Carrera Alefe Luiz Caliani, Curuci Eloy Henrique Pares, Lucena Dayvid Vianêis Farias, Costa Lucas Vasconcelos, Faustino Rodrigo Carvalho de Souza, Silva Stefânia Carolino Claudino, Dias Luis Gustavo Gosuen Gonçalves, Minto Bruno Watanabe
Department of Veterinary Clinics and Surgery, School of Agricultural and Veterinary Studies, São Paulo State University, São Paulo, Brazil.
Veterinary Orthopedics, Veterinary Surgeon, São Paulo, Brazil.
PLoS One. 2025 Jul 22;20(7):e0327247. doi: 10.1371/journal.pone.0327247. eCollection 2025.
Medial patellar luxation (MPL) and cranial cruciate ligament disease (CCLD) frequently co-occur in dogs, with excessive tibial torsion adding surgical complexity. This study evaluates the clinical outcomes of total proximal tibial osteotomy (tPTO) combined with cranial closing wedge ostectomy (CCWO) for treating MPL and CCLD in dogs exhibiting excessive external tibial torsion. A retrospective case series was conducted at a single referral hospital, including dogs with concomitant MPL and CCLD, exhibiting external tibial torsion ≥20°, and treated with tPTO and CCWO. A total of 31 patients met the inclusion criteria. Postoperatively, tibial torsion was corrected in all cases, with 74.2% (n = 23) achieving near 0° alignment. The tibial plateau angle decreased from 23.0° ± 5.0° to 7.0° ± 3.4°. Antirotational techniques were used to prevent reluxation in 25.8% (n = 8) of cases because of stifle soft tissue laxity. The initial success rate for patellar and stifle stability was 87.1%, whereas 12.9% (n = 4) of cases exhibited patellar reluxation, necessitating surgical reintervention with antirotational techniques. Bone healing averaged 70.2 ± 21.2 days, aligning with full clinical recovery. Following the four surgical reinterventions, all patients achieved patellar and stifle dynamic stability with normal weight bearing. The combination of tPTO and CCWO proved effective for treating concomitant MPL and CCLD in dogs with excessive tibial torsion, demonstrating favorable outcomes and complication rates. This technique should be considered for managing these complex cases.
内侧髌骨脱位（MPL）和前交叉韧带疾病（CCLD）在犬类中经常同时出现，胫骨过度扭转增加了手术的复杂性。本研究评估了全胫骨近端截骨术（tPTO）联合前闭合楔形截骨术（CCWO）治疗表现出胫骨外旋过度的犬类MPL和CCLD的临床结果。在一家单一的转诊医院进行了一项回顾性病例系列研究，纳入了同时患有MPL和CCLD、胫骨外旋≥20°并接受tPTO和CCWO治疗的犬类。共有31只犬符合纳入标准。术后，所有病例的胫骨扭转均得到纠正，74.2%（n = 23）的犬实现了接近0°的对线。胫骨平台角从23.0°±5.0°降至7.0°±3.4°。由于 stifle 软组织松弛，25.8%（n = 8）的病例采用了抗旋转技术来防止复发。髌骨和 stifle 稳定性的初始成功率为87.1%，而12.9%（n = 4）的病例出现了髌骨复发，需要采用抗旋转技术进行手术再次干预。骨愈合平均为70.2±21.2天，与完全临床恢复一致。经过四次手术再次干预后，所有犬均实现了髌骨和 stifle 的动态稳定，且负重正常。tPTO和CCWO联合使用被证明对治疗胫骨扭转过度的犬类同时患有MPL和CCLD有效，显示出良好的结果和并发症发生率。对于处理这些复杂病例，应考虑采用该技术。
