Quiz Question
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, when did cranial tibial translation (CTT) occur after CBLO **without** hamstring loading?
🔍 Key Findings
- CBLO reduced tibial plateau angle (TPA) from a mean of 28.1° to 9.7°, aligning with its goal of flattening the tibial slope.
- CBLO eliminated cranial tibial translation (CTT) following CCL transection and meniscal release at all angles except 140° without hamstring load.
- Hamstring loading (20% quadriceps load) significantly reduced or delayed the onset of CTT, improving stifle stability.
- Medial meniscus was confirmed as a secondary stabilizer; its release (MMR) caused more CTT than CCLx alone.
- PTA (patellar tendon angle) increased with joint extension; CBLO shifted the PTA curve lower and parallel to intact values, suggesting effective flexion of the joint.
- Combined CBLO and hamstring loading resulted in the most stable joints, especially from 50° to 135° joint angles.
- Residual CTT occurred in CBLO-only limbs at higher extension angles (e.g., 140°), but hamstring load mitigated this.
- Stifle stability post-CBLO is multifactorial, depending on joint angle, meniscal integrity, and hamstring activation.
Veterinary Surgery
6
2022
Effect of center of rotation of angulation‐based leveling osteotomy on ex vivo stifle joint stability following cranial cruciate ligament transection and medial meniscal release with and without a hamstring load
2022-6-VS-mazdarani-2
In Haine 2022 et al., on outcomes in canine limb tumors, which lateral surgical margin width significantly reduced R1 margin rates?
🔍 Key Findings
- Fewer R1 margins (tumor on ink) were achieved in mast cell tumors (MCTs) when using 6–10 mm lateral margins versus 0–5 mm (7% vs. 55%; _P_ = .049).
- For soft tissue sarcomas (STSs), no benefit was seen in margin completeness between 0–5 mm vs. 6–10 mm lateral margins (41% vs. 43% R1).
- Overall R1 rates were 26% for MCTs and 42% for STSs following PNE.
- R scheme (“tumor on ink” = R1) had better interobserver agreement (83%) compared to ≤1 mm margin criteria (68% agreement).
- Complication rate was moderate (26%), but no surgeries required revision.
- Local recurrence/metastasis occurred in 14% of dogs, with 60% of those having R1 margins.
- Adjunctive therapy was considered clinically indicated in 46% of 0–5 mm margin cases vs. 24% of 6–10 mm cases.
- Histologic grade and tumor size were not predictive of margin completeness.
Veterinary Surgery
7
2022
Incomplete histological margins following planned narrow excision of canine appendicular soft tissue sarcomas and mast cell tumors, using the residual tumor classification scheme
2022-7-VS-haine-2
In Banks 2024 et al., what patient factor was associated with higher preoperative and postoperative TPAs?
🔍 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
Veterinary Surgery
1
2024
A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
2024-1-VS-banks-4
In Peycke 2022 et al., on CBLO in immature dogs, what was the most common **complication** from improper screw placement in CBLO?
🔍 Key Findings
- CBLO was effective for stifle stabilization in skeletally immature dogs with CrCL injuries, avoiding disruption of proximal tibial growth plates.
- Radiographic union of the osteotomy occurred in a mean of 6 weeks (range: 4–8 weeks), indicating rapid bone healing.
- Full limb function was restored in all cases by long-term follow-up (mean 23 months), including dogs with initial complications.
- Two dogs developed 19° valgus deformities due to screw interference with the proximal tibial physis; both were corrected surgically with return to function.
- One dog developed 10° recurvatum due to over-rotation of the tibial plateau, but retained full function without revision.
- CCS (countersink compression screw) caused early apophyseal closure in older dogs but had no adverse clinical effects.
- In contrast, K-wire or plate-only fixation preserved open apophysis, suggesting implant choice may influence growth.
- No meniscal injuries were observed, and all CrCL injuries were managed arthroscopically — 6 complete, 6 partial, 4 avulsions.
Veterinary Surgery
3
2022
Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs
2022-3-VS-peycke-2
In Cortina 2023 et al., on modified TTT outcomes for MPL in dogs, how did the complication rate of the m-TTT compare to historical methods?
🔍 Key Findings
- m-TTT yielded a low overall major complication rate (4.3%) and minor complication rate of 15%, consistent with or better than previous techniques.
- Patellar reluxation occurred in only 4.3% of stifles, with high-grade reluxation seen in just 0.6% of cases—lower than the 12.4–21% range reported for other techniques.
- Implant migration rate was 3.7%, lower than previously reported for smooth pin fixation (7.7–24.6%).
- Use of a tension band with single Steinmann and Kirschner wire reduced stress risers and fixation failure, supporting better stability.
- Tibial tuberosity fracture occurred in only 1.3% of cases, lower than the 1–6% seen in other reports.
- All long-term major complications (1.3%) were related to pin migration, but were easily resolved.
- Radiographic follow-up confirmed complete bone healing in all examined cases, even up to 9 years postoperatively.
- Owner satisfaction was 100%, and 95% rated quality of life as good to excellent based on CBPI surveys.
