{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:29:05Z","timestamp":1789586945665,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Animals"],"abstract":"<jats:p>This study explored the complications and prognosis of modified tibial plateau leveling osteotomy with tibial tuberosity transposition (mTPLO-TTT) for simultaneously correcting high-grade medial patellar luxation (MPL) and cranial cruciate ligament disease (CCLD) in small-breed dogs. This retrospective study evaluated patient data, lameness scores, radiographic outcomes, and complications over a median follow-up period of 10 weeks. Additionally, an owner interview was conducted 6 months postoperatively. Nine stifles from seven dogs were included in this study. All cases showed satisfactory patellar alignment and stability after surgery, with no major complications or reluxations. The lameness scores improved, and radiographic assessments confirmed implant stability and appropriate bone healing. Owner-reported outcomes at 6 months were also favorable. These findings suggest that simultaneous mTPLO-TTT is an effective surgical option for small-breed dogs with concurrent CCLD and Grade IV MPL.<\/jats:p>","DOI":"10.3390\/ani15071042","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T03:36:45Z","timestamp":1743737805000},"page":"1042","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Simultaneous Modified Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Grade IV Medial Patellar Luxation and Cranial Cruciate Ligament Disease in Small-Breed Dogs"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9991-6234","authenticated-orcid":false,"given":"Changsu","family":"Jung","sequence":"first","affiliation":[{"name":"JCS Animal Surgical Center, Goyang-si 10380, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2419-1775","authenticated-orcid":false,"given":"Byung-Jae","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0091-0279(71)50052-1","article-title":"Patellar luxation in dogs","volume":"1","author":"DeAngelis","year":"1971","journal-title":"Vet. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1532-950X.2005.00016.x","article-title":"Applications of evidence-based medicine: Cranial cruciate ligament injury repair in the dog","volume":"34","author":"Aragon","year":"2005","journal-title":"Vet. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"716","DOI":"10.2460\/javma.1994.205.05.716","article-title":"Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982\u20131992)","volume":"205","author":"Hayes","year":"1994","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1055\/s-0038-1632502","article-title":"A survey of orthopaedic conditions in small animal veterinary practice in Britain","volume":"9","author":"Ness","year":"1996","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1532-950X.1987.tb00910.x","article-title":"Clinical results of surgical correction of medial luxation of the patella in dogs","volume":"16","author":"Willauer","year":"1987","journal-title":"Vet. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"887","DOI":"10.2460\/javma.236.8.887","article-title":"Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs: 162 cases (2004\u20132007)","volume":"236","author":"Campbell","year":"2010","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_7","first-page":"234","article-title":"Patellar luxation in dogs and cats: Pathogenesis and diagnosis","volume":"24","author":"Montavon","year":"2002","journal-title":"Compendium"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1748-5827.2006.00004.x","article-title":"Patellar luxation in 70 large breed dogs","volume":"47","author":"Gibbons","year":"2006","journal-title":"J. Small Anim. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.2460\/javma.232.12.1818","article-title":"Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs","volume":"232","author":"Witsberger","year":"2008","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1748-5827.2009.00854.x","article-title":"Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling","volume":"51","author":"Langenbach","year":"2010","journal-title":"J. Small Anim. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1055\/s-0038-1676296","article-title":"Technique and outcome of a modified tibial plateau levelling osteotomy for treatment of concurrent medial patellar luxation and cranial cruciate ligament rupture in 76 stifles","volume":"32","author":"Flesher","year":"2019","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"536","DOI":"10.3415\/VCOT-15-12-0195","article-title":"Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation","volume":"29","author":"Leonard","year":"2016","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_13","first-page":"45","article-title":"Complications and long-term outcomes after combined tibial plateau leveling osteotomy and tibial tuberosity transposition for treatment of concurrent cranial cruciate ligament rupture and grade III or IV medial patellar luxation","volume":"37","author":"Redolfi","year":"2023","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.17236\/sat00261","article-title":"A new approach to treatment selection in dogs with cruciate ligament rupture: Patient-specific treatment recommendations","volume":"162","author":"Lampart","year":"2020","journal-title":"Schweiz. Arch. Tierheilkd."