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Comparison of Healing of the Osteotomy Gap after Tibial Tuberosity Advancement with and without Use of an Autogenous Cancellous Bone Graft


  • Presented in part at the 36th Annual Conference Veterinary Orthopedic Society, Steamboat Springs, CO, March 2009.

Corresponding Author
Tomás G. Guerrero, Dr med vet, Diplomate ECVS, Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse, 260, Zurich, Switzerland


Objective: To evaluate and compare healing, with and without the use of bone graft, of the gap created during tibial tuberosity advancement (TTA).

Study Design: Prospective study and case series.

Animals: Dogs treated with TTA (n=67).

Methods: Prospective study: Mediolateral radiographic projections (6 weeks and 4 months) after TTA without use of bone graft (group I, n=14) were compared with radiographs of consecutive TTA in which the gap was filled with autologous cancellous bone graft (group II, n=14). Two scoring techniques (A, B) were used. Score A was used to grade the overall osteotomy healing (0=no healing, 4=healed osteotomy). Score B evaluated, independently of each other, healing in 3 sites: proximal to the cage (B1), between cage and plate (B2), and distal to the plate (B3). Case series: nongrafted TTA (4–25 weeks, n=39) were evaluated for healing (Score A). Data was analyzed using t-tests and ANOVA. Significance was set at P≤.05.

Results: Prospective study: Score A, B2, and B3 showed no difference in healing between groups at 6.8 weeks and 4.2 months. Score B1 revealed, in both rechecks, a significantly higher density in group II. Case series: Radiographs at 11.59±5.99 weeks scored 3.3 (2–4). No healing related complications were observed.

Conclusion: The osteotomy gap created during TTA healed within expected time regardless of bone graft use.

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