Advances in the Canine Cranial Cruciate Ligament, 2nd edition

(Wang) #1
Treatment of Excessive Tibial Plateau Angle 259

2.7-mm straight bone plate can be added to
the standard 3.5-mm TPLO plate, or a 3.5-mm
broad TPLO plate can be used. In most patients
weighing>40 kg an additional 3.5-mm straight
bone plate can be added to the standard 3.5-mm
TPLO plate.


Outcome


A multicenter, case-control study compared the
surgical treatment options for cruciate ligament
rupture in larger-breed dogs with eTPA, and
found that surgical treatment had a higher com-
plication rate but a comparable outcome to
that of dogs without eTPA. In addition, owner-
perceived outcome was superior for eTPA dogs
when TPLO resulted in a TPA≤ 14 ◦, compared
to dogs with postoperative TPA> 14 ◦. Therefore,
TPLO/CCWO with a target TPAof 5◦is the pro-
cedure of choice of the author. In a retrospective
study evaluating the TPLO/CCWO procedure
in 18 stifles of 15 dogs, postoperative compli-
cations included implant loosening or breakage
(27.8%), seroma formation (11.1%), and local
irritation due to implants (11.1%) (Talaatet al.
2006). Anecdotally, as more experience has been
gained with this technique, the complication
rate is considerably lower, and is now similar
to that reported for TPLO alone, with the occa-
sional need for Kirschner or tension band wire
removal being the most common complication.


References


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