Lindsay C Peterson, Stanley E Kim, Adam H Biedrzycki
{"title":"Evaluation of a crescent saw guide for tibial plateau-leveling osteotomy: An ex vivo study.","authors":"Lindsay C Peterson, Stanley E Kim, Adam H Biedrzycki","doi":"10.1111/vsu.13781","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a novel crescent-shaped tibial plateau-leveling osteotomy (TPLO) saw guide (crescent guide) to assist with saw control in novice participants.</p><p><strong>Study design: </strong>Ex vivo study.</p><p><strong>Sample population: </strong>Synthetic bones (n = 54) and medium sized dog pelvic limbs (n = 36).</p><p><strong>Methods: </strong>The 6 participants (interns and residents) without any prior experience performing a TPLO each performed 9 osteotomies on synthetic tibia models, and 6 osteotomies in cadaveric limbs of medium-sized dogs. Osteotomies made with the crescent guide were compared with those made with a standard jig and a radial saw guide with a jig. Osteotomy angulation, distance of eccentricity (DOE), and medial tibial cortical damage (synthetic bone models only) were measured from calibrated photographs. Participants rated their experiences with each technique.</p><p><strong>Results: </strong>There was no difference in the DOE, coronal or axial osteotomy angulation between the 3 alignment devices for synthetic bone models or cadavers. Average medial cortical damage with the crescent guide (3.8 ± 7.3 mm<sup>2</sup> ) was lower than with the radial guide (35.7 ± 27 mm<sup>2</sup> ) and standard jig (51.2 ± 63.2 mm<sup>2</sup> ) guides (P = <.01). Five of 6 participants preferred the crescent guide over the standard jig and radial guide.</p><p><strong>Conclusion: </strong>There was no difference in accuracy of osteotomy positioning but using the crescent guide resulted in lower cortical damage and more favorable participant perceptions.</p><p><strong>Clinical relevance: </strong>The crescent guide may improve control of the radial saw during TPLO in novice surgeons but does not appear to aid accurate osteotomy positioning.</p>","PeriodicalId":123280,"journal":{"name":"Veterinary surgery : VS","volume":" ","pages":"509-519"},"PeriodicalIF":0.0000,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary surgery : VS","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.13781","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/2/16 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the effectiveness of a novel crescent-shaped tibial plateau-leveling osteotomy (TPLO) saw guide (crescent guide) to assist with saw control in novice participants.
Study design: Ex vivo study.
Sample population: Synthetic bones (n = 54) and medium sized dog pelvic limbs (n = 36).
Methods: The 6 participants (interns and residents) without any prior experience performing a TPLO each performed 9 osteotomies on synthetic tibia models, and 6 osteotomies in cadaveric limbs of medium-sized dogs. Osteotomies made with the crescent guide were compared with those made with a standard jig and a radial saw guide with a jig. Osteotomy angulation, distance of eccentricity (DOE), and medial tibial cortical damage (synthetic bone models only) were measured from calibrated photographs. Participants rated their experiences with each technique.
Results: There was no difference in the DOE, coronal or axial osteotomy angulation between the 3 alignment devices for synthetic bone models or cadavers. Average medial cortical damage with the crescent guide (3.8 ± 7.3 mm2 ) was lower than with the radial guide (35.7 ± 27 mm2 ) and standard jig (51.2 ± 63.2 mm2 ) guides (P = <.01). Five of 6 participants preferred the crescent guide over the standard jig and radial guide.
Conclusion: There was no difference in accuracy of osteotomy positioning but using the crescent guide resulted in lower cortical damage and more favorable participant perceptions.
Clinical relevance: The crescent guide may improve control of the radial saw during TPLO in novice surgeons but does not appear to aid accurate osteotomy positioning.