Virtual study of proposals for changes in the material and techniques of tibial plateau leveling osteotomy (TPLO) in dogs
Corrective tibial osteotomies, tibial plateau angle, knee instability in dogs, TPLO.
Surgical correction of cranial cruciate ligament rupture is the most effective form of treatment, with excellent long-term results, depending on the technique used. Tibial plateau leveling osteotomy (TPLO) is one of the most used to correct the resulting instability. The purpose of this research was 1) to develop a mathematical formula to calculate the rotation of the proximal fragment, at values greater than 5 degrees, in TPLO (from 8 to 12 degrees), as well as 2) to evaluate in the VPOP-pro program what it is the correct angulation of the proximal screws in TPLO plates available on the Market and 3) determine the correct relationship between the width of the saws used (arch cord) and the measurements of the tibiae in its proximal portion. Proximal screw angulations were tested on 68 radiographic images of dog tibiae in caudocranial projection. All measurements and angulation of the plates in relation to the screws were performed using the Vpop-pro software. The means of the angulations that the screws should be on the Lincevet and Fixin plates were respectively (15.6 ± 4.66 and 14.8 ± 3.97). There was a significant difference in the angle between the two brands (p < 0.05). Five tables were created with final tibial plateau angles (APTf) between 8 and 12 degrees, from initial tibial plateau angles (APTi) ranging between 15 and 50 degrees, and saws with a radius between 8 and 30 mm. Analyzing the tables generated in 40 mediolateral radiographs of dog tibiae, it was observed that there was a statistical difference (p<0.05) between the final angulations expected by the tables and the final angulations obtained in Vpop-pro, in relation to the tibial plateau angle. In 52 images of the tibia (in the mediolateral projection), the chord of the arc of the TPLO saws corresponding to each tibia evaluated in the Vpop-pro program were tested. For the chord of the arc, the value of 144% of a constant was reached, which allows the calculation of the correct relationship that should exist between the saw and the tibia, in order to avoid complications.