Evaluation of a crescent saw guide for tibial plateau-leveling osteotomy: An ex vivo study.

Veterinary surgery : VS Pub Date : 2022-04-01 Epub Date: 2022-02-16 DOI:10.1111/vsu.13781
Lindsay C Peterson, Stanley E Kim, Adam H Biedrzycki
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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.

评估新月锯引导胫骨平台水平截骨:一项离体研究。
目的:评价一种新型的新月形胫骨平台-水平截骨(TPLO)锯导器(新月形导器)在新手中辅助锯控制的有效性。研究设计:体外研究。样本群体:合成骨(n = 54)和中等大小的狗骨盆肢(n = 36)。方法:6名没有TPLO手术经验的参与者(实习生和住院医师)分别对中型犬的合成胫骨模型进行了9次截骨,对尸体肢体进行了6次截骨。将月牙形导骨器与标准导骨器和带导骨器的径向锯导骨器进行了比较。截骨角度、偏心距离(DOE)和胫骨内侧皮质损伤(仅合成骨模型)从校准的照片中测量。参与者对他们使用每种技术的体验进行了打分。结果:在合成骨模型和尸体上,3种对准装置在DOE、冠状或轴向截骨角度上无差异。月牙形导轨的平均内侧皮质损伤(3.8±7.3 mm2)低于桡骨导轨(35.7±27 mm2)和标准支架(51.2±63.2 mm2) (P =结论:截骨定位的准确性没有差异,但月牙形导轨的皮质损伤更小,参与者的认知更良好。临床意义:在新手TPLO手术中,新月形导具可以改善桡骨锯的控制,但似乎不能帮助准确的截骨定位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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