한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제41권4호
  • /
  • Pages.228-233
  • /
  • 2024
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지
DOI QR코드

DOI QR Code

Cranial Tibial Wedge Osteotomy for Treatment of Concomitant Cranial Cruciate Ligament Rupture and Medial Patellar Luxation Using Patient-Specific Surgical Guide in an Immature Cat

  • Ho-Hyun Kwak (College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Su-Hwan Koh (College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Jun-Hyung Kim (College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University) ;
  • Heung-Myong Woo (College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University)
  • 투고 : 2024.06.23
  • 심사 : 2024.08.11
  • 발행 : 2024.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 7-month-old, 5.2 kg spayed female Norwegian Forest cat was referred for chronic, non-weight-bearing lameness in the left pelvic limb that has been present since 3 months old and has not responded to medical conservative therapy. Based on orthopedic and radiographic examination, concomitant cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL) of the left hind limb were diagnosed. In this case, cranial tibial wedge osteotomy (CTWO) was adopted to overcome side effect of performing other osteotomy techniques such as impairing the growth plates in the proximal tibia. Additionally, patient-specific surgical guides were applied to improve surgical accuracy. The patient showed an improvement in weight-bearing scores and gait condition during follow-up periods without complications. In our case, CTWO combined with corrective surgery for MPL can be used to treat concomitant CCLR and MPL without damaged on the growth plates and shows good clinical outcomes in an immature cat. Furthermore, the use of a surgical guide facilitates surgical procedures that minimize surgical error and increase surgical precision. This case study suggests that CTWO assisted by patient-specific surgical guides may be a viable surgical option for treating an immature cat with concomitant CCLR and MPL.

