Quiz Question
In Wang 2025 et al., on TPLO osteotomy alignment, what was the **intended postoperative TPA** targeted in this study?
🔍 Key Findings
- Fluoroscopy-guided osteotomy placement achieved a median postoperative TPA of 3° (range: 0–4.5°), showing excellent accuracy.
- The D1 measurement (from patellar ligament insertion to osteotomy exit) was more reproducible and accurate intraoperatively than D2.
- Median R1 value (D1-based) matched the intended 21 mm radius with only 0.5 mm deviation, while R2 deviated by 2.5 mm.
- Real-time fluoroscopy allowed dynamic limb positioning and reduced osteotomy placement variability.
- Intraoperative fluoroscopy reduced reliance on preoperative planning, especially in cases with difficult anatomy or positioning.
- Radiation exposure was minimal (avg. 3 images per case) and within safe limits using standard protection protocols.
- Study standardized to 21 mm blades and excluded dogs with developmental orthopedic conditions to reduce confounders.
- Targeting a lower postoperative TPA (3°) may reduce meniscal load and cranio-caudal instability, though long-term outcomes require further study.
Veterinary Surgery
7
2025
Accuracy of fluoroscopy-guided osteotomy placement in TPLO: Postoperative tibial plateau angle and preoperative planning evaluation
2025-7-VS-wang-3
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 Katz 2022 et al., on meniscal flounce sign, which meniscal tear type was observed in stifles that retained a positive flounce sign?
🔍 Key Findings
- A positive meniscal flounce sign was associated with normal menisci in 95.5% of cases, demonstrating strong predictive value.
- Absence of the meniscal flounce sign was associated with meniscal tears in 92.7% of cases.
- Overall diagnostic accuracy of the flounce sign was 94.6%, with 96.6% sensitivity and 90.5% specificity.
- Most tears in flounce-negative stifles were bucket-handle tears (73.8%), while radial tears were present in some flounce-positive stifles.
- Radial tears did not consistently eliminate the flounce sign, suggesting they may not disrupt meniscal fiber tension sufficiently.
- All procedures were arthroscopically performed, with probing and visualization of the medial meniscus' caudal pole.
- Flounce sign should complement, not replace, probing—especially as some tear types (e.g., radial) may not abolish the sign.
- Limb positioning and joint distraction may affect flounce visibility, introducing minor observer variability.
Veterinary Surgery
2
2022
The significance of the meniscal flounce sign in canine stifle arthroscopy
2022-2-VS-katz-2
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, the release of the medial meniscus (MMR) led to which of the following?
🔍 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-4
In McLean 2024 et al., what was the average increase in TPA among dogs with rock-back?
🔍 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
Veterinary and Comparative Orthopedics and Traumatology
6
2024
Effect of Plate Inclination and Osteotomy Positioning on Rock-back following Tibial Plateau Levelling Osteotomy in Dogs
2024-6-VCOT-mclean-3
In Jeong 2025 et al., on contoured saw guide vs jig, what was a key outcome in terms of osteotomy *inclination* on cadaver limbs?
🔍 Key Findings
- TPLO with the contoured saw guide achieved more accurate osteotomy angles for both inclination and torsion in bone models and cadaveric limbs (p < .05).
- Medial cortical damage was significantly lower with the contoured guide (247 vs. 1866 pixels in bone models; p < .001).
- No significant difference in eccentricity (distance between actual and intended osteotomy center) was found between groups.
- Postoperative tibial plateau angle (TPA) was similar between groups (6.4° vs. 7.6°; p = .15), though both were slightly higher than the target of 6°.
- Deviation in medial mechanical proximal tibial angle (mMPTA) showed no significant group difference; valgus deformity occurred in both.
- Osteotomy and device application times were similar between the contoured guide and jig-assisted TPLO.
- The contoured guide eliminated the need for proximal jig pin, potentially reducing intra-articular pin risk.
- The guide's multiple pin fixation system improved stability and alignment, supporting safer osteotomy on curved tibial surfaces.
