Cora Based Leveling Osteotomy (CBLO)

Cora Based Leveling Osteotomy (CBLO)

Osteotomy techniques are based on a dynamic stabilization of cranial cruciate ligament deficient stifles. This implies the rearrangement of forces in order to prevent cranial tibial trust during the stance phase. World-wide, TTA and TPLO are the leading techniques, with 90% owner satisfaction. However, in 10%, dogs may experience suboptimal function after osteotomy techniques. In cases where TPLO was performed, second look arthroscopy revealed cartilage lesions in the caudal joint compartment. These lesions most likely occur due to a pressure overload. Since TPLO pivots the tibial plateau to 6°, the stifle is in constant flexion. Animals may experience this as constantly walking downhill. In order to overcome this phenomenon, the osteotomy technique can be changed in an attempt to restore the mechanical tibial axis, prevent pressure differences, reduce the tibiale slope, advance the tibial tuberosity and reduce pressure on the caudal medial meniscus. In cases of excessive TPA (tibial plateau angle 30° or more), TTA is presumably less effective in neutralizing cranial trust forces.

Every canine tibia has a natural procurvatum. This physiologically results in a slope of the tibial plateau. Since the procurvatum automatically generates 2 axes (1 through the tibial plateau and 1 through the tibial diaphysis), there is a CORA (Center of Rotation of the Angulation). A semicircular rotation on the CORA reduces the procurvatum, restores the mechanical axis and advances the tibial crest. […]