← Articles

Guénégo et al: Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg
Veterinary and Comparative Orthopaedics and Traumatology 3, 2025

🔍 Key Findings

  • AMA-based CCWO realigned the anatomical and mechanical axes in 82% of dogs >50 kg, with postoperative AMA angle of 0° in most cases.
  • Surgical site infection (SSI) rate was only 0.5%, markedly lower than TPLO-reported rates in similar populations (up to 37.5%).
  • All osteotomies achieved Grade 4 healing by 8 weeks, with no implant failures.
  • AMA-based planning based on preoperative AMA and TPA allowed for better correction of proximal tibial angulation compared to TPLO in large dogs.
  • Use of a double locking plate (DLP) fixation and Robert Jones bandage (RJB) contributed to improved mechanical stability and infection prevention.
  • Dogs with AMA angle >3.4° (hyper-CCAPT) were 38% of the cohort, supporting AMA as a critical metric in planning.
  • Postoperative alignment of the AA and MA was more consistently achieved when preoperative AMA was >2.4°, confirming suitability of AMA-based CCWO for severe angulation.
  • Most infections in TPLOs occur within 15 days, but RJB plus antibiotics in this study appeared protective, suggesting benefit for early-phase SSI prevention.

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
‍We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
‍Mind trying that again?
← Articles

Guénégo et al: Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg
Veterinary and Comparative Orthopaedics and Traumatology 3, 2025

🔍 Key Findings

  • AMA-based CCWO realigned the anatomical and mechanical axes in 82% of dogs >50 kg, with postoperative AMA angle of 0° in most cases.
  • Surgical site infection (SSI) rate was only 0.5%, markedly lower than TPLO-reported rates in similar populations (up to 37.5%).
  • All osteotomies achieved Grade 4 healing by 8 weeks, with no implant failures.
  • AMA-based planning based on preoperative AMA and TPA allowed for better correction of proximal tibial angulation compared to TPLO in large dogs.
  • Use of a double locking plate (DLP) fixation and Robert Jones bandage (RJB) contributed to improved mechanical stability and infection prevention.
  • Dogs with AMA angle >3.4° (hyper-CCAPT) were 38% of the cohort, supporting AMA as a critical metric in planning.
  • Postoperative alignment of the AA and MA was more consistently achieved when preoperative AMA was >2.4°, confirming suitability of AMA-based CCWO for severe angulation.
  • Most infections in TPLOs occur within 15 days, but RJB plus antibiotics in this study appeared protective, suggesting benefit for early-phase SSI prevention.

Simini Surgery Review Podcast

Know What Matters in the Literature - and Why

We distill peer-reviewed surgical studies into clinically relevant summaries and
exam-style questions, so you can make informed decisions with confidence.

Free Access. No Spam. Just Smarter Surgical Learning

Multiple Choice Questions on this study

In Guénégo 2025 et al., on AMA-based CCWO, which subgroup had the most consistent axis alignment postoperatively?

A. Dogs with TPA < 25°
B. Dogs with no miniarthrotomy
C. Dogs with AMA > 2.4°
D. Dogs with AMA < 2.4°
E. Dogs with patellar ligament thickening

Answer: Dogs with AMA > 2.4°

Explanation: Realignment of AA and MA was achieved more consistently in dogs with higher pre-op AMA.
In Guénégo 2025 et al., on AMA-based CCWO, what proportion of dogs had contralateral CCLR after initial AMA-based CCWO?

A. 20%
B. 38%
C. 66%
D. 10%
E. 50%

Answer: 66%

Explanation: 66% of dogs developed contralateral CCLR during the study period.
In Guénégo 2025 et al., on AMA-based CCWO, which combination was key to minimizing SSIs in AMA-based CCWO?

A. Double plating alone
B. Rigid external fixation only
C. Robert Jones bandage and antibiotics
D. TPLA and cerclage wire
E. Caudal closing wedge technique

Answer: Robert Jones bandage and antibiotics

Explanation: Use of RJB and postop antibiotics was associated with a low SSI rate.
In Guénégo 2025 et al., on AMA-based CCWO, what was the surgical site infection (SSI) rate observed?

A. 9.1%
B. 5.5%
C. 0.5%
D. 21.3%
E. None reported

Answer: 0.5%

Explanation: Only one SSI occurred in 204 dogs, giving a 0.5% infection rate.
In Guénégo 2025 et al., on AMA-based CCWO, what was the postoperative AMA angle achieved in most dogs?

A. 0°
B. >2.4°
C. –1°
D. <3.4°
E. Unchanged from pre-op

Answer: 0°

Explanation: The AMA angle was reduced to 0° in most dogs, achieving axis alignment.

Access the full library of surgical summaries and exam-style questions.

Get Instant Access

Educational content developed independently and supported by Simini.

The maker of Simini Protect Lavage.

Review More Key Summaries from this Veterinary and Comparative Orthopaedics and Traumatology Journal Issue

Lin

 et al: 

Does the Craniolateral Approach Provide Better Exposure to the Radius than the Craniomedial Approach for Internal Fracture Fixation in Dogs?

Guénégo

 et al: 

Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg

Trefny

 et al: 

Effect of Plate Screw Configuration on Construct Stiffness and Plate Strain in a Synthetic Short Fragment Small Gap Fracture Model Stabilized with a 12-Hole 3.5-mm Locking Compression Plate

Sullivan

 et al: 

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Cheon

 et al: 

Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs