Correlation of Radiographic and Palpable Landmarks Used for Tibial Plateau Levelling Osteotomy Planning.

Use MAGCAL landmark intraoperatively; avoid relying solely on MCL for TPLO planning.

This cadaveric study evaluated the reliability of palpable and radiographic landmarks used for planning tibial plateau leveling osteotomy (TPLO) in dogs. Thirty-nine canine stifles were examined, with anatomic landmarks including the medial collateral ligament (MCL), palpable and radiographic tibial tuberosity (pTT and rTT), patellar ligament enthesis (PLE), and medial anatomic groove caudal to the patellar ligament attachment (MAGCAL) compared between preoperative radiographic planning and intraoperative anatomy. Results demonstrated no significant difference between radiographic and palpable tibial tuberosity locations, supporting their use for initial positioning. However, the MCL proved unreliable for osteotomy planning, being directly centered over the intercondylar eminence in only 51% of specimens, with remaining cases displaced caudally. The MAGCAL showed promise as an intraoperative landmark, with planned osteotomies positioned cranial to or within this groove in 84% of cases. These findings suggest modifications to current TPLO planning techniques to improve accuracy and reproducibility of the surgical approach.

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