Excessive TPA

Question 1

Story VS 2024

impact of 4 sx to correct eTPA

Answer 1

Schlag: CBLO and CCWO -> greatest mechanical shift
Talaat 2006: TPLO and CCWO -> tibial shortening
Frederick and Cross 2017: mCCWO
Fox 2019: proximal tibial neutral wedge osteotomy

TPA correction accuracy varied least with CBLO and CCWO, and mCCWO

all achieved <14deg TPA

Question 2

Worden VCOT 2023
(Oxley)

radiographic comparison of 6 virtual surgical corrective options for eTPA

Answer 2

-CCWO (wallace 2011)
-Modified CCWO (Fred and Cross 2017) - balances moderate alterations to tibial geomtry while preserving osteotomy overlap
-Isosceles CCWO (Oxley 2013)
-Neutral isosceles CCWO
-TPLO/CCWO (Talaat 2006) - least effect on tibial morphology alteration
-Coplanar CBLO (Schlag 2020) - largest change to tibial morphology

Question 3

Schlag VS 2020

Retrospective, eTPA
CBLO and CCWO

Answer 3

Minimal complications
All healed 8w postop

Duerr VS 2008 osteotomy healing

Question 4

Terreros VS 2020

Retrospective, eTPA
Modified CCWO (incomplete cut)

Answer 4

11% comp rate
progression in OA noted in all

Question 5

Shimada VCOT 2022

eTPA models created
effect of TPLO

Answer 5

eTPA induced CrCL degeneration can be suppressed by prophylactically performing TPLO

Question 6

Ichinohe AJVR 2021

cadaveric eTPA on ligament tensile load

Answer 6

increasing load increases tensile forces on craniomedial and caudolateral CrCL but not on collateral ligs

at 60N load, tensile force on craniomedial band, but not other lig, was greater for eTPA group

Question 7

Dumartinent JAAHA 2021

2 case reports eTPA secondary to growth anomaly

Answer 7

double cut CORA + CCWO led to good outcome