Ex Vivo Comparison of Three Surgical Techniques to Stabilize Canine Cranial Cruciate Ligament Deficient Stifles

Authors: 
LYNNE A. SNOW, DVM 1,2,3,4 , RICK WHITE, DVM 1,2,3,4 , SCOTT GUSTAFSON, DVM, MS, Diplomate ACVS 1,2,3,4 , LIN XIE, BS 1,2,3,4 , GISELLE HOSGOOD, BVSc, MS, PhD, Diplomate ACVS 1,2,3,4 , W. TODD MONROE, PhD, PE 1,2,3,4 , JOHN P. CASEY, BS 1,2,3,4 , and MAND
Volume: 
39
Number: 
2
Pages: 
195-207
Journal: 
Vet Surg
Date: 
February 2010

ABSTRACT
Objective—To quantify and compare canine stifle stability after 3 stabilization techniques.
Study Design—Randomized controlled study.
Sample Population—Adult canine cadaveric pelvic limbs.
Methods—Total craniocaudal (CrCa) tibial translation quantified in stifles with the cranial cruciate ligament (CrCL) intact, transected, and stabilized with 1 of 3 techniques: (1) hamstring graft (HG); (2) modified retinacular imbrication (MRIT); (3) anatometric fascia lata translocation (AFLT). Tibial translation was quantified from radiographs generated during application of cranial and caudal forces to the tibia. After removal of all soft tissues except periarticular ligaments and fixation, CrCa tibial translation, as before, and medial–lateral rotation, via torsional loading, was quantified with an active motion analysis system. Total tibial translation was evaluated for effect of technique and cruciate status using mixed effect linear model with significance considered at P-value <.05.
Results—CrCa translation was not significantly different across stabilization techniques with CrCLs intact, transected, or after stabilization. Poststabilization translation was significantly less than posttransection for all techniques. Compared with the intact CrCL, CrCa translation poststabilization after HG was significantly greater whereas poststabilization after MRIT and AFLT was not significantly different. Tibial rotation exceeded instrumentation limits in 62.5% HG limbs, 20% MRIT limbs, and 60% AFLT limbs.
Conclusions—All 3 stifle stabilization techniques confer comparable CrCa translational stability after CrCL disruption with that provided by the MRIT and AFLT techniques comparable to the intact CrCL.
Clinical Relevance—The extra- and intracapsular techniques evaluated in this study reduced CrCa tibial translation in CrCL deficient stifles to varying amounts.

Small animal: