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Mclean et al: Effect of Plate Inclination and Osteotomy Positioning on Rock-back following Tibial Plateau Levelling Osteotomy in Dogs
Veterinary and Comparative Orthopedics and Traumatology 6, 2024

🔍 Key Findings Summary

  • 95 TPLO procedures reviewed retrospectively with follow-up radiographs
  • Rock-back defined as increase in tibial plateau angle (TPA) ≥2° from immediate post-op to recheck
  • 21% of stifles (20/95) experienced rock-back
  • Mean ΔTPA among rock-back cases = 3.2° ± 2.6°
  • No implant failures or tibial tuberosity fractures were reported in these cases
  • Plate inclination and exit cut angle (ECA) were not associated with increased risk of rock-back (p = 0.4 and 0.2)
  • Authors hypothesize that compression across osteotomy in vivo may mitigate torsional effects from ECA, unlike in gap-model studies
  • Emphasizes that rock-back is relatively common, even with well-placed implants

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← Articles

Mclean et al: Effect of Plate Inclination and Osteotomy Positioning on Rock-back following Tibial Plateau Levelling Osteotomy in Dogs
Veterinary and Comparative Orthopedics and Traumatology 6, 2024

🔍 Key Findings Summary

  • 95 TPLO procedures reviewed retrospectively with follow-up radiographs
  • Rock-back defined as increase in tibial plateau angle (TPA) ≥2° from immediate post-op to recheck
  • 21% of stifles (20/95) experienced rock-back
  • Mean ΔTPA among rock-back cases = 3.2° ± 2.6°
  • No implant failures or tibial tuberosity fractures were reported in these cases
  • Plate inclination and exit cut angle (ECA) were not associated with increased risk of rock-back (p = 0.4 and 0.2)
  • Authors hypothesize that compression across osteotomy in vivo may mitigate torsional effects from ECA, unlike in gap-model studies
  • Emphasizes that rock-back is relatively common, even with well-placed implants

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Multiple Choice Questions on this study

In McLean 2024 et al., what was the average increase in TPA among dogs with rock-back?

A. 2.1° ± 1.2°
B. 2.7° ± 2.1°
C. 3.2° ± 2.6°
D. 3.8° ± 1.9°
E. 4.5° ± 2.8°

Answer: 3.2° ± 2.6°

Explanation: Dogs with rock-back had an average TPA increase of 3.2° ± 2.6°:contentReference[oaicite:2]{index=2}
In McLean 2024 et al., which variables were found to have no significant association with rock-back?

A. Blade size and age
B. Plate inclination and exit cut angle (ECA)
C. Postoperative TPA and dog weight
D. Surgical limb and breed
E. Meniscal status and implant type

Answer: Plate inclination and exit cut angle (ECA)

Explanation: Neither plate inclination nor ECA were associated with rock-back in this clinical study (p = 0.4 and 0.2):contentReference[oaicite:1]{index=1}
In McLean 2024 et al., why might ECA not have correlated with rock-back in this study?

A. Patients had implant loosening
B. TPAs were inconsistently measured
C. A gap model was used in the study
D. ECA was not radiographically assessed
E. Compression across osteotomy reduced interfragmentary motion

Answer: Compression across osteotomy reduced interfragmentary motion

Explanation: Unlike biomechanical gap models, clinical compression may resist rotational forces from ECA:contentReference[oaicite:4]{index=4}
In McLean 2024 et al., what was the mean postoperative TPA in dogs **without** rock-back?

A. 5.5°
B. 6.6°
C. 6.8°
D. 7.5°
E. 8.0°

Answer: 6.8°

Explanation: The mean follow-up TPA in non-rock-back dogs was 6.8°:contentReference[oaicite:3]{index=3}
In McLean 2024 et al., on TPLO rock-back, what proportion of cases demonstrated rock-back (TPA increase ≥2°)?

A. 11%
B. 17%
C. 21%
D. 28%
E. 35%

Answer: 21%

Explanation: 21% of TPLOs (20/95) showed TPA increase ≥2°, defining rock-back:contentReference[oaicite:0]{index=0}

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