Köpeklerde ön çapraz bağ kopuklarının sağaltımında üçlü tibial osteotomi tekniğinin klinik ve radyolojik değerlendirilmesi
Özet
The Triple Tibial Osteotomy is a technique which combines tibial tuberosity advancement (TTA) and tibial wedge osteotomy (TWO) for treatment of partial and complete anterior cruciate ligament rupture in dogs. In contrast to the other techniques, this technique achieves the same outcomes, to reduce the tibial plateau slope to an angle perpendicular to the patellar ligament in order to eliminate cranial tibial thrust dynamically, with less radical angular changes in proximal tibia. The main purpose of this study is to evaluate TTO as a surgical technique to treatment of anterior cruciate ligament rupture and its early stages postoperative complications, and to evaluate preoperative-postoperative clinical-radiological results comparatively. The material of this study consists of 16 large breed dogs with mean body weight 44.6 kg referred to Department of Surgery, Faculty of Veterinary Medicine, Ankara University, with complaint of hind limb lameness. In these dogs, anterior cruciate ligament rupture was diagnosed. TTO cases were assessed clinically and radiologically, preoperatively and postoperatively on the 10th, 30th, 60th and 90th days. Operated stifles were evaluated clinically by using pain and lameness scala and radiologically by using osteortritis progression scores. Ninety days after the operation, non progression of new bone noted in one case, minimum progression in 12 cases and moderate progression in two cases. One case could not be followed up completely. Mean pain and lameness score was 3.46 preoperatively but reduced to 1.4 on the postoperative 90th days. Functional recovery was achieved in all cases (Case 9 was not included for statistical analysis). Preoperative and postoperative mean PTA and TPA angles were calculated as 103°-94,18°, 21°-15°. In the study, TTO complication rate was %18.75 (n=3) in all cases. Intraoperative tuberositas tibia fracture was seen in case 2 and 12; postoperative tuberositas tibia fracture was seen in case 3 and necessitated a revision surgery (%6.25). As a result, in this study, based on clinic and radiologic data, TTO technique was performed in large breed dogs with cranial cruciate ligament rupture. It was seemed that this technique was successful, safe and easy to apply. Keywords: Cranial cruciate ligament, dog, stifle, triple tibial osteotomy