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"208","DOI":"10.2460\/javma.249.2.208","article-title":"Outcomes and complications following surgical correction of grade IV medial patellar luxation in dogs: 24 cases (2008\u20132014)","volume":"249","author":"Dunlap","year":"2016","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"162","DOI":"10.5326\/JAAHA-MS-6329","article-title":"Outcome following surgical correction of grade 4 medial patellar luxation in dogs: 47 stifles (2001\u20132012)","volume":"52","author":"Hans","year":"2016","journal-title":"J. Am. Anim. Hosp. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1136\/inp.d453","article-title":"Investigation of lameness in dogs","volume":"33","author":"Witte","year":"2011","journal-title":"Practice"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Duerr, F.M. (2020). Canine Lameness, John Wiley & Sons.","DOI":"10.1002\/9781119473992"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/j.1532-950X.2012.01053.x","article-title":"Comparison of Tibial PA, bone healing, and intra-articular screw placement using conventional nonlocked application of surgeon-contoured versus locked application of precontoured TPLO plates in dogs","volume":"41","author":"Krotscheck","year":"2012","journal-title":"Vet. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1111\/j.1532-950X.2004.04053.x","article-title":"Influence of limb positioning and measurement method on the magnitude of the tibial plateau angle","volume":"33","author":"Reif","year":"2004","journal-title":"Vet. Surg."},{"key":"ref_21","first-page":"ajvr.23.06.0146","article-title":"Three-dimensional\u2013printed patient-specific guides for tibial deformity correction in small-breed dogs","volume":"84","author":"Jeon","year":"2023","journal-title":"Am. J. Vet. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"456","DOI":"10.2460\/javma.1983.183.04.456","article-title":"Cranial tibial thrust: A primary force in the canine stifle","volume":"183","author":"Slocum","year":"1983","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jeong, E., Jeon, Y., Kim, T., Lee, D., and Roh, Y. (2024). Assessing the effectiveness of modified tibial plateau leveling osteotomy plates for treating cranial cruciate ligament rupture and medial patellar luxation in small-breed dogs. Animals, 14.","DOI":"10.3390\/ani14131937"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"339","DOI":"10.17555\/jvc.2024.41.6.339","article-title":"Effects of bupivacaine infiltration anesthesia using temperature-responsive hydrogel in dogs undergoing celiotomy","volume":"41","author":"Song","year":"2024","journal-title":"J. Vet. Clin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/00003086-198510000-00033","article-title":"Accuracy of radiologic assessment of Tibia1 shaft fracture union in humans","volume":"199","author":"Hammer","year":"1985","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3415\/VCOT-10-07-0109","article-title":"Retrospective study of 476 tibial plateau levelling osteotomy procedures","volume":"24","author":"Gatineau","year":"2011","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"893","DOI":"10.2460\/ajvr.79.8.893","article-title":"Effects of low-level laser therapy on bone healing and signs of pain in dogs following tibial plateau leveling osteotomy","volume":"79","author":"Kennedy","year":"2018","journal-title":"Am. J. Vet. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0040-1701502","article-title":"Outcome after tibial plateau levelling osteotomy and modified Maquet procedure in dogs with cranial cruciate ligament rupture","volume":"33","author":"Knebel","year":"2020","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3415\/VCOT-12-11-0138","article-title":"Evaluation of surgical treatment of medial patellar luxation in Pomeranian dogs","volume":"26","author":"Wangdee","year":"2013","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1053\/jvet.2003.50038","article-title":"In vitro effects of osteotomy angle and osteotomy reduction on tibial angulation and rotation during the tibial plateau-leveling osteotomy procedure","volume":"32","author":"Wheeler","year":"2003","journal-title":"Vet. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/j.1532-950X.2008.00464.x","article-title":"Biomechanical comparison of two alternative tibial plateau leveling osteotomy plates with the original standard in an axially loaded gap model: An in vitro study","volume":"38","author":"Kloc","year":"2009","journal-title":"Vet. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1055\/s-0043-1768163","article-title":"Effect of plate type on tibial plateau levelling and medialization osteotomy for treatment of cranial cruciate ligament rupture and concomitant medial patellar luxation in small breed dogs: An in vitro study","volume":"36","author":"Dallago","year":"2023","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"iii","DOI":"10.1055\/a-2544-9567","article-title":"Refracture of the toy breed radius","volume":"38","author":"Johnson","year":"2025","journal-title":"Vet. Comp. Orthop. Traumatol."}],"container-title":["Animals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2615\/15\/7\/1042\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:10:00Z","timestamp":1760029800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2615\/15\/7\/1042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":33,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["ani15071042"],"URL":"https:\/\/doi.org\/10.3390\/ani15071042","relation":{},"ISSN":["2076-2615"],"issn-type":[{"value":"2076-2615","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,4]]}}}