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33rd Annual Scientific Meeting proceedings


Stream:   |   Session: Orthopaedic Short Communications
Date/Time: 05-07-2024 (17:45 - 18:00)   |   Location: Auditorium 1
Femoral Isometric Placement of Internal Brace Implants Crucial for Stifle Stability Following TPLO
Wylie S, Solano M*, Danielski A*
The Ralph Veterinary Referral Centre, Marlow, United Kingdom.

Objectives:

The pivot shift phenomenon is a well-known complication following tibial plateau levelling osteotomy (TPLO) surgery. This study investigated the accuracy of internal brace implant placement at the femoral isometric point during TPLO and its impact on stifle stability at follow-up

Methods:

This study included dogs undergoing TPLO surgery (2020-2023), where Swivelock™ and FastAK™ (Arthrex, Naples, USA) implants were used to address concurrent pivot shift phenomenon. Data collected included dog’s signalment, implant type, and the presence of pivot shift at the 6-week follow-up assessment. Implant placement was evaluated using mediolateral postoperative radiographs and categorized as appropriate or inappropriate based on whether the femoral implant was entering the bone at the reported isometric point of the femoral condyle. The degree of stifle instability compared to the immediate postoperative examination was recorded.

Results:

Forty-one dogs were included in this study. Postoperative radiographs revealed that the internal brace implants were correctly positioned in 56.1% (n=23) of cases and incorrectly positioned in 43.9% (n=18) of cases. Follow-up examination was available for 27 cases. In 13 dogs (48%) the pivot shift was still negative at the follow-up examination. Multivariate analysis confirmed that correct isometric positioning of the implants within the femoral condyle was significantly associated with negative pivot shift phenomenon at the six-week follow-up examination (p=0.001).

Conclusions:

Inappropriate placement of the implants at the femoral isometric point may lead to breakage of the suture and presence of stifle instability in the post-operative period. Accurate femoral isometric placement of the implants is therefore vital.

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