Guénégo et al: Modified Cranial Closing Wedge Osteotomy (AMA-Based CCWO) to Treat Cranial Cruciate Ligament Deficient Stifle in 204 Dogs Over 50 Kg
Veterinary and Comparative Orthopaedics and Traumatology 3, 2025

🔍 Key Findings

  • AMA-based CCWO realigned the anatomical and mechanical axes in 82% of dogs >50 kg, with postoperative AMA angle of 0° in most cases.
  • Surgical site infection (SSI) rate was only 0.5%, markedly lower than TPLO-reported rates in similar populations (up to 37.5%).
  • All osteotomies achieved Grade 4 healing by 8 weeks, with no implant failures.
  • AMA-based planning based on preoperative AMA and TPA allowed for better correction of proximal tibial angulation compared to TPLO in large dogs.
  • Use of a double locking plate (DLP) fixation and Robert Jones bandage (RJB) contributed to improved mechanical stability and infection prevention.
  • Dogs with AMA angle >3.4° (hyper-CCAPT) were 38% of the cohort, supporting AMA as a critical metric in planning.
  • Postoperative alignment of the AA and MA was more consistently achieved when preoperative AMA was >2.4°, confirming suitability of AMA-based CCWO for severe angulation.
  • Most infections in TPLOs occur within 15 days, but RJB plus antibiotics in this study appeared protective, suggesting benefit for early-phase SSI prevention.

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