Triple tibial osteotomy for treatment of the canine cranial cruciate ligament-deficient stifle joint. Surgical findings and postoperative complications in 97 stifles

Vet Comp Orthop Traumatol. 2009;22(6):473-8. doi: 10.3415/VCOT-09-01-0004. Epub 2009 Oct 29.

Abstract

Objective: To report the surgical findings and early post-operative complications of triple tibial osteotomy (TTO) for the treatment of cranial cruciate ligament disruption in dogs.

Methods: Clinical records of 84 dogs (97 stifles) that had TTO procedures were reviewed. Surgical findings and postoperative complications were assessed. A complication was defined as any undesirable outcome resulting from TTO that required further diagnostic investigation or surgical treatment.

Results: Mean tibial wedge angle was 13.6 degrees (range 10-20). Incomplete tibial crest osteotomy was achieved in 79% of TTO procedures. Implants were placed in the tibial crest in 67% of stifles. Early postoperative complications occurred in 23% of joints, and included avulsion of the tibial crest (9.1%), fracture at the distal cortical attachment of the tibial crest (6.2%), fibula fracture (4.1%), patellar tendonitis (3.1%), late meniscal injury (3.1%), implant complications (3.1%) and patellar fracture (2.1%). Increased patient age (p = 0.023), increased wedge angle (p = 0.009) and intra-operative fracturing of the cranial tibial cortex (p = 0.017) were significantly associated with postoperative tibial crest avulsion. Implants did not prevent tibial crest avulsion. Increased patient age (p = 0.012) was significantly associated with tibial crest fracture.

Clinical relevance: Tibial crest avulsion and fracture are the most common postoperative complications for TTO. Late meniscal injury is uncommon after TTO.

MeSH terms

  • Animals
  • Anterior Cruciate Ligament / surgery*
  • Dog Diseases / surgery*
  • Dogs / injuries*
  • Osteotomy / adverse effects
  • Osteotomy / methods
  • Osteotomy / veterinary*
  • Postoperative Complications / etiology
  • Postoperative Complications / veterinary*
  • Retrospective Studies
  • Stifle / surgery
  • Tibia / surgery