Laurie's Blogs.

A new research paper came out that looked at ROM in dogs following surgery for cruciate ligament rupture.  They wanted to compare the differences in stifle joint range of motion (ROM), both flexion angle (FA) and extension angle (FA), for dogs that underwent tibial tuberosity advancement (TTA), tibial plateau leveling osteotomy (TPLO) and tight rope (TR) procedures. 

This was a retrospective study, that evaluated the archived records of client-owned dogs treated at the Department of Veterinary Medical Sciences of the University of Bologna, Italy.  The inclusion criteria consisted of recording of the passive ROM (EA and FA) and the grade of lameness at the time of diagnosis (T0) of the CCL rupture, one month (T1) following the surgical procedure and, when available, even after 6 months (T6).

ROM Results

The results are rather interesting.  The figure below give the best visual description of the findings:

Figure 1: The histogram shows the percentage (%) of stifle joints with normal and abnormal angles in both the extension and the flexion angles. The values obtained at the time of diagnosis (T0) were considered to be baseline and were compared at 1 month (T1) and 6 months (T6) postoperatively. EA, extension angle; FA flexion angle; a) TTA; b) TPLO; c) TR. The asterisk on top of the bars indicates a significant p value.

The statistics above are shocking. I am honestly shocked at the ROM data.  The percentages of “normal” don’t seem to be good enough for any of the procedures, in my opinion.  But, I also don’t think that the main reason to undergo a surgery for cruciate repairs is to obtain 100% normal ROM.  The goal is / should be function (and hopefully, to delay or reduce osteoarthritis in the joint moving forward long term).  My 2 cents anyways!

So, what about function?  The researchers also looked at lameness scores.

TTA Group & Lameness

At T0, all the dogs had lameness. There was significant improvement in scores 1–4 at T1; score 0 (no lameness) increased to 39.3 % of the dogs at T1 and reached 90.9 % at T6.

TPLO Group & Lameness

T0: All the dogs showed lameness. There was a statistically significant improvement in lameness at both T1 and T6 (no lameness in 14.3 % and 95.7 %, respectively) without, however, a significant redistribution of scores.

TR Group & Lameness

At T0, all the dogs showed lameness. At T1, 25 % of the dogs had no lameness and, at T6, 62.5 % of the dogs had no lameness. At each examination point, there was an increase in the number of dogs without lameness which was statistically significant.

The Winner?

The paper obviously didn’t state a ‘winner’ in their reporting, but I will!  So if I care about ROM and lameness (which I do), then I would have to say that the TPLO is the winner of this contest.

And now you are up to date on a wee bit of ROM and lameness in cruciate repair cases.

Until next time,

Cheers!

Laurie

Reference:

Pinna S, Di Benedetto M, Tassani C. How does cruciate ligament rupture treatment affect range of motion in dogs? Vet J. 2024 Dec;308:106253.