Long-term assessment of a modified tibial tuberosity advancement technique in dogs

ABSTRACT The purpose of study was to assess long-term clinical and radiographic aspects of dogs’ stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient’s gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner’s perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners’ perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.

摘要 本研究旨在评估接受改良胫骨结节前移术（modified tibial tuberosity advancement, mTTA）的犬膝关节的长期临床与影像学结局。本研究共纳入11只患犬的15个因前十字韧带（cranial cruciate ligament, CCL）疾病接受mTTA手术的膝关节。评估内容包括患犬步态分析、前抽屉试验与胫骨压迫试验、膝关节测角术（评估关节活动度）、大腿及小腿周径测量，以及骨关节炎进展的影像学证据。分别在术后早期（M0）、术后120天（M1）及术后约5年（M2）三个时间点，对手术侧肢体与健侧肢体的各项指标进行对比分析。本研究还对术后约5年时犬主的主观感受进行了问卷调查。多数手术侧膝关节的前抽屉试验与胫骨压迫试验结果呈阳性。膝关节活动度测值及大腿周径出现下降，而小腿周径则有所增加。尤其在长期随访阶段（M2），可观察到骨关节炎进展的影像学表现。步态分析结果显示，多数患犬在不同工况下存在不同程度的跛行，这与犬主的主观感受存在差异。针对CCL疾病实施mTTA手术后，犬仍会发生骨关节炎。但总体而言，犬主对患犬的术后恢复情况较为满意，且愿意为前十字韧带断裂的患犬选择mTTA手术。