Good clinical outcomes achieved in young dogs with tibial tuberosity avulsion fracture repairs when implants were left in situ past skeletal maturity
OBJECTIVETo evaluate outcomes of tibial tuberosity avulsion fractures (TTAF) in dogs with implants left in situ past skeletal maturity and to compare clinical outcomes with published outcomes in dogs whose implants were removed 4 to 6 weeks postoperatively. ANIMALS47 client-owned dogs. PROCEDURESIn...
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Published in: | Journal of the American Veterinary Medical Association Vol. 260; no. 15; pp. 1941 - 1946 |
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Language: | English |
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01-12-2022
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Abstract | OBJECTIVETo evaluate outcomes of tibial tuberosity avulsion fractures (TTAF) in dogs with implants left in situ past skeletal maturity and to compare clinical outcomes with published outcomes in dogs whose implants were removed 4 to 6 weeks postoperatively. ANIMALS47 client-owned dogs. PROCEDURESIn this retrospective study, 47 dogs had surgery to correct a TTAF before 10 months of age and had the implants left in situ past skeletal maturity. Of these, 42 were followed for a median of 36 months postoperatively. Short- and long-term complications were recorded and compared with historically published data in which the implants were removed within 6 weeks of surgery. RESULTS14% (6/42) of our population experienced minor long-term complications (stiffness and lameness), 6% (3/47) experienced major short-term complications (repair failure), and 14% (6/24) experienced major long-term complications (implant removal). There was no difference in long-term outcomes when compared with results of historical reports in which implants were removed 4 to 6 weeks postoperatively. Client satisfaction was high, with 93% (38/41) grading outcomes as excellent and 95% (39/41) stating they would have surgery performed again in retrospect. CLINICAL RELEVANCEImmature dogs with surgically repaired TTAFs have favorable long-term outcomes when the implants were left in situ past skeletal maturity. Dogs with TTAF repairs may not need implant removal unless it becomes clinically necessary. Avoiding a second procedure will decrease patient morbidity, recovery time, and cost. |
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AbstractList | OBJECTIVETo evaluate outcomes of tibial tuberosity avulsion fractures (TTAF) in dogs with implants left in situ past skeletal maturity and to compare clinical outcomes with published outcomes in dogs whose implants were removed 4 to 6 weeks postoperatively. ANIMALS47 client-owned dogs. PROCEDURESIn this retrospective study, 47 dogs had surgery to correct a TTAF before 10 months of age and had the implants left in situ past skeletal maturity. Of these, 42 were followed for a median of 36 months postoperatively. Short- and long-term complications were recorded and compared with historically published data in which the implants were removed within 6 weeks of surgery. RESULTS14% (6/42) of our population experienced minor long-term complications (stiffness and lameness), 6% (3/47) experienced major short-term complications (repair failure), and 14% (6/24) experienced major long-term complications (implant removal). There was no difference in long-term outcomes when compared with results of historical reports in which implants were removed 4 to 6 weeks postoperatively. Client satisfaction was high, with 93% (38/41) grading outcomes as excellent and 95% (39/41) stating they would have surgery performed again in retrospect. CLINICAL RELEVANCEImmature dogs with surgically repaired TTAFs have favorable long-term outcomes when the implants were left in situ past skeletal maturity. Dogs with TTAF repairs may not need implant removal unless it becomes clinically necessary. Avoiding a second procedure will decrease patient morbidity, recovery time, and cost. |
Author | Mason, David Kass, Philip H. Cabrera, Sady Y. Miller, Zachary A. |
Author_xml | – sequence: 1 givenname: Zachary A. surname: Miller fullname: Miller, Zachary A. organization: Department of Surgery, Las Vegas Veterinary Specialty Center, Las Vegas, NV, Department of Surgery, Metropolitan Animal Hospital, Copley, OH – sequence: 2 givenname: Sady Y. surname: Cabrera fullname: Cabrera, Sady Y. organization: Department of Surgery, Metropolitan Animal Specialty Hospital, Los Angeles, CA – sequence: 3 givenname: David surname: Mason fullname: Mason, David organization: Department of Surgery, Las Vegas Veterinary Specialty Center, Las Vegas, NV – sequence: 4 givenname: Philip H. surname: Kass fullname: Kass, Philip H. organization: Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA |
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References | Rossanese M, German AJ, Comerford E, Pettitt R, Tomlinson A, de Vicente F (ref16) 2019; 32 Linney WR, Hammer DL, Shott S (ref21) 2011; 238 Pratt JN (ref1) 2001; 149 Dymond NL, Goldsmid SE, Simpson DJ (ref12) 2010; 88 Stanke NJ, Stephenson N, Hayashi K (ref17) 2014; 55 Skelly CM, McAllister H, Donnelly WJ (ref4) 1997; 38 Johnson AL (ref9) 2018 Cook JL, Evans R, Conzemius MG (ref11) 2010; 39 Johnson KA, Goldsmid S (ref3) 1991; 4 Schiedel F, Probst A, Buller TC, Rödl R (ref13) 2009; 129 Mostafa AA, Griffon DJ, Thomas MW, Constable PD (ref15) 2008; 37 von Pfeil DJ, Decamp CE, Ritter M (ref22) 2012; 25 Zide AN, Jones SC, Litsky AS, Kieves NR (ref6) 2020; 33 DeAngelis M, Hohn RB (ref18) 1970; 156 Yeadon R, Fitzpatrick N, Kowaleski MP (ref14) 2011; 24 DeCamp CE, Johnston SA, Dejardin LM, Schaefer SL (ref19) 2006 von Pfeil DJ, Decamp CE, Diegel KL, Gholve PA, Probst CW, Dejardin LM (ref5) 2009; 22 Moyer AL, Hudson CC, Beale BS (ref7) 2019; 32 Gower JA, Bound NJ, Moores AP (ref2) 2008; 49 Hayashi K, Kapatkin AS (ref8) 2017 Cashmore RG, Havlicek M, Perkins NR (ref20) 2014; 27 von Pfeil DJF, Glassman M, Ropski M (ref10) 2017; 30 |
