Walker et al: Evaluation of a modified radiographic union scale for tibial fractures scoring system in staged bilateral tibial plateau leveling osteotomy procedures and comparison of first and second side radiographic bone healing
Veterinary Surgery 8, 2022

🔍 Key Findings

• TPLO mRUST scoring showed improved inter-rater reliability (ICC = 0.56) compared to subjective evaluation (Kappa = 0.33).
• Intra-rater reliability was similar for both methods (TPLO mRUST: 0.73, subjective: 0.72).
• TPLO mRUST scores ≥10/12 strongly correlated with radiographic union, as subjectively assessed (99% agreement).
• No significant difference in healing between first and second TPLO sides (P = .09), countering assumptions about load-bearing impact.
• Higher initial lameness scores and younger age were associated with higher TPLO mRUST scores, suggesting more robust healing in those groups.
• Postoperative complications were linked to lower TPLO mRUST scores, indicating impaired healing.
• Medial cortex was excluded from scoring due to plate obstruction, validating use of only 3 cortices for scoring.
• The TPLO mRUST system may standardize healing assessment, reducing subjective bias across specialties.