Veterinary Surgery
5
2023
Outcomes and complications of a modified tibial tuberosity transposition technique in the treatment of medial patellar luxation in dogs
2023-5-VS-cortina-4
In Evers 2023 et al., on medial meniscal tear detection, which aspect of the procedure was significantly more difficult using NA compared to SA?
🔍 Key Findings
- Needle arthroscopy (NA) had 95% sensitivity and 100% specificity for diagnosing medial meniscal tears in dogs with CCLR.
- NA missed 1 medial and 1 lateral meniscal tear, both nondisplaced and stable.
- Visibility of all meniscal horns was significantly lower with NA compared to standard arthroscopy (SA) (P < .005 for all horns).
- Probing the caudal horn of the lateral meniscus was significantly more difficult with NA (P = .0017), though medial horn probing was similar.
- Mean NA procedure time was 8 ± 3 minutes, significantly shorter than SA (15 ± 9 min, P = .0041).
- No increase in lameness observed after NA, indicating minimal procedural morbidity.
- NA was performed under sedation in most dogs, though 10/26 required additional chemical restraint or short anesthesia.
- NA was most accurate for displaced vertical longitudinal tears, with all 14 correctly identified; one stable tear and a lateral tear were missed.
Veterinary Surgery
6
2023
Accuracy of needle arthroscopy for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture
2023-6-VS-evers-2
In Kikuchi 2025 et al., on arthroscopic MMI in toy breeds, which variable was **not** part of the final regression model predicting MMI?
🔍 Key Findings
- Medial meniscus injury (MMI) occurred in 36.3% of stifles with CrCLR in toy breed dogs (<5 kg)
- Complete CrCLR was significantly associated with MMI (15.3% of complete vs. 3.4% of partial)
- Severe lameness (grade 3) increased the likelihood of MMI compared to mild lameness (grade 1)
- Higher body weight, even within the toy breed range, was positively associated with MMI
- Yorkshire Terriers had the highest MMI incidence (55.6%), but this was not a significant independent factor due to multicollinearity
- Arthroscopy identified more meniscal damage (including small radial tears and bucket-handle lesions) than gross examination might detect
- MMI was classified as mild (radial tear) or severe (bucket-handle or flap) with implications for partial meniscectomy
- Arthroscopy was used in all cases, underscoring its utility in small-breed stifle assessment
Veterinary and Comparative Orthopaedics and Traumatology
5
2025
Incidence of Medial Meniscus Injury Detected by Arthroscopy in Toy Breed Dogs
2025-5-VCOT-kikuchi-4
In Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), which two techniques demonstrated the most accurate achievement of their target TPA values?
🔍 Key Findings
- All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
- Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
- Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
- Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
- Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
- Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
- All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
- Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.
Veterinary Surgery
8
2024
Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis
2024-8-VS-story-3
In Moreira 2024 et al., on predictive equations for TPA correction, which of the following is true regarding the Oxley mCCWO technique?
🔍 Key Findings
- A linear relationship was observed between wedge angle and tibial plateau angle (TPA) correction across all four CCWO techniques.
- All techniques produced predictable TPA corrections using linear regression-derived equations, allowing wedge angle extrapolation to achieve a target postoperative TPA of 5°.
- TLA shift (tibial long axis) increased with wedge angle and influenced final TPA; greatest in Frederick & Cross method.
- Tibial shortening (mTL%) varied by technique, being most severe (up to 40.9%) in traditional Slocum & Devine CCWO and least in newer techniques (7.5–12%).
- The Oxley mCCWO technique showed lower TLA shift compared to the Frederick & Cross and Christ techniques, though similar to Slocum & Devine; tibial shortening was more pronounced than other modified techniques at wedge angles ≤40°.
- Techniques varied in craniocaudal translation and wedge apex positioning, influencing planning accuracy and mechanical axis alignment.
- The corrective wedge angle equations reliably predicted TPA within 4–6° across varied tibial conformations.
- The study supports equation-based planning over static TPA–5° subtraction to reduce risk of under- or over-correction.
Veterinary Surgery
8
2024
Predicting tibial plateau angles following four different types of cranial closing wedge ostectomy
2024-8-VS-moreira-5
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, which metric showed no significant difference between treatment and placebo groups?
🔍 Key Findings
- Liposomal bupivacaine (LB) infiltration did not reduce the need for rescue analgesia compared with placebo in dogs undergoing TPLO.
- CMPS-SF pain scores were not significantly different between LB and placebo groups at any postoperative time point.
- % body weight distribution (%BWdist) to the operated limb did not differ significantly between treatment groups across all time points.
- No correlation was found between CMPS-SF scores and %BWdist, suggesting these metrics assess different aspects of postoperative pain.
- Postoperative carprofen administration was standardized, and LB did not provide additional detectable analgesic benefit.
- Three-layer infiltration technique (joint capsule, fascia, subcutis) was used consistently across all cases.
- Adverse events were minor and comparable between LB and placebo groups.
- Post hoc analysis suggested a much larger sample size (58–436 dogs) would be needed to detect significant differences in %BWdist.
Veterinary Surgery
5
2023
Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery
2023-5-VS-aldrich-1
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings