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Banks et al: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Study Design: Retrospective study of 100 radiographs using in silico and clinical data
  • Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
  • Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
  • Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
  • Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
  • Increased distalization → greater under-correction of TPA (p = .01)
  • Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
  • Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA

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← Articles

Banks et al: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Study Design: Retrospective study of 100 radiographs using in silico and clinical data
  • Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
  • Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
  • Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
  • Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
  • Increased distalization → greater under-correction of TPA (p = .01)
  • Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
  • Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA

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Multiple Choice Questions on this study

In Banks 2024 et al., on postoperative outcome, what was the median achieved TPA in the full clinical sample?

A. 4.0°
B. 4.5°
C. 5.5°
D. 6.0°
E. 7.0°

Answer: 5.5°

Explanation: Median postoperative TPA was 5.5°, falling short of the target 5°, especially in small dogs.
In Banks 2024 et al., which surgical factor was significantly associated with under-correction of TPA?

A. Excessive wedge angle
B. Proximal wedge placement
C. Increased ostectomy distalization
D. Inadequate implant compression
E. Use of dynamic compression plate

Answer: Increased ostectomy distalization

Explanation: More distal ostectomy placement correlated with higher postoperative TPA (p = .01).
In Banks 2024 et al., on preoperative planning, what was the mean planned TPA in the in silico analysis?

A. 4.5°
B. 5.0°
C. 6.0°
D. 7.6°
E. 8.2°

Answer: 7.6°

Explanation: Mean planned TPA based on virtual planning was 7.6°, which did not meet the target of 5° (p < .01).
In Banks 2024 et al., what ostectomy position was associated with the most accurate postoperative TPA?

A. >10 mm from patellar tendon
B. Exactly 8 mm from tibial crest
C. ≤7.5 mm from patellar tendon origin
D. ≥9.5 mm from tibial plateau
E. Between 5–8 mm from joint line

Answer: ≤7.5 mm from patellar tendon origin

Explanation: Accuracy in achieving target TPA was best when the ostectomy was placed ≤7.5 mm from patellar tendon origin.
In Banks 2024 et al., what patient factor was associated with higher preoperative and postoperative TPAs?

A. Limb rotation
B. Age >8 years
C. Body condition score >7/9
D. Small body size
E. Previous stifle surgery

Answer: Small body size

Explanation: Small dogs had significantly higher pre- and postoperative TPAs than large dogs.

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