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Banks et al: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
Veterinary Surgery 8, 2024

🔍 Key Findings

  • Oxley's modified CCWO did not achieve the target TPA of 5° in most cases, even with planning.
  • Mean planned TPA was 7.6°, higher than target, and consistent across dog sizes.
  • Postoperative TPAs were significantly higher in small dogs (median 7°) than in large dogs (median 4.5°).
  • Distalization >7.5 mm of the osteotomy from the patellar tendon led to increased under-correction of TPA.
  • Only dogs with preoperative TPA >35° achieved post-planning TPAs close to the 5° target.
  • Postoperative osteotomy positions were generally more distal than recommended (8.6 mm median).
  • Virtual plate fit was appropriate for all dogs at 5 mm or 7.5 mm positions, suggesting no need for excessive distalization.
  • Excessive correction leading to negative TPAs occurred in some cases, risking caudal cruciate ligament strain.

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← Articles

Banks et al: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
Veterinary Surgery 8, 2024

🔍 Key Findings

  • Oxley's modified CCWO did not achieve the target TPA of 5° in most cases, even with planning.
  • Mean planned TPA was 7.6°, higher than target, and consistent across dog sizes.
  • Postoperative TPAs were significantly higher in small dogs (median 7°) than in large dogs (median 4.5°).
  • Distalization >7.5 mm of the osteotomy from the patellar tendon led to increased under-correction of TPA.
  • Only dogs with preoperative TPA >35° achieved post-planning TPAs close to the 5° target.
  • Postoperative osteotomy positions were generally more distal than recommended (8.6 mm median).
  • Virtual plate fit was appropriate for all dogs at 5 mm or 7.5 mm positions, suggesting no need for excessive distalization.
  • Excessive correction leading to negative TPAs occurred in some cases, risking caudal cruciate ligament strain.

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Multiple Choice Questions on this study

In Banks 2024 et al., on CCWO outcomes, what was the **median postoperative TPA** in small dogs?

A. 4.5°
B. 5.0°
C. 5.5°
D. 6.0°
E. 7.0°

Answer: 7.0°

Explanation: Median postoperative TPA in small dogs was 7°, exceeding the target.
In Banks 2024 et al., on CCWO planning accuracy, which **group based on preoperative TPA** was closest to the 5° TPA target postoperatively?

A. ≤20°
B. 21–25°
C. 26–30°
D. 31–35°
E. >35°

Answer: >35°

Explanation: Dogs with preoperative TPA >35° (eTPA) were closest to achieving the 5° goal.
In Banks 2024 et al., on CCWO planning accuracy, what was the **mean planned tibial plateau angle (TPA)** using Oxley’s modified method?

A. 5°
B. 6.0°
C. 7.6°
D. 8.4°
E. 10.1°

Answer: 7.6°

Explanation: Mean planned TPA across all groups was 7.6°, exceeding the 5° target.
In Banks 2024 et al., on CCWO technique, what was the observed effect of **osteotomy distalization >7.5 mm**?

A. It improved implant fit without affecting TPA
B. It had no effect on outcome
C. It improved TPA correction
D. It caused progressive TPA under-correction
E. It led to excessive shortening

Answer: It caused progressive TPA under-correction

Explanation: Osteotomy performed >7.5 mm distal to the patellar tendon led to worse TPA correction.
In Banks 2024 et al., on CCWO complications, what is a potential **consequence of negative TPA** resulting from overcorrection?

A. Improved patellar tracking
B. Increased limb length
C. Caudal cruciate ligament strain
D. Medial meniscus impingement
E. Increased implant stress

Answer: Caudal cruciate ligament strain

Explanation: Negative TPA shifts load to the caudal cruciate ligament, risking injury.

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