[논문]Effects of Osteotomy Angle on Tibial Angulation and Torsion During CORA-Based Leveling Osteotomy in Toy Breed Dogs: A Computer Modeling-Based Study

Jeong, Youngeun; Jeong, Jaemin; Cho, Cheongwoon; Jeong, SeongMok; Lee, Hae Beom

doi:10.17555/jvc.2020.08.37.4.175

Effects of Osteotomy Angle on Tibial Angulation and Torsion During CORA-Based Leveling Osteotomy in Toy Breed Dogs: A Computer Modeling-Based Study 원문보기

Journal of veterinary clinics = 한국임상수의학회지, v.37 no.4, 2020년, pp.175 - 179

Jeong, Youngeun (College of Veterinary Medicine, Chungnam National University) , Jeong, Jaemin (College of Veterinary Medicine, Chungnam National University) , Cho, Cheongwoon (College of Veterinary Medicine, Chungnam National University) , Jeong, SeongMok (College of Veterinary Medicine, Chungnam National University) , Lee, Hae Beom (College of Veterinary Medicine, Chungnam National University)

Abstract ▼ AI-Helper

The objective of this study was to determine the effect of osteotomy angle and tibial proximal segment rotation angle on angular and torsional tibial deformities and to assess the trends of these deformities during the rotation of the tibial proximal segment in a center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) by performing computer modeling of the tibia. Four tibias of toy breed dogs with no history of lameness were used in this study. Osteotomies were performed in the proximal tibias at angles of 0°, 10°, 20°, -10°, and -20°, perpendicular to either the proximodistal or craniocaudal tibial axes. The mechanical medial proximal tibial angle (mMPTA) and transcondylar (TC) and distal cranial tibial (CnT) axes were used to measure angular and torsional deformities, respectively. All tibias showed an increase in angular and rotational deformities with an increase in the tibial plateau rotation angle. The tibia with osteotomies performed in the proximodistal and craniocaudal directions showed the highest magnitude of torsional and angular deformities, respectively. The results of this study revealed a tendency of occurrence of angular and torsional deformities with osteotomy performed along the proximodistal and craniocaudal directions in the CBLO.

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문제 정의

The objective of this study was to describe the effect of the osteotomy angle and tibial proximal segment rotation angle on angular and torsional tibial deformities and to assess the trends of these deformities during rotation of the tibial proximal segment in the CBLO by using computer modeling. We hypothesized that angular and torsional limb deformities after the CBLO procedure may result from an osteotomy that is not truly perpendicular to the craniocaudal axis or not parallel to the tibial plateau.
The maximum angular and torsional deformities were confirmed to be approximately 10° in the craniocaudal and proximodistal directions, respectively. Therefore, our hypothesis that the deformity according to the magnitude of saw blade angulation will increase can be proved in this study.
The results of this study revealed a tendency of occurrence of angular and torsional deformity with osteotomy along the proximodistal and craniocaudal directions in the CBLO. To the best of our knowledge, the present study makes a clinically significant contribution as the first report in veterinary medicine to confirm the deformities according to the magnitude of saw blade angulation. Further studies on the difference between the medial aligned cortex and complete reduction during plate application are needed.

가설 설정

However, there were some cases in which the outcome did not correspond with the tendency of the angle size. In theory, for reduced osteotomies, the variation of angular or torsional deformity induced by tibial proximal segment rotation through an osteotomy angle along either the proximodistal or craniocaudal axes should be linearly related to both the degree of tibial proximal segment rotation and the angle of the osteotomy (21). The reasons for the deviations from the results of Wheeler et al.
The objective of this study was to describe the effect of the osteotomy angle and tibial proximal segment rotation angle on angular and torsional tibial deformities and to assess the trends of these deformities during rotation of the tibial proximal segment in the CBLO by using computer modeling. We hypothesized that angular and torsional limb deformities after the CBLO procedure may result from an osteotomy that is not truly perpendicular to the craniocaudal axis or not parallel to the tibial plateau.

제안 방법

Coordinate changes between landmarks for mMPTA, TC, and CnT on the tibia were used to calculate the magnitude of tibial angular and torsional deformity induced as the tibial proximal segment was rotated using 3d MAX. For each of the nine tibias, five data collections were performed.
Each test consisted of angular and torsional values recorded at 0° ,5° , 10° , 15° , 20° , 25° , and 30° of tibial proximal segment rotation.
This tibia was assigned the notation of PD (proximodistal) =0 and CC (craniocaudal) = 0, which indicates that the saw was at an angle of 0° , perpendicular to the proximal axis, and 0° , perpendicular to the craniocaudal axis. For the purpose of this study, the proximal and craniocaudal axes of the tibia were defined as being perpendicular to the tibial plateau and tibial mechanical axis, respectively. For all tibias, osteotomies with variations along the craniocaudal axis were perpendicular to the craniocaudal axis, CC = 0, and osteotomies with variation along the proximodistal axis were perpendicular to the proximodistal axis, PD = 0.
Therefore, the direction of deformity in each osteotomy is opposite to that of reported by Wheeler et al. Furthermore, Wheeler et al. performed manual tibial osteotomy and tibial proximal segment rotation, but in this study, it was performed more accurately using 3D computer software. Finally, this study could have yielded a more accurate result than did previous studies because unlike previous studies that used only one limb, this study used more limbs.
8 mm. In the resulting CT data set, the femur and tarsus were manually excluded to isolate the tibia, and 3D reconstruction of the tibia was performed using a 3D slicer (Slicer 4.10.2; open source software, www.slicer.org).
Tibial proximal segment rotation was achieved automatically during data collection. Mean angular and torsional tibial deformity values for each tibial proximal segment rotation point were determined for each tibia to evaluate trends in the induced limb deformity with varying tibial proximal segment rotation and tibial osteotomy angles.

