Comparison of surgical treatment options for cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle

Objective- To identify surgical techniques performed by veterinary surgeons for the treatment of cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle (eTPA), compare their outcomes, identify risk factors for postoperative complications, and compare outcome and complication rate with tibial plateau leveling osteotomy (TPLO) in dogs without eTPA. Study Design- Multicenter, case-control study. Animals- eTPA group (TPA >= 35 degrees)=58 dogs (78 stifles); control group (TPA <= 30 degrees)=58 dogs (72 stifles). Methods- Control and eTPA group dogs were identified. Medical records, radiographic reviews, and pet-owner interviews were used to identify surgical treatments performed, their complications, and outcome. Odds ratios with 95% confidence intervals, chi(2) tests, and t-tests were calculated to discern differences between eTPA and control-group dogs. Results- TPLO was the most common treatment for eTPA. Owner-perceived outcome was superior for eTPA group dogs when TPLO resulted in TPA <= 14 degrees compared with those with postoperative TPA > 14 degrees. Loss of tibial plateau leveling during convalescence was the most commonly observed major complication; addition of ancillary implants to TPLO significantly reduced its incidence. Postoperative complications were more common in dogs with eTPA than in dogs without eTPA; however, no difference in owner-perceived outcome was identified. Conclusions- Surgical treatment of dogs with eTPA has a higher complication rate, but comparable outcome to that of dogs without eTPA. Clinical Relevance- Postoperative TPA <= 14 degrees and addition of ancillary implants are recommended when using TPLO to treat dogs with eTPA. (C) Copyright 2008 by The American College of Veterinary Surgeons.