Combined Tibial Plateau Leveling Osteotomy and Cranial Tibial Closing Wedge Osteotomy for Surgical Management of Cranial Cruciate Ligament Rupture in 2 Dogs with Steep Tibial Plateau Angle

Farzad-Mohajeri, Saeed; Nouri-Mashhadi-Jafarloo, Melina; Sotoudefar, Mahya; Safavi, Seyedeh Fatemeh; Ashjaei, Mohammad Mahdi; Dehghan, Mohammad Mehdi

doi:10.30500/ivsa.2026.583112.1492

Combined Tibial Plateau Leveling Osteotomy and Cranial Tibial Closing Wedge Osteotomy for Surgical Management of Cranial Cruciate Ligament Rupture in 2 Dogs with Steep Tibial Plateau Angle

Articles in Press

Document Type : Clinical Report

Authors

Saeed Farzad-Mohajeri

Melina Nouri-Mashhadi-Jafarloo

Mahya Sotoudefar

Seyedeh Fatemeh Safavi

Mohammad Mahdi Ashjaei

Mohammad Mehdi Dehghan

Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.

10.30500/ivsa.2026.583112.1492

Abstract

Cranial cruciate ligament rupture is among the most common causes of hindlimb lameness in dogs, often leading to stifle instability, cranial tibial subluxation, pain, and progressive osteoarthritis. Tibial plateau leveling osteotomy is widely used to stabilize the stifle, but in dogs with an excessively steep tibial plateau angle, this technique alone may not achieve adequate correction within a safe biomechanical range. Cranial tibial closing wedge osteotomy offers an alternative, though relying on it alone for large corrections can risk limb shortening and patellar displacement. Combining the two procedures may offer a better surgical option. To our knowledge, this report describes the first clinical presentation, radiographic planning, surgical management, and short-term outcome of combined tibial plateau leveling osteotomy and cranial tibial closing wedge osteotomy in two dogs with cranial cruciate ligament rupture and a steep tibial plateau angle, in Iran. Two middle-aged spayed female dogs 17 kg (Case 1) and 15 kg (Case 2), with body condition scores of 8/9 and 9/9 presented with acute hindlimb lameness, following sudden pain during running in Case 1 and trauma in Case 2. Orthopedic examination in both revealed a positive cranial drawer test and tibial compression test with no muscle atrophy, indicating acute rupture. Radiographs confirmed the rupture and cranial tibial subluxation, with a tibial plateau angle of 36° in Case 1 and 36.6° in Case 2. Both angles were corrected to a target of 5° using 21° and 21.6° of rotational correction through tibial plateau leveling osteotomy, combined with 10° of correction via closing wedge osteotomy. Stabilization used Kirschner wires, a tension band wire, and a contoured plate. Postoperatively, the tibial compression test was negative in both dogs. Both were re-examined at four weeks, and Case 1 also at 12 weeks; both showed good implant positioning, sound bone healing, and comfortable ambulation.

Keywords

Canine

Lameness

Osteoarthritis

Osteotomy

Stifle

Subjects