{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:12:53Z","timestamp":1789751573197,"version":"4.0.1"},"reference-count":11,"publisher":"American Veterinary Medical Association (AVMA)","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine how frequently routine 8-week tibial plateau leveling osteotomy (TPLO) radiographs resulted in a change to the prescribed postoperative management plan when evaluated by surgery residents versus senior clinicians, and how often the resident and senior clinician plans differed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective interobserver agreement study, dogs that presented for a routine 8-week TPLO evaluation at a single veterinary referral hospital between October 2024 and July 2025 were eligible for enrollment. Three evaluators (2 senior clinicians, 1 surgical resident) independently performed physical examinations (PEs) and later reviewed each dog\u2019s radiographic evaluation (RE). After each PE and RE, each evaluator documented their findings and management decision on standard forms. A Cohen \u03ba score was used to evaluate interrater reliability for PE and RE management choice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>97 dogs (291 evaluations) were enrolled. Corresponding PE and RE recommendations were consistent in most cases (173 [59.5%]). The elected case management plans after each evaluation differed more often for senior clinicians (45.4%) than residents (30.5%). Interrater reliability for overall, PE, and RE prescribed management plans were fair (\u03ba = 0.2233), fair (\u03ba = 0.2252), and slight (\u03ba = 0.1965), respectively. Patellar desmitis (99 [34.2%]) was the most common radiographic finding, but rarely resulted in a different management plan (18 [18.2%]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Management plans based on PE and RE evaluations were inconsistent, with REs resulting in prolonged exercise restriction in up to 40.5% of dogs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Clinicians should weigh the costs and risks associated with routine radiographs against their anticipated protocol changes until practical guidance about the clinical impact of common radiographic findings is available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.26.06.0467","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:45:49Z","timestamp":1789749949000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Eight-week postoperative tibial plateau leveling osteotomy radiographs do not change the prescribed management plan for most dogs"],"prefix":"10.2460","author":[{"given":"Courtney L.","family":"Hancock","sequence":"first","affiliation":[{"name":"Small Animal Medicine and Surgery, BluePearl Pet Hospital, Stone Oak, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-3632","authenticated-orcid":true,"given":"Steven W.","family":"Frederick","sequence":"additional","affiliation":[{"name":"Medical Affairs, Mars Veterinary Health, Vancouver, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Israel","sequence":"additional","affiliation":[{"name":"Small Animal Medicine and Surgery, BluePearl Pet Hospital, Stone Oak, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"5","key":"ref1","series-title":"J Am Vet Med Assoc","first-page":"586","article-title":"Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds)","volume":"253","author":"von Pfeil DJF","year":"2018","unstructured":"von Pfeil DJF, Kowaleski MP, Glassman M, Dejardin LM. Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds). J Am Vet Med Assoc. 2018;253(5):586-597. doi:10.2460\/javma.253.5.586"},{"issue":"5","key":"ref2","series-title":"Vet Comp Orthop Traumatol","first-page":"349","article-title":"Complications of tibial plateau levelling osteotomy in dogs","volume":"25","author":"Bergh MS","year":"2012","unstructured":"Bergh MS, Peirone B. Complications of tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol. 2012;25(5):349-358. doi:10.3415\/VCOT-11-09-0122"},{"issue":"5","key":"ref3","series-title":"Vet Comp Orthop Traumatol","first-page":"333","article-title":"Retrospective study of 476 tibial plateau levelling osteotomy procedures: rate of subsequent \u2018pivot shift\u2019, meniscal tear and other complications","volume":"24","author":"Gatineau M","year":"2011","unstructured":"Gatineau M, Dupuis J, Plant\u00e9 J, Moreau M. Retrospective study of 476 tibial plateau levelling osteotomy procedures: rate of subsequent \u2018pivot shift\u2019, meniscal tear and other complications. Vet Comp Orthop Traumatol. 2011;24(5):333-341. doi:10.3415\/VCOT-10-07-0109"},{"issue":"2","key":"ref4","series-title":"J Am Vet Med Assoc","first-page":"184","article-title":"Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001)","volume":"222","author":"Pacchiana PD","year":"2003","unstructured":"Pacchiana PD, Morris E, Gillings SL, Jessen CR, Lipowitz AJ. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001). 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Vet Surg. 2021;50(8):1644-1649. doi:10.1111\/vsu.13726"},{"issue":"1","key":"ref6","series-title":"Vet Surg","first-page":"44","article-title":"Influence of radiographic examination findings on recommendations made during routine clinical re-evaluation of dogs with uncomplicated tibial plateau leveling osteotomy","volume":"50","author":"Alexander A","year":"2021","unstructured":"Alexander A, Compagnone K, Grierson J,  Influence of radiographic examination findings on recommendations made during routine clinical re-evaluation of dogs with uncomplicated tibial plateau leveling osteotomy. Vet Surg. 2021;50(1):44-52. doi:10.1111\/vsu.13533"},{"issue":"8","key":"ref7","series-title":"Vet Surg","first-page":"905","article-title":"Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine","volume":"39","author":"Cook JL","year":"2010","unstructured":"Cook JL, Evans R, Conzemius MG,  Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg. 2010;39(8):905-908. doi:10.1111\/j.1532-950X.2010.00763.x"},{"issue":"1","key":"ref8","series-title":"BMJ Qual Saf","first-page":"54","article-title":"Overuse of diagnostic testing in healthcare: a systematic review","volume":"31","author":"M\u00fcskens JLJM","year":"2022","unstructured":"M\u00fcskens JLJM, Kool RB, van Dulmen SA, Westert GP. Overuse of diagnostic testing in healthcare: a systematic review. BMJ Qual Saf. 2022;31(1):54-63. doi:10.1136\/bmjqs-2020-012576"},{"issue":"1","key":"ref9","series-title":"Vet Surg","first-page":"146","article-title":"Extended long-term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog","volume":"49","author":"Moore EV","year":"2020","unstructured":"Moore EV, Weeren R, Paek M. Extended long-term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog. Vet Surg. 2020;49(1):146-154. doi:10.1111\/vsu.13277"},{"issue":"4","key":"ref10","series-title":"Vet Surg","first-page":"482","article-title":"The effect of shock wave therapy on patellar ligament desmitis after tibial plateau leveling osteotomy","volume":"41","author":"Gallagher A","year":"2012","unstructured":"Gallagher A, Cross AR, Sepulveda G. The effect of shock wave therapy on patellar ligament desmitis after tibial plateau leveling osteotomy. Vet Surg. 2012;41(4):482-485. doi:10.1111\/j.1532-950X.2012.00958.x"},{"key":"ref11","article-title":"United States Nuclear Regulatory Commission","unstructured":"ALARA. United States Nuclear Regulatory Commission. Updated March 9, 2021. Accessed July 20, 2026. https:\/\/www.nrc.gov\/reading-rm\/basic-ref\/glossary\/alara.html"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/aop\/javma.26.06.0467\/javma.26.06.0467.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/aop\/javma.26.06.0467\/javma.26.06.0467.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:45:49Z","timestamp":1789749949000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/aop\/javma.26.06.0467\/javma.26.06.0467.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":11,"URL":"https:\/\/doi.org\/10.2460\/javma.26.06.0467","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,18]]}}}