대상 데이터

Four dogs were enrolled during the study period. Breeds consisted of one German spitz, one Toy Poodle, one Maltese, and one Chihuahua. One dog was female, one dog was spayed female and two dogs were castrated males.
Four dogs were enrolled during the study period. Breeds consisted of one German spitz, one Toy Poodle, one Maltese, and one Chihuahua.
Images were acquired using a CT scanner (Alexion^TM, Tosiba, Japan) with a slice thickness of 1 mm and an overlapping increment of 0.8 mm. In the resulting CT data set, the femur and tarsus were manually excluded to isolate the tibia, and 3D reconstruction of the tibia was performed using a 3D slicer (Slicer 4.

성능/효과

The inclusion criteria were having a CT scan of appropriate quality to allow reconstruction into the 3D model and with a complete tibia, being skeletally mature, weighing < 5 kg and not having orthopedic diseases including fractures, osteoarthritis or neoplasia.
The results of this study revealed a tendency of occurrence of angular and torsional deformity with osteotomy along the proximodistal and craniocaudal directions in the CBLO. To the best of our knowledge, the present study makes a clinically significant contribution as the first report in veterinary medicine to confirm the deformities according to the magnitude of saw blade angulation.

후속연구

To the best of our knowledge, the present study makes a clinically significant contribution as the first report in veterinary medicine to confirm the deformities according to the magnitude of saw blade angulation. Further studies on the difference between the medial aligned cortex and complete reduction during plate application are needed.
Therefore, deformity will be more severe after performing reduction for aligning of the medial cortex. However, this limitation is beyond the scope of our study, and further studies are required to assess the effect of medial aligned cortex on the development of iatrogenic deformity during CBLO.

참고문헌 (21)

Apelt D, Kowaleski MP, Dyce J. Comparison of computed tomographic and standard radiographic determination of tibial torsion in the dog. Vet Surg 2005; 34: 457-462.

상세보기
Aper R, Kowaleski MP, Apelt D, Tod Drost W, Dyce J. Computed tomographic determination of tibial torsion in the dog. Vet Radiol Ultrasound 2005; 46: 187-191.

상세보기
Aragon CL, Budsberg SC. Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog. Vet Surg 2005; 34: 93-98.

상세보기
Arnoczky S, Marshall J. The cruciate ligaments of the canine stifle: an anatomical and functional analysis. Am J Vet Res 1977; 38: 1807-1814.

상세보기
Dismukes DI, Tomlinson JL, Fox DB, Cook JL, Song KJE. Radiographic measurement of the proximal and distal mechanical joint angles in the canine tibia. Vet Surg 2007; 36: 699-704.

상세보기
Elkins A, Pechman R, Kearney M, Herron M. A retrospective study evaluating the degree of degenerative joint disease in the stifle joint of dogs following surgical repair of anterior cruciate ligament rupture. J Am Anim Hosp Assoc 1991; 27: 533-540.
Innes J, Bacon D, Lynch C, Pollard A. Long-term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147: 325-328.

상세보기
Jerram R, Walker A. Cranial cruciate ligament injury in the dog: pathophysiology, diagnosis and treatment. N Z Vet J 2003; 51: 149-158.

상세보기
Kim SE, Pozzi A, Kowaleski MP, Lewis DD. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111-125.

상세보기
Kishi EN, Hulse D. Owner evaluation of a cora-based leveling osteotomy for treatment of cranial cruciate ligament injury in dogs. Vet Surg 2016; 45: 507-514.

상세보기
Korvick D, Johnson A, Schaeffer D. Surgeons' preferences in treating cranial cruciate ligament ruptures in dogs. J Am Vet Med Assoc 1994; 205: 1318-1324.

상세보기
Korvick D, Pijanowski G, Schaeffer D. Three-dimensional kinematics of the intact and cranial cruciate ligament-deficient stifle of dogs. J Biomech 1994; 27: 77-87.

상세보기
Raske M, Hulse D, Beale B, Saunders WB, Kishi E, Kunze C. Stabilization of the CORA based leveling osteotomy for treatment of cranial cruciate ligament injury using a bone plate augmented with a headless compression screw. Vet Surg 2013; 42: 759-764.

상세보기
Reif U, Hulse DA, Hauptman JG. Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study. Vet Surg 2002; 31: 147-154.

상세보기
Slocum B, Devine T. Cranial tibial thrust: a primary force in the canine stifle. J Am Vet Med Assoc 1983; 183: 456-459.
Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777-795.

상세보기
Vasquez B, Hulse D, Beale B, Kerwin S, Andrews C, Saunders BW. Second-look arthroscopic findings after CORA-based leveling osteotomy. Vet Surg 2018; 47: 261-266.

상세보기
Vasseur P. Clinical results following nonoperative management for rupture of the cranial cruciate ligament in dogs. Vet Surg 1984; 13: 243-246.

상세보기
Vasseur P, Berry C. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992; 28: 129-136.
Warzee CC, Dejardin LM, Arnoczky SP, Perry RL. Effect of tibial plateau leveling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: An in vitro experimental study. Vet Surg 2001; 30: 278-286.

상세보기
Wh eler JL, C ross A R, G ingrich W. In v itro effects of osteotomy angle and osteotomy reduction on tibial angulation and rotation during the tibial plateau-leveling osteotomy procedure. Vet Surg 2003; 32: 371-377.

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