키워드

참고문헌

  1. Bailey CJ, Smith BA, Black AP. Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs. Vet Comp Orthop Traumatol 2007; 20: 169-174.  https://doi.org/10.1160/VCOT-06-02-0012
  2. Boge GS, Engdahl K, Moldal ER, Bergstrom A. Cranial cruciate ligament disease in cats: an epidemiological retrospective study of 50 cats (2011-2016). J Feline Med Surg 2020; 22: 277-284.  https://doi.org/10.1177/1098612X19837436
  3. Bula E, Perry KL. Tibial tuberosity transposition advancement for treatment of concomitant cranial cruciate ligament rupture and medial patellar luxation in four feline stifles. JFMS Open Rep 2021; 7: 20551169211044695. 
  4. Clarke SP, Bennett D. Feline osteoarthritis: a prospective study of 28 cases. J Small Anim Pract 2006; 47: 439-445.  https://doi.org/10.1111/j.1748-5827.2006.00143.x
  5. Corr SA, Brown C. A comparison of outcomes following tibial plateau levelling osteotomy and cranial tibial wedge osteotomy procedures. Vet Comp Orthop Traumatol 2007; 20: 312-319.  https://doi.org/10.1160/VCOT-07-02-0013
  6. Crosse KR, Worth AJ. Computer-assisted surgical correction of an antebrachial deformity in a dog. Vet Comp Orthop Traumatol 2010; 23: 354-361.  https://doi.org/10.1055/s-00035023
  7. Fauron AH, Bruce M, James DR, Owen MA, Perry KL. Surgical stabilization of concomitant canine medial patellar luxation and cranial cruciate ligament disease. Effect of fixation method on postoperative complication rate and clinical outcome. Vet Comp Orthop Traumatol 2017; 30: 209-218.  https://doi.org/10.3415/VCOT-16-10-0148
  8. Flesher K, Beale BS, Hudson CC. Technique and outcome of a modified tibial plateau levelling osteotomy for treatment of concurrent medial patellar luxation and cranial cruciate ligament rupture in 76 stifles. Vet Comp Orthop Traumatol 2019; 32: 26-32.  https://doi.org/10.1055/s-0038-1676296
  9. Hoots EA, Petersen SW. Tibial plateau leveling osteotomy and cranial closing wedge ostectomy in a cat with cranial cruciate ligament rupture. J Am Anim Hosp Assoc 2005; 41: 395-399.  https://doi.org/10.5326/0410395
  10. Hulse D, Hyman W, Beale B, Saunders B, Peycke L, Hosgood G. Determination of isometric points for placement of a lateral suture in treatment of the cranial cruciate ligament deficient stifle. Vet Comp Orthop Traumatol 2010; 23: 163-167.  https://doi.org/10.3415/VCOT-09-05-0054
  11. Kim SE, Pozzi A, Kowaleski MP, Lewis DD. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37: 111-125.  https://doi.org/10.1111/j.1532-950X.2007.00361.x
  12. Kowaleski MP, Boudrieau RJ, Pozzi A. Stifle joint. In: Johnston SA, Tobias KM, editors. Veterinary surgery: small animal. 2nd ed. St. Louis: Elsevier. 2017: 1071-1167. 
  13. Lampart M, Knell S, Pozzi A. [A new approach to treatment selection in dogs with cruciate ligament rupture: patient-specific treatment recommendations]. Schweiz Arch Tierheilkd 2020; 162: 345-364. German.  https://doi.org/10.17236/sat00261
  14. Langenbach A, Marcellin-Little DJ. Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling. J Small Anim Pract 2010; 51: 97-103.  https://doi.org/10.1111/j.1748-5827.2009.00854.x
  15. Loughin CA, Kerwin SC, Hosgood G, Ringwood PB, Williams J, Stefanacci JD, et al. Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002). J Am Vet Med Assoc 2006; 228: 1370-1375.  https://doi.org/10.2460/javma.228.9.1370
  16. McLaughlin RM. Surgical diseases of the feline stifle joint. Vet Clin North Am Small Anim Pract 2002; 32: 963-982.  https://doi.org/10.1016/S0195-5616(02)00021-9
  17. Mindner JK, Bielecki MJ, Scharvogel S, Meiler D. Tibial plateau levelling osteotomy in eleven cats with cranial cruciate ligament rupture. Vet Comp Orthop Traumatol 2016; 29: 528-535.  https://doi.org/10.3415/VCOT-15-11-0184
  18. Nelson SA, Krotscheck U, Rawlinson J, Todhunter RJ, Zhang Z, Mohammed H. Long-term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs. Vet Surg 2013; 42: 38-50.  https://doi.org/10.1111/j.1532-950X.2012.01052.x
  19. Perez-Mananes R, Burro JA, Manaute JR, Rodriguez FC, Martin JV. 3D surgical printing cutting guides for open-wedge high tibial osteotomy: do it yourself. J Knee Surg 2016; 29: 690-695.  https://doi.org/10.1055/s-0036-1572412
  20. Perry K, Fitzpatrick N. Tibial tuberosity advancement in two cats with cranial cruciate ligament deficiency. Vet Comp Orthop Traumatol 2010; 23: 196-202.  https://doi.org/10.3415/VCOT-09-02-0014
  21. Ruthrauff CM, Glerum LE, Gottfried SD. Incidence of meniscal injury in cats with cranial cruciate ligament ruptures. Can Vet J 2011; 52: 1106-1110. 
  22. Scavelli TD, Schrader SC. Nonsurgical management of rupture of the cranial cruciate ligament in 18 cats. J Am Anim Hosp Assoc 1987; 23: 337-340. 
  23. Sousa RD, Sutcliffe M, Rousset N, Holmes M, Langley-Hobbs SJ. Treatment of cranial cruciate ligament rupture in the feline stifle. Biomechanical comparison of a standard fabella-tibial suture and lateral sutures placed between quasi-isometric points. Vet Comp Orthop Traumatol 2015; 28: 401-408.  https://doi.org/10.3415/VCOT-14-05-0078
  24. Yeadon R, Fitzpatrick N, Kowaleski MP. Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog. Surgical technique, radiographic and clinical outcomes. Vet Comp Orthop Traumatol 2011; 24: 18-26. https://doi.org/10.3415/VCOT-10-01-0015