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The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation

Mini Dissertation (MMedVet (Small Animal Surgery))--University of Pretoria, 2023.

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Other Authors: Kitshoff, Adriaan
Format: Thesis
Language:English
Published: University of Pretoria 2024
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author2 Kitshoff, Adriaan
author_browse Kitshoff, Adriaan
author_facet Kitshoff, Adriaan
collection Thesis
dc_rights_str_mv © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Mini Dissertation (MMedVet (Small Animal Surgery))--University of Pretoria, 2023.
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institution University of Pretoria (South Africa)
language English
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provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2024
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spelling oai:repository.up.ac.za:2263/94362 The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation Kitshoff, Adriaan peterguyvet@gmail.com Elliott, Ross Guy, Peter UCTD Medial patella luxation Canine Osteotomy segment size Complications Trochlear augmentation Mini Dissertation (MMedVet (Small Animal Surgery))--University of Pretoria, 2023. Background: Medial patellar luxation is a common cause of hindlimb lameness in dogs, affecting both small and large breeds. The condition arises from developmental abnormalities and anatomical irregularities in the hindlimb. Tibial tuberosity transposition is a widely used surgical technique for realigning the quadriceps mechanism and treating MPL. Postoperative complications are common following surgical treatment. During the routine evaluation of post operative radiographs, osteotomy segment size appeared to be associated with an increased incidence of complications. This prompted investigation into this possible association between osteotomy segment size and the incidence of complications. Hypothesis: The complication rate significantly differs when the osteotomized segment of the tibial tuberosity is transposed medially and measures less than 80% of the mid-tibial diaphysis on preoperative radiographs Animals: Client-owned dogs (n= 88) that underwent MPL surgery Methods: Records of 88 dogs (108 stifles) that underwent TTT for treatment of MPL were reviewed. Data collected included patient signalment, clinical presentation, surgical factors, pre and postoperative radiographs and complications. The dimensions of tibial tuberosity osteotomy were calculated as a ratio to preselected tibial dimensions based on immediate postoperative radiographs. Mixed-effects logistic regression analysis was performed to determine the impact of osteotomy segment size (O1:D3 ratio) on the occurrence of post-surgical complications following TTT. Results: Out of 108 surgical procedures performed, 40 (37%) resulted in complications. There was no significant difference in overall complication rates related to patient factors or surgical variables (such as pin direction, tension band, open physis, and complete osteotomy). However, concurrent trochlear augmentation procedures were associated with a decreased risk of complications (hazard ratio (95% CI): 0.31 (0.13 - 0.70), p=0.005). The predicted probability of surgical complications based on the O1:D3 ratio indicated that osteotomy segment sizes between 0.8-0.99 (hazard ratio (95% CI): 0.23 (0.10 – 0.56) p=0.001) and 1-1.19 (hazard ratio (95% CI): 0.05 (0.01 – 0.38), p=0.004) had a lower risk of complications compared to ratios below 0.8 or above 1.2 (hazard ratio (95% CI): 0.26 (0.07 – 0.90), p=0.033). Conclusions and clinical importance: This study highlighted the clinical importance of considering tibial tuberosity osteotomy segment size in dogs undergoing surgical treatment for MPL by retrospectively analyzing a significant number of cases, the study provided valuable insights into the incidence of postoperative complications related to osteotomy segment size. The findings indicated an association between the O1:D3 ratio (the ratio of osteotomy segment size to preselected tibial dimensions) and the occurrence of complications. Osteotomy segment sizes between 0.8-0.99 and 1-1.19 were associated with a lower risk of complications, while ratios below 0.8 or above 1.2 showed increased risk. Therefore, careful consideration of osteotomy segment size, aiming for sizes equal to or slightly larger than the mid-diaphyseal diameter, is crucial in surgical planning for dogs with MPL. Companion Animal Clinical Studies MMedVet (Small Animal Surgery) Unrestricted Faculty of Veterinary Science 2024-02-06T13:27:22Z 2024-02-06T13:27:22Z 2024-04-02 2023-09-21 Mini Dissertation * A2024 http://hdl.handle.net/2263/94362 10.25403/UPresearchdata.25117307 en © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle UCTD
Medial patella luxation
Canine
Osteotomy segment size
Complications
Trochlear augmentation
The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title_full The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title_fullStr The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title_full_unstemmed The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title_short The effect of operative technique and tibial osteotomy ratio on post-surgical complications in dogs with medial patella luxation
title_sort effect of operative technique and tibial osteotomy ratio on post surgical complications in dogs with medial patella luxation
topic UCTD
Medial patella luxation
Canine
Osteotomy segment size
Complications
Trochlear augmentation
url http://hdl.handle.net/2263/94362