DOI
https://doi.org/10.18849/ve.v5i2.297Abstract
PICO question
In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
There were no papers that answered the PICO question
Strength of evidence
Zero
Outcomes reported
Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg
Conclusion
Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Bergh, M.S., Sullivan, C., Ferrell, C. L., Troy, J. & Budsberg, S.C. 2014. ‘Systematic review of surgical treatments for cranial cruciate ligament disease in dogs.’ Journal of the American Animal Hospital Association. 50(5): 315–321. DOI: http://dx.doi.org/10.5326/JAAHA-MS-6356
Di Dona, F., Della Valle, G., Lamagna, F., Balestriere, C., Del Prete, C. & Fatone, G. 2015. ‘Force plate analysis for comparison of lateral fabellar suture and Maquet Modified Procedure Tibial Tuberosity Advancement techniques for treatment of dogs with cranial cruciate ligament disease.’ Joint meeting, LXIX Convegno SISVet, XV Convegno SICV, XIII Convegno SIRA, XII Convegno AIPVet, XI Convegno SoFiVet, II Convegno RNIV, Perugia, Italia 15–17 giugno 2015. Atti 2015. 229.
Hamilton, M. 2016. ‘TPLO, TTA or lateral suture? What's the difference?’ BSAVA Congress 2016 Proceedings, 7–10 April 2016, Birmingham, UK. 324. DOI: https://doi.org/22233/9781910443446.35.2
Innes, J.F. 2012. ‘Management of cruciate ligament rupture: what is 'best practice'?’ Veterinary Ireland Journal. 2(1): 36–41.
Krotscheck, U., Nelson, S.A., Todhunter, R.J., Stone, M. & Zhang, Z. 2016. ‘Long term functional outcome of tibial tuberosity advancement vs. tibial plateau leveling osteotomy and extracapsular repair in a heterogeneous population of dogs.’ Veterinary Surgery. 45(2): 261–268. DOI: https://doi.org/10.1111/vsu.12445
Krotschek, U., Nelson, S.A., Rawlinson, J., Todhunter, R.J., Stone, M., Zhang, Z. & Mohammed, H. ‘Long-Term Functional Outcome of Tibial Plateau Leveling Osteotomy Versus Extracapsular Repair in a Heterogenous Population of Dogs’, Veterinary Surgery. 42(1): 38–50. DOI: https://doi.org/10.1111/j.1532-950X.2012.01052.x
Mölsä, S.H., Hyytiäinen, H.K., Hielm-Björkman, A.K. & Laitinen-Vapaavuori, O.M. 2014. ‘Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs.’ BMC Veterinary Research, 10: 266. DOI: http://dx.doi.org/10.1186/s12917-014-0266-8
Mölsä, S.H., Hyytiäinen, H.K., Hielm-Björkman, A.K. & Laitinen-Vapaavuori, O.M. 201 ‘Use of an owner questionnaire to evaluate long-term surgical outcome and chronic pain after cranial cruciate ligament repair in dogs: 253 cases (2004–2006).’ Journal of the American Veterinary Medical Association. 243(5): 689–695. DOI: http://dx.doi.org/10.2460/javma.243.5.689
Muir, P. 2018. Advances In The Cranial Cruciate Ligament, 2nd Hoboken:NJ: Wiley: American College of Veterinary Surgeons, p.202.
Vasseur, P.B. 1984. ‘Clinical Results Following Nonoperative Management for Rupture of the Cranial Cruciate Ligament in Dogs’ Veterinary Surgery. 13(4): 243–246. DOI: http://dx.doi.org/10.1111/j.1532-950X.1984.tb00801.x
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