Veterinary Surgery
7
2025
Evaluation of a contoured saw guide for tibial plateau leveling osteotomy in dogs
2025-7-VS-jeong-1
In Eskelinen 2025 et al., on Plate–Pin fixation for MPL, what was the rate of patellar luxation recurrence?
🔍 Key Findings
- Plate–Pin TTT fixation resolved MPL in 64/65 stifles with low recurrence (1.5%) and good lameness outcomes postoperatively.
- Complication rate was 21.5% (14/65 stifles), mostly minor (57%); major issues included pin migration, fracture, or capsular failure.
- Pin-related issues accounted for 8 of 20 total complications, highlighting implant refinement is needed.
- No avulsions, TT fixation failures, or luxation recurrence occurred in cases where surgical technique was followed precisely.
- Surgical deviations increased complication risk 11.3× (p < 0.05), suggesting adherence to protocol is critical.
- Single-session bilateral MPL surgery had comparable complication rate (3/20) to unilateral surgery (11/45).
- Screw breakage occurred in 3 cases, suggesting at least 3 screws may be needed for secure TT fixation.
- Authors suggest temporary pin fixation and later removal may reduce complications, though prospective studies are needed.
Veterinary and Comparative Orthopaedics and Traumatology
4
2025
Outcome and Complications Following Medial Patellar Luxation Corrective Surgery with Tibial Tuberosity Transposition Using a Locking Plate and a Pin Fixation: 45 Unilateral and 20 Single-Session Bilateral Procedures
2025-4-VCOT-eskelinen-1
In Silveira 2022 et al., on GTO in canine THR, which scenario was considered a suitable indication for performing a greater trochanter osteotomy?
🔍 Key Findings
- GTO enabled successful cementless THR in dogs with severe medialization of the greater trochanter or chronic craniodorsal hip luxation.
- All 5 hips had acceptable long-term outcomes (median follow-up: 48 months) with full function and no persistent complications.
- Only one major complication occurred—a luxation unrelated to the GTO and successfully corrected with cup revision.
- GTO facilitated femoral canal access and gluteal preservation, reducing risk of iatrogenic injury during broaching.
- All GTOs healed radiographically (4 by 6 weeks, 1 by 12 weeks), with no cases of nonunion or implant migration.
- No complications related to GTO or PTBW fixation (pins + tension band) were observed in any dog.
- Surgical planning included templating both THR and GTO to ensure ideal alignment and reduce fracture risk.
- GTO may be especially valuable in luxoid hip dysplasia phenotypes or chronically fixed luxations.
Veterinary Surgery
2
2022
Greater trochanter osteotomy as a component of cementless total hip replacement: Five cases in four dogs
2022-2-VS-silveira-4
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, which statement best describes the **patellar ligament angle (PTA)** after CBLO?
🔍 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-5
In Husi 2023 et al., on TPLO vs TPLO-IB biomechanics, how did the TPLO-IB construct affect rotational stability compared to TPLO alone?
🔍 Key Findings
- TPLO alone failed to neutralize rotational instability under tibial pivot compression (TPT), despite a negative TCT.
- TPLO combined with lateral augmentation (TPLO-IB) restored both craniocaudal and rotational stability to near-intact levels.
- Cranial tibial translation was 6× greater after TPLO vs intact stifles when tested with TPT (p < .001).
- No significant difference in cranial tibial translation or internal rotation between intact stifles and TPLO-IB group during TCT, eTPT, or iTPT.
- TPLO-IB did not overconstrain the stifle, avoiding excessive external rotation.
- External tibial rotation (eTPT) was more sensitive than TCT in detecting persistent instability after TPLO.
- Excellent intraobserver reliability for both eTPT and iTPT (ICC > 0.9).
- Study supports intraoperative use of TPT to identify cases needing additional rotational stabilization.
Veterinary Surgery
5
2023
Comparative kinetic and kinematic evaluation of TPLO and TPLO combined with extra-articular lateral augmentation: A biomechanical study
2023-5-VS-husi-3
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings