Tibial Plateau Levelling Osteotomy and Lateral Fabellotibial Suture for Cranial and Internal Rotational Stability of the Tibia

Objective:
To report the use of tibial plateau leveling osteotomy and lateral fabellotibial suture in combination for treatment of pre-operative severe internal tibial rotational instability in cranial cruciate deficient stifles.

Methods:
Twenty-three stifles in nineteen dogs were diagnosed with cranial cruciate ligament rupture with concurrent severe internal rotation of the tibia. A combined tibial plateau leveling osteotomy and lateral fabellotibial suture procedure were performed to stabilize the stifle joint and eliminate tibial internal rotational instability. The surgical complications, short-term lameness scores and owner satisfaction were evaluated.

Results:
The postoperative complication rate was 21.7% with two minor (8.7%) and three major (13.0%) complications. At short-term follow-up one dog had an intermittent low- grade lameness and two dogs had some degree of tibial internal rotational instability present on palpation without lameness. Owner’s overall satisfaction with the operation and recovery was good (21.4%) to excellent (78.6%).

Clinical Significance:
The use of lateral fabellotibial suture in combination with tibial plateau leveling osteotomy is an effective technique for managing cranial cruciate ligament rupture with severe pre-operative internal tibia rotation instability.