Measuring Tibial Torsion Like a Pro — No Bones About It!

Veterinary Surgery 2025

Author

Obi Veterinary Education
November 13, 2025

Danyelle R. C. Ferreira, Eloy H. P. Curuci, Luís G. G. G. Dias, Dayvid V. F. de Lucena, Renato O. do Rego, Luciano P. de Barros, Bruno W. Minto

Background
Tibial torsion affects the alignment of the canine stifle and is closely associated with medial patellar luxation (MPL). Traditional tomographic methods are limited, particularly in small breeds, due to anatomical visibility issues. This study aimed to develop and evaluate a new 3D CT-based method for measuring tibial torsion, hypothesizing greater repeatability and reproducibility than current approaches.

Methods
A retrospective study analyzed 40 tibiae from dogs diagnosed with MPL. Four orthopedic surgeons evaluated tibial torsion using both the traditional (Aper et al.) method and a newly proposed method based on 3D CT reconstructions. One observer repeated the new method thrice for intraobserver analysis. Intraclass correlation coefficients (ICCs) assessed repeatability and reproducibility.

Results
The new method demonstrated excellent intraobserver repeatability (ICC = 0.99) and high interobserver reproducibility (ICC = 0.83). In contrast, the traditional method showed only moderate interobserver agreement (ICC = 0.52). Torsion values were higher with the new method (mean = 16.00° ± 8.77) than with the traditional one (mean = 8.76° ± 4.92).

Limitations
All observers were experienced orthopedic surgeons, limiting generalizability to less experienced users. Anatomical validation was not feasible, as measurements were performed on clinical CT scans from client-owned dogs.

Conclusions
The new CT-based method for measuring tibial torsion in dogs with MPL is reliable, repeatable, and reproducible. It is suitable for a wide range of dog breeds, including small breeds, and enhances clinical assessment and preoperative planning for MPL-associated deformities.

The positioning of the dog on the computed tomography (CT) examination table for the acquisition of images that were used to measure the degree of tibial torsion. The dog was positioned in sternal recumbency on foam support, with the pelvic limbs parallel to one another, using orthopedic splints and adhesive tapes to maintain the talocrural joint between 90 and 110°

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