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Reverse TPLO in a young dog
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TPLO is a popular technique to treat rupture of the cranial cruciate Ligament in Dogs. But what is the indication for a reverse TPLO and how is this performed? A very interesting recently online published articlle describes a 4āĀ·ā5-month-old, 13āĀ·ā8ākg, female neutered mixed breed dog that was presented for evaluation of acute non-weight bearing right pelvic limb lameness and was treated with this technique.
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Radiographs revealed a tibial tuberosity avulsion fracture for which open reduction/internal fixation was performed.
Asymmetrical premature closure of the cranial aspect of the proximal tibial physis ensued with a tibial plateau angle of ā12Ā°.
Abnormal stifle biomechanics resulted in lameness and caudal cruciate ligament fraying.
Tibial plateau -levelling osteotomy was performed in standard fashion with the exception that the proximal tibial -fragment wasārotated cranioproximally to increase the tibial plateau angle from ā12Ā° to +5Ā° (reverse tibial -plateau levelling osteotomy).
Normal healing and resolution of lameness followed and the dog remained -clinically healthy 2āyears postoperatively.
This case report demonstrates that any change in proximal tibial anatomy, whether traumatic, iatrogenic or with therapeutic intent, can cause altered stifle biomechanics and should not be underestimated. Surgical management through corrective -osteotomy can be used to restore adequate function.
Source: Demianiuk, R. M. and Guiot, L. P. (2014), Reverse TPLO for asymmetrical -premature closure of the proximal tibial physis in a dog. Journal of Small Animal Practice. doi: 10.1111/jsap.12245
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