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Control of hemorrhage through the osteotomy gap during tibial plateau leveling osteotomy: 9 cases

Matres‐Lorenzo, Luis, McAlinden, Aidan, Bernardé, Antoine, Bernard, Fabrice
Veterinary surgery 2018 v.47 no.1 pp. 60-65
blood transfusion, cranial cruciate ligament, dogs, hematocrit, hemorrhage, hemostasis, medical records, osteotomy, questionnaires, radiography, stifle, tibia
OBJECTIVE: To describe a new technique to control intraoperative hemorrhage during tibial plateau leveling osteotomy (TPLO) and report subsequent short‐term and long‐term complications. STUDY DESIGN: Retrospective case series. ANIMALS: Nine dogs with arterial hemorrhage during TPLO. METHODS: Medical records of dogs with hemorrhage controlled through the osteotomy gap of a TPLO were reviewed at 2 institutions over 8 years. Inclusion criteria included diagnosis of single cranial cruciate ligament rupture, intraoperative arterial hemorrhage during the radial osteotomy controlled with bipolar electrocautery or hemostatic clips placed along the cranial tibial artery through the osteotomy, complete medical records, radiographic follow‐up for at least 8 weeks postoperatively, and completion of long‐term follow‐up questionnaire by the owner. RESULTS: Dogs were 4.6 ± 1.8 years old and weighed 36.6 ± 9.7 kg. In total, 3 ± 1 hemostatic clips were placed per stifle. Intraoperative hemostasis was achieved in all cases. One of the first dogs received a blood transfusion during the procedure and had a postoperative packed cell volume of 37%. The only complication consisted of fibular fracture, which was noticed on radiographs of 1 dog 8 weeks after TPLO. CONCLUSION: Arterial hemorrhage during the radial osteotomy of a TPLO can be controlled by occlusion of the compromised artery through distraction of the osteotomy gap. This technique was not associated with long‐term complications.