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Wylie et al: Evaluation of femoral isometric placement accuracy of internal brace implants and its impact on stifle stability in the management of pivot shift phenomenon following TPLO
Veterinary Surgery 7, 2025

🔍 Key Findings

  • Accurate femoral isometric placement was achieved in 63% of cases, significantly more with SwiveLock (78.6%) than FASTak (38.9%).
  • Inaccurate placement was associated with increased internal tibial rotation at follow-up (p = .009), suggesting potential implant failure.
  • Pivot shift grade improved in 90.9% of stifles postoperatively, regardless of implant positioning accuracy.
  • SwiveLock implants had a faster learning curve and higher placement accuracy than FASTak.
  • Higher patient weight was linked to more accurate implant placement (p = .012), likely due to easier anatomical landmark identification.
  • No correlation found between implant type or positioning accuracy and final pivot shift grade at 6 weeks.
  • Minor and major complications were low and not significantly different between implant types.
  • A simplified 2-grade pivot shift system was proposed for clinical use (Grade 1: glide, Grade 2: clunk), aiding intraoperative decision-making.

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← Articles

Wylie et al: Evaluation of femoral isometric placement accuracy of internal brace implants and its impact on stifle stability in the management of pivot shift phenomenon following TPLO
Veterinary Surgery 7, 2025

🔍 Key Findings

  • Accurate femoral isometric placement was achieved in 63% of cases, significantly more with SwiveLock (78.6%) than FASTak (38.9%).
  • Inaccurate placement was associated with increased internal tibial rotation at follow-up (p = .009), suggesting potential implant failure.
  • Pivot shift grade improved in 90.9% of stifles postoperatively, regardless of implant positioning accuracy.
  • SwiveLock implants had a faster learning curve and higher placement accuracy than FASTak.
  • Higher patient weight was linked to more accurate implant placement (p = .012), likely due to easier anatomical landmark identification.
  • No correlation found between implant type or positioning accuracy and final pivot shift grade at 6 weeks.
  • Minor and major complications were low and not significantly different between implant types.
  • A simplified 2-grade pivot shift system was proposed for clinical use (Grade 1: glide, Grade 2: clunk), aiding intraoperative decision-making.

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Multiple Choice Questions on this study

In Wylie 2025 et al., on femoral implant accuracy, what is true regarding the simplified pivot shift grading system introduced in the study?

A. It includes 4 grades based on human ACL literature
B. It is based on radiographic tibial rotation only
C. It differentiates between “glide” and “clunk” types of instability
D. It requires objective force plate analysis
E. It measures medial meniscus excursion

Answer: It differentiates between “glide” and “clunk” types of instability

Explanation: The simplified system uses 2 grades: grade 1 = glide, grade 2 = clunk, aiding intraoperative assessment of rotational instability.
In Wylie 2025 et al., on femoral implant accuracy, which factor was significantly associated with more accurate implant placement?

A. Younger age
B. Smaller femoral condyle
C. Higher patient weight
D. Implant type not significant
E. TPA correction magnitude

Answer: Higher patient weight

Explanation: Higher weight was linked to better implant placement (p = .012), likely due to improved anatomical landmark visibility and surgical access.
In Wylie 2025 et al., on femoral implant accuracy, what was the effect of inaccurate isometric placement on postoperative stifle stability?

A. It caused higher rates of patellar luxation
B. It was associated with reduced meniscal injury
C. It was significantly associated with increased internal tibial rotation
D. It resulted in a higher final pivot shift grade
E. It had no measurable clinical impact

Answer: It was significantly associated with increased internal tibial rotation

Explanation: Inaccurate femoral implant positioning was significantly associated with increased internal tibial rotation at follow-up (p = .009), indicating possible implant failure.
In Wylie 2025 et al., on femoral implant accuracy, what was the overall effect of internal brace augmentation on pivot shift grades at 6 weeks?

A. All dogs required revision surgery
B. Pivot shift grades worsened in most cases
C. Pivot shift grades improved in over 90% of stifles
D. Pivot shift grades remained unchanged
E. Only dogs with accurate placement improved

Answer: Pivot shift grades improved in over 90% of stifles

Explanation: At 6-week follow-up, 90.9% of stifles showed improvement in pivot shift grade, regardless of implant positioning accuracy.
In Wylie 2025 et al., on femoral implant accuracy, which implant type had the highest placement accuracy?

A. FiberWire sutures
B. FiberTape anchors
C. FASTak anchors
D. SwiveLock interference screws
E. Toggle pin fixation

Answer: SwiveLock interference screws

Explanation: SwiveLock implants had a significantly higher accuracy rate (78.6%) compared to FASTak (38.9%) and showed a faster learning curve.

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