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The
Red Bank Veterinary Hospital Surgery Department is pleased
to announce the addition of two surgical options for
the treatment of cranial cruciate injuries in dogs: the
Tibial Plateau Leveling Osteotomy (TPLO) and the Tibial
Tuberosity Advancement (TTA).
TIBIAL PLATEAU LEVELING OSTEOTOMY
The TPLO procedure is well known and has been performed
for many years. The |
TPLO is designed to neutralize the cranial tibial thrust
that is generated in the cruciate deficient stifle by realignment
of the weight-bearing surface of the proximal tibial plateau.
In most dogs, the tibial plateau is not level but is angled
in a caudal direction. One of the functions of the cranial
cruciate ligament, therefore, is to stabilize the stilfe
so that the femur does not "slip" backwards off the
plateau (and thus allowing the tibia to "thrust"
cranially) during weight bearing.
After careful measurements are performed from preoperative
radiographs of the stifle and tibia, a curved osteotomy is
performed on the proximal tibia with a special saw. The proximal
portion of the tibia containing the tibial plateau is then
rotated into a predetermined, and more level, position. The
tibia is secured with a special TPLO plate and screws. The
TPLO very often allows an early return to weight bearing and
minimizes post-operative degenerative joint disease.
TIBIAL TUBEROSITY
ADVANCEMENT
The TTA is also designed to neutralize the cranial tibial thrust by changing
the direction of force of the patellar ligament so that it is perpendicular to
the tibial plateau. Based on percise measurements made from pre-operative radiographs,
the tibial tuberosity is separated from the body of hte tibia by a bone saw and,
by the insertion of a titanium cage or spacer, it is repositioned in a more cranial
position and stabilized with a special plate. While this surgery is relatively
new, compared with the TPLO and other more traditional procedures, it has already
shown great promise and is championed by many surgeons throughout the country. |
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The addition of the TPLO and TTA procedures will allow RBVH
to offer more options for the surgical management of cruciate
injuries. While both the TPLO and TTA procedures have been
performed in dogs of all sizes, the suregeons at RBVH tend
to believe they are best suited for larger dogs (over 60 lbs).
The more traditional lateral imbrication suture technique (often
referred to as the DeAngelis technique) and the fibular head
transportation are still offered and commonly performed at
RBVH. These expanded options will allow us, working with the
owner and the referring veterinarian, to select the procedure
that is best suited for each case.
If you have any questions regarding these procedures, or the
management of cruciate injuries in general, please contact
the surgical staff at Red Bank Veterinary Hospital by calling
(732) 747-3636.
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