Grant #02682-A: The Effects of a Modified Approach to Early Weight Bearing in Dogs Following a Tibeal Plateau Leveling Osteotomy for Cranial Cruciate Ligament Rupture.
Principal Investigator: Dominique Sawyere Hansford, BVSc, MS
Research Institution: Virginia-Maryland Regional College of Veterinary Medicine
[Year 2 Progress Report 2021] [Progress Report end 2021]
Project Description: A tibial plateau leveling osteotomy (TPLO) is a common procedure performed to address stifle (knee) instability secondary to cranial cruciate ligament rupture in dogs. During the surgical approach for a TPLO, some of the tendons of muscles attaching to the inside of the tibia are cut. These tendons are referred to as the medial crural fascia. The medial crural fascia is important for the normal function of the dog’s stifle. As opposed to the rapid gain in wound strength displayed in skin and the GI tract, restoration of fascia integrity is relatively prolonged. In the first week of healing, fascia incisions have no inherent strength; therefore, the repair is entirely dependent on the suture material, making it prone to inadequate healing. The clinical implication of this on early weight bearing and limb use following TPLO surgery is unknown. Additionally, tendons only reach 50-80% of their original strength at one year following reconstruction. In humans, deficiency in the repair of the medial crural fascia has been associated with decreased rotational stability, increased meniscal injury, and continued knee instability following surgery for cranial cruciate ligament rupture. If these findings are consistent in dogs, lack of attention to medial crural reconstruction and its inability to return to the original strength may contribute to continued subluxation of tibia and latent meniscal injury. In this study, dogs who undergo a modified approach to a TPLO will be evaluated to determine normalization of gait parameters and thigh circumference as compared to dogs who undergo a standard approach to a TPLO. Results from this study may change the approach to TPLO surgery in the future and provide canine patients with improved short- and long-term outcomes.