Another paper in support of TPLO
'Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study' - Jeong et al 2021 Vet Surg.
Here are my summary notes for anyone interested. My take home is that this paper provides additional evidence that TPLO is superior to TTA.
Methods: 15 purpose bred beagles. mean weight 9.7kg.
Cruciate transected bilaterally and TTA performed on one pelvic limb, TPLO on the other pelvic limb (coin flip).
Limbs were excluded from the final analysis when the stifle had inappropriate advancement (PTA <85 or >95) or inappropriate rotation (<5 or >12).
Dogs were evaluated daily and complete ortho exam was performed at 4,12, and 32 weeks. Lameness graded. OA graded on radiographs 12 and 32 weeks. 10 dogs were euth at 12 weeks and 5 at 32 weeks. All stifles were assessed grossly.
Results: 5/15 TTA dnd 3/15 TPLO limbs were lame at 12 weeks. 1 limb (TTA) was lame at 32 weeks. 5/15 TTA and 2/15 TPLO had positive tibial compression test at 12 weeks.
All TTA stifles and 10/15 TPLO stifles had mild OA evidence radiographically at 12 weeks.
11/15 TTA stifles had a meniscal tear at gross evaluation and 5/5 euth at 32 weeks had meniscal tear.
1/15 stifles in the TPLO group had a meniscal tear at 32 weeks.
Articular cartilage damage was higher in the TTA groups at 32 weeks.
Take homes: Not all dogs with meniscal damage are lame - this may underestimate meniscal tears in clinical papers. Not all dogs with meniscal tears have meniscal clicks (we knew this already though).
Limitations: Experimental model with acutely unstable stifles, lack of longer-term follow-up.
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