ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Veterinary Surgery
Volume 12 - 2025 | doi: 10.3389/fvets.2025.1456869
MONOFILAMENT ANTI-ROTATIONAL SUTURE COMBINED WITH TPLO TO PREVENT PIVOT SHIFT: SURGICAL TECHNIQUE AND NOVEL TPLO PLATE DESIGN Dirsko JF. von Pfeil, Dr.med.vet., DVM, DACVS, DECVS, DACVSMR, DECVSMR, ACVS Founding Fellow MIS (SA-Orthopedics) 1* , Parker N House 2
Provisionally accepted
- 1Small Animal Surgery Locum, PLLC, Dallas, United States
- 2College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States
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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 antirotational-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.
Keywords: dog, Cranial cruciate ligament rupture, Tibial plateau leveling osteotomy, Pivot shift, Antirotational suture
Received: 29 Jun 2024; Accepted: 24 Jun 2025.
Copyright: © 2025 Von Pfeil and House. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dirsko JF Von Pfeil, Small Animal Surgery Locum, PLLC, Dallas, United States
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