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Applied Nonparametric Statistics

Objective—To identify surgical and postoperative complications of tibial plateau leveling osteotomy (TPLO) in dogs with rupture of the cranial cruciate ligament (CCL) and compare their incidence with those reported in the literature for other commonly performed CCL stabilization procedures. Design—Retrospective study. Animals—346 dogs undergoing 397 TPLO procedures. Procedure—Medical records of dogs undergoing 563 consecutive TPLO procedures were reviewed. Complications were recorded and assigned to groups on the basis of the period during which the complication was observed. Results—397 TPLOs met the criteria for inclusion in the study. Complications (n = 136) were recorded in 113 of the 397 (28%) procedures. Multiple complications developed in 10 dogs. In 19 dogs, a second surgery was performed to manage complications. Development of a complication after surgery was not associated with age or body weight of the dog, tibial plateau angle prior to stifle joint surgery, or experience of the surgeon. Factor...

Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001).

Objective To evaluate risk factors for complications, including meniscal injury and infection, after tibial plateau leveling osteotomy (TPLO) in dogs. Study design Retrospective case series. Sample population Dogs (n=1000; 1146 stifles) with cranial cruciate ligament (CCL) rupture that had TPLO. Methods Medical records (January 2004-March 2009) were reviewed for dogs operated sequentially by medial arthrotomy with instrumented meniscal inspection (IMI) and TPLO by a single experienced surgeon. Multiple logistic regression models were used to evaluate independent contribution of risk factors to the recorded complications. Results Overall complication rate was 14.8%, of which 6.6% were major complications. Incidence of primary meniscal injury (PMI) was 33.2%, and subsequent meniscal injury (SMI) 2.8%. Postoperative infection occurred in 6.6% dogs. Bilateral CCL rupture was diagnosed in 14.6% dogs and no statistically significant complication incidence difference was recorded for simultaneous or staged bilateral surgical procedures. Administration of postoperative antibacterial therapy and being a Labrador reduced infection incidence, whereas increased body-weight and being an intact male increased infection risk. Increased body-weight and complete (versus partial) CCL rupture were significant predictors of overall complications. Conclusions Incidence of SMI recorded in this study is similar to that reported previously involving arthroscopic meniscal inspection at time of TPLO. Infection was the single most important complication and antibiotic therapy was protective. Complication rate did not differ between bilateral simultaneous or staged procedures. Clinical relevance Complication rate after TPLO with arthrotomy and IMI is lower than previously reported, bilateral simultaneous TPLO is reasonable, and incidence of major complications compares favorably with general orthopedic procedures.

Predictive Variables for Complications after TPLO with Stifle Inspection by Arthrotomy in 1000 Consecutive Dogs

Objective—To compare tibial plateau angle (TPA) between Greyhounds without damage to the cranial cruciate ligaments and Labrador Retrievers with and without damage to the cranial cruciate ligaments. Design—Clinical study. Animals—87 client-owned dogs and 15 research colony Greyhounds. Procedure—Standing position, horizontal-beam radiography was performed on Greyhounds and unaffected Labrador Retrievers to determine standing TPA. Lateral radiography of the stifle joint was performed on all dogs to determine traditional TPA. Age and body weight were recorded for unaffected and affected Labrador Retrievers. Results—Greyhounds had mean standing TPA of 1.56° and mean traditional TPA of 22.50°. Unaffected Labrador Retrievers had mean standing TPA of 3.52° and traditional TPA of 27.97°. Affected Labrador Retrievers had mean traditional TPA of 25.55°. No significant difference was found in mean standing TPA between Greyhounds and unaffected Labrador Retrievers. Standing TPAs in Greyhounds and unaffected Labrador ...

Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament

Cranial cruciate ligament (CCL) deficiency is the leading cause of lameness of the canine stifle and has important consequences in terms of morbidity and cost associated with its management. In spite of this impact, development of preventive strategies remains in its infancy, largely because of gaps in our understanding of the complex and likely multifactorial origin of CCL deficiency. The purpose of this article is to provide a critical review of the literature related to the pathogenesis of CCL deficiency and place this evidence in the context of potential preventive measures. Trauma accounts for a minority of CCL ruptures in dogs, whereas progressive degeneration of the ligament has been attributed to a variety of factors that may be broadly classified as genetic, conformational, environmental, immune-mediated, and inflammatory. Genetic screening appears promising as a long-term option in selected breeds while immunomodulating therapies may be implemented in the nearer future to reduce the incidence of contralateral disease in dogs with unilateral CCL deficiency. Preventive modification of conformation factors may be applicable to most breeds predisposed to CCL deficiency but requires further investigations into the relative contribution of individual factors, as well as into the feasibility, and potential risks of large-scale implementation.

A Review of the Pathogenesis of Canine Cranial Cruciate Ligament Disease as a Basis for Future Preventive Strategies

An intercondylar notch width index was determined in 45 stifles with cranial cruciate ligament (CCL) injuries and 98 normal stifle joints. Stifles with CCL injuries were found to have significantly smaller intercondylar notch width indices as compared to normal stifles.

Intercondylar Notch Width in Dogs With and Without Cranial Cruciate Ligament Injuries

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Intercondylar Notch Width in Dogs With and Without Cranial Cruciate Ligament Injuries