Stopień powikłań po 214 kolejnych zabiegach TTA stosowanych w terapii zerwania więzadła krzyżowego przedniego

Our study offers a contradictory result, because four of the revision surgeries were performed after initially releasing the medial meniscus. The differences could be explained by: the different techniques (TPLO vs TTA), the reported advantage of not minimally opening a joint (4), the individual techniques of releasing a meniscus (axial or abaxial), the body weight of the patient and the postoperative protocol. The pathogenesis of late meniscal injuries should be seen in the light of the biomechanical change produced by the osteotomies.

For the TTA technique, it was suspected that the selection of a too small cage size would not sufficiently eliminate shear forces (8). Experimental studies with oversized cages resulted in caudally directed shear forces (24). In the postoperative period, stifle joints are not fully held in place by the joint capsule, muscles or bandages, which may explain why the caudal horn of the medial meniscus may be exposed to unphysiological loading and subsequently, be wedged and torn. This underlines the need for accurate surgical planning and optimal postoperative physiotherapy.

Major complications as a sequel to infection were few. Fistulation may have been the result of loosened screws. Using titanium implant material for TTA surgery may further reduce the risk of infections (26). Patellar luxation probably occurred because the osteotomy planes were not perpendicular to the sagittal plane of the tibial. As the cut is made from the medial to the [...]

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