An in silico comparison of a novel CORA-based cranial closing wedge ostectomy methodology with three other techniques

To describe a CORA-based cranial closing wedge ostectomy methodology (CCWO_CORA) and to determine whether the CCWO_CORA achieves a more accurate and precise postoperative tibial plateau angle (TPA_POST) than three previously described methods.

In silico study.

Thirteen client-owned dogs.

Computed tomography (CT) scans of six Labrador retriever, six German shepherd, six Rottweiler, and six small-breed dog (<10 kg) tibiae, originally acquired for unrelated purposes, were used for in silico planning and execution of the CCWO_CORA and previously described procedures. The TPA_POST, tibial long axis shift, change in tibial length and wedge angle were recorded and a linear mixed-effects model was used to compare differences amongst techniques.

The median TPA_POST for the CCWO_CORA method was 5.00° (range: 5.00-5.00°) across a variety of tibial morphologies, whereas all other methods showed greater variability. Differences in TPA_POST were evident amongst methods (p < .001) and breeds (p < .001).

In silico, CCWO_CORA methodology always achieved the target TPA_POST due to its intrinsic geometric principles. As such, CCWO_CORA surgeries achieved a more accurate TPA_POST than previously described CCWO techniques.

The CCWO_CORA provides clinicians with a cranial closing-wedge ostectomy methodology with entirely predictable TPA_POST.