New Mini Tibia Leveling Osteotomy (TPLO) Jig
Cranial cruciate ligament tears are a common cause of lameness in dogs. The slope of the tibial plateau in canines is much greater than in humans meaning that over time, any repetitive force or loading can lead to chronic, progressive damage and rupture of the cranial cruciate ligament. The TPLO procedure dynamically stabilizes the knee by eliminating cranial tibial subluxation during the weight bearing phase of locomotion. The TPLO plates are available with six different profiles (3.5 mm, 3.5 mm small stature, 3.5 mm broad, 2.7 mm, 2.4 mm, and 2.0 mm) meaning the procedure can be preformed across all sizes of dogs and cats. The appropriate placement of the plates is facilitated by the use of a jig.
Until recently, the TPLO Jig was only available for the 3.5 mm, 3.5 mm small stature, and 3.5 mm broad TPLO Plates. The TPLO system has now been expanded with the new Mini TPLO Jig (Fig 1) which is designed to be used with the 2.0 mm, 2.4 mm, and 2.7 mm TPLO Plates.
The new Mini TPLO Jig
The Mini TPLO Jig is designed specifically for the 2.0 mm, 2.4 mm, and 2.7 mm size TPLO cases and helps to maintain stability and limb alignment after the proximal tibial osteotomy. The jig can be used with any tibia leveling osteotomy plate, but was designed to be used with the new Synthes Mini TPLO Plates. The jig can be positioned with great versatility to best suit a broad range of patient anatomy and can also be used to provide similar functions when performing corrective osteotomy for treatment of angular limb deformity.
The Mini TPLO Jig features a 45 degree jig pin screw orientation for more access to plate head holes. Further, it attaches to the bone with K-wires of 1.6 mm to 2.5 mm diameter to accommodate the great variety of patient size. The jig arms can be angled as needed to position the jig pins optimally in the proximal and distal aspect of the tibia. During sawing, the surgeon will appreciate the vibration resistant hinge screw (Fig 2). In the past, a loss of hinge screws during the osteotomy procedure has led to dissatisfaction.
The jig is designed to allow ample room for the saw blade during a proximal tibial osteotomy. The jig arms can be positioned as needed to accommodate the individual patient. The jig is designed to accommodate jig pin diameters from 1.6 mm to 2.5 mm. Additionally, the jig can be easily disassembled for removal and cleaning.
The new Mini TPLO Jig completes the TPLO implant and instrument range. Surgeons can now be prepared for all sizes and breeds of cat and dog.
Case: Active dog becomes lame after running
(Case provided by Brian Beale, Houston, USA)
A Bichon Frise became acutely non weightbearing lame following running, with a tear of the cranial cruciate ligament.
The preoperative tibial plateau angle was 36. The jig pin diameter was 1.6 mm. A 10 mm TPLO saw blade was used to make the osteotomy while the jig was in place. A 2.0 mm Synthes TPLO Plate was applied with three 2.0 mm locking screws proximally and three 2.0 mm cortical screws distally.
Locking screws were the best option in the proximal tibial segment due to the small gap between the contoured plate and the bone. The postoperative TPA was 5.
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