Preoperative planning for tibial plateau leveling osteotomy based on proximal tibial width

Abstract

The purpose of this study was to evaluate the applicability and feasibility of a novel preoperative planning method for tibial plateau leveling osteotomy (TPLO) based on the width of the proximal tibia. All TPLO procedures were performed by the same surgeon. In preoperative planning, the width of the tibial crest to the caudal edge of the medial tibial plateau (W) was measured, and the saw blade size that was closest to the distance between the point of the cranial third W and the intercondylar tubercles was selected. The postoperative tibial plateau angle (TPA), distance of eccentricity (DOE), and minimum thickness of the tibial tuberosity remaining cranial to the osteotomy (tibial tuberosity width; TTW) were documented. Complications in the perioperative and follow-up periods were documented. Thirty-one TPLO procedures were performed in 28 dogs, including both small and large breeds. The postoperative TPA was 8.4 ± 2.0° and the DOE was 3.55 ± 2.88 mm. The ratio of the TTW to the preoperative W was 0.27 ± 0.06. There were no major complications, such as fractures of the tibial tuberosity or implant breakage. This preoperative planning method allowed appropriate planning for TPLO with a clear index that was based on the size of the tibia rather than the breed or weight of the dog. This method should be of benefit to the surgeon, whether an expert or a novice, and contribute to the success of TPLO.