Comparação entre métodos para o cálculo do avanço da tuberosidade tibial, em cães

Abstract

Cranial cruciate ligament rupture causes joint instability and is one of the most common causes of lameness in dogs. One of the most popular current surgical techniques for the treatment of this condition is the tibial tuberosity advancement (TTA). The main objectives were to compare the advance calculation methods described by Koch (2016), Ness (2011), the tibial plateau by Slocum (1993), the common tangent by Dennler et al. (2006) and the table with pre-established values according to the animal weight presented by Vezzoni (2010), also checking between the two stifles of the same animal, if the necessary advance would be the same; and whether the advancement required indicated by the methods used in the study is compatible with the size of cages manufactured in Brazil for standard TTA and TTA rapid technique. For this, digital radiographs of 80 knees from 40 dogs attended at a diagnostic imaging clinic were performed, excluding dogs presenting tibial plateau angle above 30 degrees. Then, the advance calculation methods in question were performed and these values were compared between themselves and between the two members of the same dog. In the present study, it was observed that there is no significant difference between the tibial plateau methods, Ness (2011) and Koch (2016) methods, but there is a difference between such methods and the common tangent methods and the table with pre-established measures by Vezzoni (2010). There was also a moderate confidence index when comparing the pre-defined frame method with all other methods, as well as the common tangent with all other methods except the tibial plateau method, which demonstrated a good reliability index. This positive result was also observed when compare the other methods among themselves. As to the side, no significant difference was observed between right and left limbs, except in the method described by Ness (2011) (p = 0.038). It was also observed in the research that the implants available in the Brazilian market, in most cases, are not exactly coincident with the measures found, being able to lead to a minor or excessive advancement of tibial tuberosity.