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

Area of Science:

• Veterinary Orthopedics
• Surgical Planning
• Biomechanical Engineering

Background:

• Tibial plateau leveling osteotomy (TPLO) is a common procedure for canine cruciate ligament injuries.
• Accurate preoperative planning is crucial for successful TPLO outcomes.
• Current planning methods may not be universally applicable across different canine sizes.

Purpose of the Study:

• To evaluate a novel preoperative planning method for TPLO based on proximal tibial width.
• To assess the feasibility and applicability of this new planning technique.
• To determine if this method offers a more objective approach than traditional methods.

Main Methods:

• A novel preoperative planning method was developed, measuring proximal tibial width (W).
• Saw blade size was selected based on a fraction of W and specific tibial landmarks.
• Thirty-one TPLO procedures were performed using this method, with measurements of postoperative tibial plateau angle (TPA), distance of eccentricity (DOE), and tibial tuberosity width (TTW).

Main Results:

• Postoperative TPA averaged 8.4 ± 2.0°, and DOE was 3.55 ± 2.88 mm.
• The ratio of TTW to preoperative W was 0.27 ± 0.06.
• No major complications like tibial tuberosity fractures or implant breakage were observed.

Conclusions:

• The novel preoperative planning method based on tibial width is applicable and feasible for TPLO.
• This method provides a clear, objective index for planning TPLO, independent of breed or weight.
• The technique is beneficial for surgeons of all experience levels, contributing to successful TPLO procedures.