RESUMO
OBJECTIVE: This study aims to compare the Modified Maquet Procedure (MMP) with the Tibial Plateau Leveling Osteotomy (TPLO) using long-term follow-up examinations over the period of more than one year (∅ 3,15 years) by clinical examination, radiographic assessment of osteoarthritis progression, and gait analysis by treadmill examination. Additional aim is to review the influence of surgeons' experience in TPLO technique. MATERIAL AND METHODS: This clinical study included 67 stifle joints of 50 dogs of different breeds between 20 and 40 kilograms body weight that were treated by TPLO (n = 48) or MMP (n = 19) following the rupture of the cranial cruciate ligament. The TPLO group was further divided into a group operated by two experienced surgeons (TPLO1, n = 25) and a second group operated by several surgeons with different experience (TPLO2, n = 23). Following a post-operative time period of more than one year in the least (mean, 3.15 ± 1.21 years) orthopedic and radiographic examinations as well as separate unilateral and bilateral gait analyses were conducted. In addition, gait analysis data were compared with an orthopedically healthy control group. RESULTS: No significant and clinically relevant differences were observed between the 3 groups in the results of their orthopedic examination.Osteoarthritis progression showed similar values in all 3 surgical groups. On average per year this feature was slightly but statistically significantly lower in the TPLO2 group in comparison to the TPLO1 and MMP groups.Gait analysis during walking exhibited significant differences in bilateral ruptures at the Peak Vertical Force and the Vertical Impulse, especially when compared to the healthy control group. Stance phase duration did not show any significant differences. At trot, no significant differences were found between the 3 surgical groups. CONCLUSION: Both surgical techniques achieved good clinical, radiological, and gait analysis results in the 3 groups at long-term follow-up, even when compared with a healthy control group. CLINICAL RELEVANCE: MMP can be considered a rapid feasible alternative to the established TPLO method also bearing satisfactory results in dogs. The degree of the surgeon's experience does not seem to influence the outcome.
Assuntos
Lesões do Ligamento Cruzado Anterior , Doenças do Cão , Osteoartrite , Cães , Animais , Ligamento Cruzado Anterior/diagnóstico por imagem , Ligamento Cruzado Anterior/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/veterinária , Osteotomia/veterinária , Osteotomia/métodos , Joelho de Quadrúpedes/diagnóstico por imagem , Joelho de Quadrúpedes/cirurgia , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Ruptura/diagnóstico por imagem , Ruptura/cirurgia , Ruptura/veterinária , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Osteoartrite/veterináriaRESUMO
OBJECTIVE: The aim of this study was to compare outcomes after tibial plateau levelling osteotomy (TPLO) and modified Maquet procedure (MMP) for the treatment of cranial cruciate ligament rupture (CCLR) in dogs using clinical and radiographic evaluation and treadmill-based force plate gait analysis. STUDY DESIGN: This study was a prospective, randomized, controlled study. MATERIALS AND METHODS: Sixty-one dogs (76 joints) with CCLR were treated with TPLO (n = 30 dogs, 41 joints) or MMP (n = 31 dogs, 35 joints) and compared with a control group of 16 healthy Labrador Retrievers. Outcomes after surgery were compared by clinical orthopaedic assessment, radiographic evaluation and force plate gait analysis performed preoperatively, and then at 6 weeks, 3 and 6 months postoperatively. For objective comparison of ground reaction forces, the data were compared with the control group. Major complications were reported. RESULTS: A significant improvement in ground reaction forces was reached in all surgically treated dogs. No significant difference was found between the surgical methods at any postoperative re-examination. With regard to peak vertical force (PVF), there were significantly more patients with TPLO within the reference range of healthy dogs at the 3 months re-examination than dogs with MMP. There was no significant difference in mean value comparisons between TPLO and control groups 6 months postoperatively. Compared with the control group, mean values of 93.9% (PVF) and 85.9% (vertical impulse [VI]) were reached by the TPLO group and 89.4% (PVF) and 79.9% (VI) by the MMP group, 6 months postoperatively.No significant differences were found regarding major complications or progression of osteoarthritis. CONCLUSIONS: Although no significant differences were found between the surgical methods, TPLO patients showed superiority with regard to clinical outcome.