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  • Title: Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs.
    Author: Bergh MS, Rajala-Schultz P, Johnson KA.
    Journal: Vet Surg; 2008 Jun; 37(4):374-82. PubMed ID: 18564262.
    Abstract:
    OBJECTIVE: To evaluate factors that predispose to tibial tuberosity (TT) fracture after tibial plateau leveling osteotomy (TPLO) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=182) with cranial cruciate ligament (CCL) rupture undergoing 213 TPLO surgeries. METHODS: Medical records and radiographs of 2 groups of dogs that had TPLO surgery (2000-2001, 2004-2005) were evaluated to determine the effect of operative technique and surgeon experience on TT fracture. RESULTS: TT fracture was diagnosed in 8 dogs (9 TPLO, 4.2% of surgical procedures). Four fractures occurred after unilateral TPLO in 167 dogs (2.4%), 4 fractures occurred after simultaneous bilateral TPLO in 5 dogs (40%), and 1 fracture occurred after staged bilateral TPLO in 36 dogs (2.8%). Simultaneous bilateral TPLO resulted in a 12.4 times higher odds of TT fracture versus unilateral TPLO (P=.046). The mean absolute thickness of the TT after TPLO was less in dogs sustaining TT fractures (7.2 +/- 2.2 mm) than those that did not (10.8 +/- 2.7 mm, P<.0001). The odds of fracture decreased by 37% when the absolute TT width postosteotomy increased by 1 mm (P<.0001). An increase in tibial plateau angle at follow-up versus immediately postoperative was associated with TT fracture (P=.025). Surgeon experience was not associated with TT fracture. CONCLUSION: A combination of surgical decision-making and surgical technique play a role in the occurrence of TT fracture after TPLO. Simultaneous bilateral TPLO was associated with a high percentage of TT fracture. CLINICAL RELEVANCE: Careful planning of osteotomy positioning is advised while performing TPLO surgery.
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