Veterinary Surgery October 2025 – Ortho Part 3: TPLO Fluoro Guidance & Internal Brace Placement

In this Simini Small Animal Surgery Podcast episode, we wrap up the October 2025 orthopedic series with two high-impact studies—each focused on improving TPLO outcomes through better intraoperative imaging and implant technique. Whether you're chasing cut precision or trying to tame rotational instability, these papers offer real-world guidance with strong clinical implications.

We cover:

✅ Wang et al. — A prospective study of fluoroscopy-guided TPLO blade placement in 25 dogs. Using intraop C-arm to guide and verify blade trajectory, the team achieved a median post-op TPA of 3°, with all outcomes falling between 0–4.5°, a dramatic improvement over conventional variability (up to 13°). They also revealed that relying on D2-based pre-op planning can systematically underestimate osteotomy radius, reinforcing the role of real-time feedback during surgery.

✅ Wylie et al. — A retrospective study on internal brace augmentation in 46 stifles post-TPLO. Despite only 63% of femoral implants being accurately placed (especially poor with FASTak anchors), over 90% of dogs showed pivot shift resolution by 6 weeks. Interestingly, final rotational stability wasn’t linked to implant position—suggesting that early bracing may simply provide time for extra-articular fibrosis to stabilize the joint naturally.

🎓 Journal Articles Discussed:

• Wang et al. — Accuracy of fluoroscopy-guided osteotomy placement in
  TPLO: Postoperative tibial plateau angle and preoperative
  planning evaluation
• Wylie et al. — Evaluation of femoral isometric placement accuracy of
  internal brace implants and its impact on stifle
  stability in the management of pivot shift
  phenomenon following TPLO
  📚 From the October 2025 issue of Veterinary Surgery

🎁 Learn more about Simini Protect Lavage or request a sample:
 👉 www.simini.com

👉 Request a Sample

Chapters

• 0:00 Introduction: Getting TPLO Right the First Time
• 1:27 Wang et al. Study: Fluoroscopy-Guided Osteotomy Placement
• 2:47 Key Finding: 3° Median Post-op TPA and Tight Variability with Fluoro
• 5:12 Simini Protect Lavage: Reinforcing Meticulous Closure Protocol
• 6:40 Wylie et al. Study: Internal Brace Augmentation and Pivot Shift
• 8:15 Placement Accuracy Challenge: Only 38.9% Accuracy with FASTack
• 10:36 Clinical Takeaway: Double Down on Isometric Placement and Simplify Grading