References_xml | – volume: 25 start-page: 524 issue: 6 year: 2012 ident: ref22 article-title: Minimally displaced tibial tuberosity avulsion fracture in nine skeletally immature large breed dogs. contributor: fullname: von Pfeil DJ, Decamp CE, Ritter M – volume: 149 start-page: 352 issue: 12 year: 2001 ident: ref1 article-title: Avulsion of the tibial tuberosity with separation of the proximal tibial physis in seven dogs. contributor: fullname: Pratt JN – volume: 38 start-page: 445 issue: 10 year: 1997 ident: ref4 article-title: Avulsion of the tibial tuberosity in a litter of Greyhound puppies. contributor: fullname: Skelly CM, McAllister H, Donnelly WJ – volume: 55 start-page: 349 issue: 4 year: 2014 ident: ref17 article-title: Retrospective risk factor assessment for complication following tibial tuberosity transposition in 137 canine stifles with medial patellar luxation. contributor: fullname: Stanke NJ, Stephenson N, Hayashi K – start-page: 670 year: 2006 ident: ref19 article-title: Fractures of the tibia and fibula contributor: fullname: DeCamp CE, Johnston SA, Dejardin LM, Schaefer SL – volume: 37 start-page: 201 issue: 3 year: 2008 ident: ref15 article-title: Proximodistal alignment of the canine patella: radiographic evaluation and association with medial and lateral patellar luxation. contributor: fullname: Mostafa AA, Griffon DJ, Thomas MW, Constable PD – volume: 32 start-page: 332 issue: 4 year: 2019 ident: ref16 article-title: Complications following surgical correction of medial patellar luxation in small-to-medium-size dogs. contributor: fullname: Rossanese M, German AJ, Comerford E, Pettitt R, Tomlinson A, de Vicente F – volume: 22 start-page: 257 issue: 4 year: 2009 ident: ref5 article-title: Does Osgood-Schlatter disease exist in the dog? contributor: fullname: von Pfeil DJ, Decamp CE, Diegel KL, Gholve PA, Probst CW, Dejardin LM – volume: 30 start-page: 279 issue: 4 year: 2017 ident: ref10 article-title: Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases. contributor: fullname: von Pfeil DJF, Glassman M, Ropski M – volume: 4 start-page: 54 issue: 2 year: 1991 ident: ref3 article-title: Complications of canine tibial tuberosity avulsion fractures. contributor: fullname: Johnson KA, Goldsmid S – start-page: 1015 year: 2018 ident: ref9 article-title: Management of specific fractures contributor: fullname: Johnson AL – volume: 49 start-page: 340 issue: 7 year: 2008 ident: ref2 article-title: Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. contributor: fullname: Gower JA, Bound NJ, Moores AP – volume: 27 start-page: 263 issue: 4 year: 2014 ident: ref20 article-title: Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. contributor: fullname: Cashmore RG, Havlicek M, Perkins NR – volume: 33 start-page: 9 issue: 1 year: 2020 ident: ref6 article-title: A cadaveric evaluation of pin and tension band configuration strength for tibial tuberosity osteotomy fixation. contributor: fullname: Zide AN, Jones SC, Litsky AS, Kieves NR – volume: 156 start-page: 587 issue: 5 year: 1970 ident: ref18 article-title: Evaluation of surgical correction of canine patellar luxation in 142 cases. contributor: fullname: DeAngelis M, Hohn RB – volume: 129 start-page: 1271 issue: 9 year: 2009 ident: ref13 article-title: The postoperative patella height: a comparison of additive and subtractive high tibial osteotomy in correcting the genu varum. contributor: fullname: Schiedel F, Probst A, Buller TC, Rödl R – volume: 88 start-page: 381 issue: 10 year: 2010 ident: ref12 article-title: Tibial tuberosity advancement in 92 canine stifles: initial results, clinical outcome and owner evaluation. contributor: fullname: Dymond NL, Goldsmid SE, Simpson DJ – volume: 32 start-page: A13 issue: 4 year: 2019 ident: ref7 article-title: Outcome of tibial tuberosity avulsion repaired by pin (Kirschner wire) fixation with or without a tension band contributor: fullname: Moyer AL, Hudson CC, Beale BS – start-page: 1176 year: 2017 ident: ref8 article-title: Fractures of the tibia and fibula contributor: fullname: Hayashi K, Kapatkin AS – volume: 238 start-page: 1168 issue: 9 year: 2011 ident: ref21 article-title: Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998–2009). contributor: fullname: Linney WR, Hammer DL, Shott S – volume: 39 start-page: 905 issue: 8 year: 2010 ident: ref11 article-title: Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. contributor: fullname: Cook JL, Evans R, Conzemius MG – volume: 24 start-page: 18 issue: 1 year: 2011 ident: ref14 article-title: 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. contributor: fullname: Yeadon R, Fitzpatrick N, Kowaleski MP |
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Title | Good clinical outcomes achieved in young dogs with tibial tuberosity avulsion fracture repairs when implants were left in situ past skeletal maturity |
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