Modular guided tibial plateau-leveling osteotomy improves osteotomy centering accuracy compared to a freehand technique.

Modular TPLO guides significantly improve osteotomy centering accuracy regardless of surgeon experience level.

This randomized controlled experimental study evaluated whether a modular surgical guide system (OssAbility) improves tibial plateau-leveling osteotomy (TPLO) accuracy compared to the traditional freehand technique. Eight surgical trainees from a single institution each performed 18 osteotomies in randomized order using both methods across three tibial bone model morphologies and three TPLO blade sizes. Outcomes assessed included osteotomy centering accuracy, angulation in the sagittal plane, and angulation in the frontal plane, all compared to a predetermined ideal target osteotomy. Results demonstrated that guided osteotomies were significantly better centered relative to the ideal planned location (95% CI, -0.85 to -0.15; P = .005). Frontal plane angulation deviation from the ideal 90° was also significantly lower in the guided group (95% CI, -2.0 to -0.03; P = .042). However, no significant improvement was observed in sagittal plane accuracy with guide use. Contrary to one hypothesis, clinical experience (number of TPLOs performed) did not significantly correlate with osteotomy accuracy in either the freehand or guided groups (r = 0.23; P = .055), though a trend approached significance in the transverse plane. These findings suggest that modular surgical guides may offer meaningful improvements in curvilinear osteotomy centering for surgeons across varying levels of training, potentially reducing technique-dependent errors in TPLO execution without replacing the need for comprehensive surgical training.

This summary was distilled by AI and may occasionally misinterpret data. Confirm critical details with the primary literature before clinical application.