This animation shows a dog’s knee viewed from the side. The two largest bones are the femur (thigh) and tibia (shin). Unlike in humans, a dog’s tibia has a sloping upper surface. On average, it slopes backwards by 25-30 degrees. Injuries to the anterior cruciate ligament (ACL) allow the femur to 'roll downhill'. A CORA-based levelling osteotomy (CBLO) involves a surgeon making a cut in the tibia (shin) and rotating it to level the tibial plateau (the top of the tibia). This helps to restore stability to the operated knee joint.

CBLO surgery is considered an effective treatment for CCL injury, but the published literature contains limited information about long-term outcome. At the time this animation was published, medium-term outcome data was available for ＜150 dogs. Here are summaries of four relevant case series:

- CASE SERIES 1: Complication rate was assessed in this short-term (~3-month) study of 31 dogs. One dog (3%) had a complication (migrating screw) which triggered a second operation. From: Raske et al (2013) Stabilization of the CORA based leveling osteotomy for treatment of cranial cruciate ligament injury using a bone plate augmented with a headless compression screw. Veterinary Surgery 42(6): 759-764 - [ Ссылка ]

- CASE SERIES 2: 41 dogs were assessed using keyhole joint inspection 14-months after CBLO. This showed minimal to no change in joint cartilage. The implication, which couldn’t be proven without a non-surgical control group, was that CBLO might limit the progression of osteoarthritis. From: Vasquez et al (2018) Second‐look arthroscopic findings after CORA‐based leveling osteotomy. Veterinary Surgery 47(2): 261-266 - [ Ссылка ]

- CASE SERIES 3: Fifteen immature dogs (14 had CBLO on one knee and 1 dog had CBLO on both knees). All owners reported dogs returned to “full function” during a telephone interview ~2-years after surgery. However, there was no veterinary analysis providing objective proof that function was genuinely normal. From: Peycke et al (2022) Center of rotation of angulation‐based leveling osteotomy for stifle stabilization in skeletally immature dogs. Veterinary Surgery 51(3): 528-535 - [ Ссылка ]

- CASE SERIES 4: Fifteen dogs were followed for one-year after CBLO. Objective gait analysis compared operated dogs to 20 normal dogs. CBLO produced complete gait symmetry, which was not statistically different to the symmetry of normal dogs. From: Coskun Ö and Viskjer S (2023) Evaluating the outcome after center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) technique to repair unilateral cranial cruciate ligament deficiency using a pressure-sensitive walkway system. Canadian Journal of Veterinary Research 87(2): 157-164 - [ Ссылка ]

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