Determination of isometric points for placement of a lateral suture in treatment of the cranial cruciate ligament deficient stifle

D. Hulse; W. Hyman; B. Beale; B. Saunders; l. Peycke; G. Hosgood

doi:10.3415/VCOT-09-05-0054

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2010; 23(03): 163-167
DOI: 10.3415/VCOT-09-05-0054

Original Research

Schattauer GmbH

Determination of isometric points for placement of a lateral suture in treatment of the cranial cruciate ligament deficient stifle

D. Hulse

¹College of Veterinary Medicine, Department of Small Animal Surgery, Texas A & M University, College Station, Texas, USA

,

W. Hyman

²Department of Biomedical Engineering, Texas A & M University, College Station, Texas, USA

,

B. Beale

³Gulf Coast Veterinary Specialists, Houston, Texas, USA

,

B. Saunders

¹College of Veterinary Medicine, Department of Small Animal Surgery, Texas A & M University, College Station, Texas, USA

,

l. Peycke

¹College of Veterinary Medicine, Department of Small Animal Surgery, Texas A & M University, College Station, Texas, USA

,

G. Hosgood

⁴Department of Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA

› Author Affiliations

Abstract

PDF Download

Summary

Complete or partial rupture of the cranial cruciate ligament (CCL) is a common injury of the canine stifle. While numerous techniques have been developed for surgical treatment, extra-articular methods with placement of a lateral suture remain a popular treatment method. The purpose of this study was to determine the potential isometry of the six suture-paired sites two on the femur and three on the tibia. In six femoro-tibial specimens with intact passive joint restraints, femoral sites adjacent to the proximal (F1) and distal (F2) poles of the fabella, and tibial sites adjacent to the patella insertion (T1), immediately cranial to (T2) and caudal to (T3) the long digital extensor tendon, were identified. A suture from one femoral site to one tibial site was placed under 0 or 5 N of preload, and tension was measured at joint angles of 150°, 130°, 90° and 50°. The F2-T3 combination was found to be most isometric. Isometry was reassessed in the same specimens with the suture in the F2-T3 position, and under 5 N, 10 N and 15 N of preload, and after transection of the CCL. The suture pair retained its isometric pattern in the CCL transected specimens. There was no effect of preload on isometry patterns.

Keywords

Cranial cruciate ligament - extra-articular repair - canine

PDF (439 kb)

References

References
1 Arnoczky SP. Pathomechanics of ligament and meniscal injuries. In: Bojrab MJ. editor Disease Mechanisms in Small Animal Surgery 2^nd ed. Philadelphia: Lea & Febiger; 1993: 764-770.
2 Vasseur PB. Stifle joint. In: Slatter D. editor Textbook of Small Animal Surgery 2^nd ed Philadelphia: Saunders; 1993: 1817-1865.
3 Arnoczky SP, Marshall JL. The cruciate ligaments of the canine stifle: an anatomical and functional analysis. AM J Vet Res 1977; 38: 1807-1814.
4 Vasseur PB. Clinical results following conservative management for rupture of the crainial cruciate ligament in dogs. Vet Surg 1984; 13: 243-246.
5 Korvick DL, Pijanowski GJ, Schaeffer DJ. Three dimensional kinematics of the intact and cranial cruciate deficient stifle of dogs. J Biomech 1994; 27: 77-87.
6 Brinker WO, Piermattei DL, Flo GL. Diagnosis and treatment of Orthopedic Conditions of the Hind-limb. In: Brinker WO, Piermattei DL, Flo GL. editors Handbook of Small Animal Orthopedics and Fracture Management 2^nd ed. Philadelphia: Saunders; 1990: 341-470.
7 Hulse DA. Cruciate ligament rupture. In: Fossum T. editor Small Animal Surgery, 2^nd ed. St. Louis: Mosby; 2002: 1110-1143.
8 Gambardella PC, Wallace LJ, Cassidy F. Lateral suture technique for management of anterior cruciate ligament rupture in dogs a retrospective study. J Am Anim Hosp Assoc. 1981; 17: 33-38.
9 Slocum B, Devine T. Cranial tibial wedge osteotomy: a technique for eliminating tibial thrust in cranial cruciate ligament repair. J Am Vet Med Assoc 1984; 184: 564-568.
10 Elkins AD, Pechman K, Herron M. A retrospective study evaluating the degree of degenerative joint disease in the stifle joint of dogs following surgical repair of anterior cruciate ligament rupture. J Am Anim Hosp Assoc 1991; 27: 533-540.
11 Roe SC. Limitations of cranial cruciate ligament repairs: prosthetic ligament substitutions. In: Proceedings of the American College of Veterinary Surgeons 1996
12 Roe SC, Kue J, Gemma J. Isometry of potential suture attachment sites for the cranial cruciate ligament deficient stifle. Vet Comp Orthop Traumatol 2008; 21: 215-220.