{"title":"单丝防旋转缝合联合TPLO防止枢轴移位：手术技术及新型TPLO钢板设计。","authors":"Dirsko J F von Pfeil, Parker N House","doi":"10.3389/fvets.2025.1456869","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To identify dogs at risk of developing pivot-shift (PS) following tibial-plateau-leveling-osteotomy (TPLO) using a rotational-instability-test (RI-test), describe a combination of a monofilament anti-rotational suture (ARS) with TPLO and assess this technique for feasibility, compare post-operative PS-incidence in dogs receiving a standard TPLO (TPLO-only) or a TPLO with ARS (TPLO+ARS), and design a novel TPLO-plate facilitating ARS-anchoring (TPLO/ARS-plate).</p><p><strong>Study design: </strong>In this clinical pilot trial on 85 client-owned dogs and instrumentation design study, the RI-test and ARS-placement-technique were described and performed. Reporting included: anesthesia and surgery times, bone-healing, post-TPLO-PS-incidence, follow-up and complications. Significance was set as <i>p</i> ≤ 0.05. Comprehensive engineering of a novel TPLO plate was performed.</p><p><strong>Results: </strong>Between TPLO-only (<i>n</i> = 57) and TPLO+ARS (<i>n</i> = 28) groups, significant differences were found for surgery time (<i>p</i> = 0.01), anesthesia time (<i>p</i><0.001) and bone healing scores (<i>p</i> = 0.03), all being longer/higher for TPLO+ARS. PS-incidence was 2/57 (TPLO-only) and 0/28 (TPLO+ARS) within the first 8 weeks post-surgery (<i>p</i> = 1.00). Medium follow-up was 642 days. Major complications during that time occurred in 2/57 (TPLO-only; infection and implant removal) and 1/28 (TPLO+ARS; infection, PS-development and implant removal) dogs (<i>p</i> = 1.00). A novel TPLO/ARS-plate was designed.</p><p><strong>Conclusion: </strong>Post-TPLO-PS might be reduced following ARS placement. Additional studies are indicated to validate and refine the RI-test and assess the novel TPLO/ARS-plate in the clinical setting.</p>","PeriodicalId":12772,"journal":{"name":"Frontiers in Veterinary Science","volume":"12 ","pages":"1456869"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490421/pdf/","citationCount":"0","resultStr":"{\"title\":\"Monofilament anti-rotational suture combined with TPLO to prevent pivot shift: surgical technique and novel TPLO plate design.\",\"authors\":\"Dirsko J F von Pfeil, Parker N House\",\"doi\":\"10.3389/fvets.2025.1456869\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To identify dogs at risk of developing pivot-shift (PS) following tibial-plateau-leveling-osteotomy (TPLO) using a rotational-instability-test (RI-test), describe a combination of a monofilament anti-rotational suture (ARS) with TPLO and assess this technique for feasibility, compare post-operative PS-incidence in dogs receiving a standard TPLO (TPLO-only) or a TPLO with ARS (TPLO+ARS), and design a novel TPLO-plate facilitating ARS-anchoring (TPLO/ARS-plate).</p><p><strong>Study design: </strong>In this clinical pilot trial on 85 client-owned dogs and instrumentation design study, the RI-test and ARS-placement-technique were described and performed. Reporting included: anesthesia and surgery times, bone-healing, post-TPLO-PS-incidence, follow-up and complications. Significance was set as <i>p</i> ≤ 0.05. Comprehensive engineering of a novel TPLO plate was performed.</p><p><strong>Results: </strong>Between TPLO-only (<i>n</i> = 57) and TPLO+ARS (<i>n</i> = 28) groups, significant differences were found for surgery time (<i>p</i> = 0.01), anesthesia time (<i>p</i><0.001) and bone healing scores (<i>p</i> = 0.03), all being longer/higher for TPLO+ARS. PS-incidence was 2/57 (TPLO-only) and 0/28 (TPLO+ARS) within the first 8 weeks post-surgery (<i>p</i> = 1.00). Medium follow-up was 642 days. Major complications during that time occurred in 2/57 (TPLO-only; infection and implant removal) and 1/28 (TPLO+ARS; infection, PS-development and implant removal) dogs (<i>p</i> = 1.00). A novel TPLO/ARS-plate was designed.</p><p><strong>Conclusion: </strong>Post-TPLO-PS might be reduced following ARS placement. Additional studies are indicated to validate and refine the RI-test and assess the novel TPLO/ARS-plate in the clinical setting.</p>\",\"PeriodicalId\":12772,\"journal\":{\"name\":\"Frontiers in Veterinary Science\",\"volume\":\"12 \",\"pages\":\"1456869\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490421/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Veterinary Science\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.3389/fvets.2025.1456869\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Veterinary Science","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.3389/fvets.2025.1456869","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Monofilament anti-rotational suture combined with TPLO to prevent pivot shift: surgical technique and novel TPLO plate design.
Objectives: To identify dogs at risk of developing pivot-shift (PS) following tibial-plateau-leveling-osteotomy (TPLO) using a rotational-instability-test (RI-test), describe a combination of a monofilament anti-rotational suture (ARS) with TPLO and assess this technique for feasibility, compare post-operative PS-incidence in dogs receiving a standard TPLO (TPLO-only) or a TPLO with ARS (TPLO+ARS), and design a novel TPLO-plate facilitating ARS-anchoring (TPLO/ARS-plate).
Study design: In this clinical pilot trial on 85 client-owned dogs and instrumentation design study, the RI-test and ARS-placement-technique were described and performed. Reporting included: anesthesia and surgery times, bone-healing, post-TPLO-PS-incidence, follow-up and complications. Significance was set as p ≤ 0.05. Comprehensive engineering of a novel TPLO plate was performed.
Results: Between TPLO-only (n = 57) and TPLO+ARS (n = 28) groups, significant differences were found for surgery time (p = 0.01), anesthesia time (p<0.001) and bone healing scores (p = 0.03), all being longer/higher for TPLO+ARS. PS-incidence was 2/57 (TPLO-only) and 0/28 (TPLO+ARS) within the first 8 weeks post-surgery (p = 1.00). Medium follow-up was 642 days. Major complications during that time occurred in 2/57 (TPLO-only; infection and implant removal) and 1/28 (TPLO+ARS; infection, PS-development and implant removal) dogs (p = 1.00). A novel TPLO/ARS-plate was designed.
Conclusion: Post-TPLO-PS might be reduced following ARS placement. Additional studies are indicated to validate and refine the RI-test and assess the novel TPLO/ARS-plate in the clinical setting.
期刊介绍：
Frontiers in Veterinary Science is a global, peer-reviewed, Open Access journal that bridges animal and human health, brings a comparative approach to medical and surgical challenges, and advances innovative biotechnology and therapy.
Veterinary research today is interdisciplinary, collaborative, and socially relevant, transforming how we understand and investigate animal health and disease. Fundamental research in emerging infectious diseases, predictive genomics, stem cell therapy, and translational modelling is grounded within the integrative social context of public and environmental health, wildlife conservation, novel biomarkers, societal well-being, and cutting-edge clinical practice and specialization. Frontiers in Veterinary Science brings a 21st-century approach—networked, collaborative, and Open Access—to communicate this progress and innovation to both the specialist and to the wider audience of readers in the field.
Frontiers in Veterinary Science publishes articles on outstanding discoveries across a wide spectrum of translational, foundational, and clinical research. The journal''s mission is to bring all relevant veterinary sciences together on a single platform with the goal of improving animal and human health.
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