Schuenemann Riccarda, Kaczmarek Jakub
Kleintierspezialisten Augsburg, Augsburg.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2023 Feb;51(1):6-14. doi: 10.1055/a-1990-0597. Epub 2023 Mar 14.
To compare complication rates and outcomes of small and large breed dogs that had locking plate Tibial Plateau Leveling Osteotomy (TPLO) performed due to cranial cruciate ligament disease during the same time period at a single institution and identify potential influencing factors.
136 cases with TPLO performed at a single institution between January 2013 and December 2015 were retrospectively reviewed. Dogs were grouped by plate sizes (2.0, 2.4, 2.7, 3.5 and 3.5 broad) and by small breeds (2.0-2.7 plate sizes) and large breeds (3.5 plates). Potential influencing factors on lameness and complications were recorded from the database and measured on radiographs and statistically compared.
Small dogs experienced fewer complications than large dogs (10% vs. 22%) and not a single major complication. Small dogs were significantly less lame at recheck and at long-term follow-up. Progression of bone healing had an influence on the lameness grade of dogs at recheck after TPLO. Distance of the most proximal screw from the joint was identified as a risk factor for implant failure. The width of the patella ligament correlated with body weight and uniformly increased 2.4 times after TPLO.
TPLO in small breed dogs has a lower overall complication rate than in large breed dogs. The TPLO plate should always be placed as close to the joint as possible to reduce the risk of implant failure.
TPLO can be recommended as treatment for cranial cruciate ligament rupture (CCLR) in dogs of all sizes.
比较在同一机构同一时期因颅交叉韧带疾病接受锁定钢板胫骨平台水平截骨术（TPLO）的小型犬和大型犬的并发症发生率及治疗结果，并确定潜在影响因素。
回顾性分析2013年1月至2015年12月在同一机构接受TPLO手术的136例病例。根据钢板尺寸（2.0、2.4、2.7、3.5和3.5宽）以及小型犬（2.0 - 2.7钢板尺寸）和大型犬（3.5钢板）进行分组。从数据库中记录影响跛行和并发症的潜在因素，并在X线片上进行测量，然后进行统计学比较。
小型犬的并发症比大型犬少（10%对22%），且无一例严重并发症。小型犬在复查和长期随访时跛行明显较轻。骨愈合进程对TPLO术后复查时犬的跛行等级有影响。最近端螺钉距关节的距离被确定为植入物失败的危险因素。髌韧带宽度与体重相关，TPLO术后平均增加2.4倍。
小型犬TPLO的总体并发症发生率低于大型犬。TPLO钢板应始终尽可能靠近关节放置，以降低植入物失败的风险。
TPLO可推荐用于所有体型犬的颅交叉韧带断裂（CCLR）治疗。
