaneous and Staged Tibial Plateau Levelling Osteotomy with Arthroscopy in 176 Cases. Vet Comp Orthop Traumatol. 2021 Mar;34(2):91-98. 

A retrospective review of 176 client-owned dogs looked at major and minor complications between dogs that had simultaneous bilateral TPLOs or staged surgeries.

Results: 

The overall complication rate was 47.5% for the simultaneous group and 19.5% for the staged group. 

The incidence of major complications was 10.1 and 3.8% in the simultaneous and stages groups respectively. 

Minor complications were 38.4 and 15.6% in the simultaneous and staged groups respectively. 

Tibial tuberosity fractures requiring revision were noted in 2% of the simultaneous group and none of the staged group.

Why is any of this important to you as a rehab professional?

Well, many of us get questioned by our clients to help them in their decision making or to help them understand why their surgeon did what they did. To be informed and be able to provide information based on science is important.  Sadly, clients aren’t always getting all of the information they need to know from the surgeon and/or they don’t think to ask certain questions when they are conversing with the surgeon.  This information is also pertinent in working with cruciate-deficient or post-operative CCL dogs.  To know about complications, means that we can sound the alarm bells when things just aren’t right with the case in front of us.  All in all, there are good studies to tuck away into the back of your brain for future use!

Have a brain-building week ahead!


Cheers,  Laurie