Use of Preoperative 3D Virtual Planning and 3D-Printed Patient-Specific Guides to Facilitate a Single-Stage Cranial Closing Wedge Ostectomy and Tibial Plateau Leveling Osteotomy Procedure to Address Proximal Tibial Deformity, an Excessive Tibial Plateau Angle, and Cranial Cruciate Ligament Insufficiency in a Dog

Figure 7

Intraoperative use of the TPLO/reduction and adjoining cranial reduction guides. (a) The TPLO/reduction guide was secured over the previously implanted parallel pins, which initially secured the cranial closing wedge osteotomy guide, to reduce and align the proximal and distal tibial segments. The cranial reduction guide was placed, and the proximal portion of the TPLO/reduction guide was used to direct the TPLO saw. (b) After the rotation of the plateau segment, an interfragmentary Kirschner wire was placed through the most proximal guide tower of the cranial reduction guide to maintain the rotation. The medially positioned TPLO/reduction guide was removed. The cranial reduction guide maintained the alignment of the tibial as the CBLO plate was applied. (c) After removing the cranial reduction guide, a precontoured conical coupling plate was secured to the cranial tibia to provide supplemental fixation.

(a)

(b)

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