Ex vivo preliminary investigation of radiographic quantitative assessment of cranial tibial displacement at varying degrees of canine stifle flexion with or without an intact cranial cruciate ligament

Abstract

BackgroundThe presence of cranial tibial subluxation can aid in the detection of joint instability as a result of CrCL injury. Detection of cranial tibial subluxation has been described using the tibial compression test (TCT) and cranial drawer test (CDT); however, diagnosis of CrCL insufficiency by assessing cranial subluxation motion of the tibia is subjective and difficult to quantify accurately. The aim of this study was to investigate a measurement technique to assess the degree of cranial tibial displacement relative to the femoral condyles on mediolateral projection stifle radiographs at varying degrees of stifle flexion (90°, 110°, and 135°) in CrCL intact, partially, and completely transected conditions. Radiographic measurements included: CrCL length and intercondylar distance (ICD), defined as the distance between the tibial mechanical axis (TMA) and the femoral condylar axis (FCA). The influence of CrCL status, stifle flexion angle, and measurement type on measured distance was evaluated. The relationship between CrCL length and ICD measurement was also assessed.ResultsComplete transection of the CrCL resulted in significant cranial tibial displacement. Stifle flexion angle affected ICD, but not CrCL length. Normalized measured CrCL length and ICD were significantly different; however, no differences existed between the change in distance detected by CrCL length and ICD measurements as CrCL transection status changed. Correlation coefficients detected a significant positive correlation between measured CrCL and ICD.ConclusionThe ICD measurement technique was able to quantify tibial displacement at various stifle flexion angles in the intact and completely transected CrCL conditions. The ICD measurement was more affected by stifle flexion angle than was the CrCL length.Electronic supplementary materialThe online version of this article (10.1186/s12917-018-1599-5) contains supplementary material, which is available to authorized users.

Correlation of spontaneous radiographic cranial tibial translation with complete cranial cruciate ligament rupture and medial meniscal tears in dogs

“…The "Cazieux-positive" sign, subjective cranial displacement of the proximal tibia in relation to the femur or spontaneous CTT, has previously been determined to always indicate a CCL rupture but is considered a rare finding with no recent reports evaluating true prevalence [5][6][7]. Other radiographic tests or measurements have been evaluated to diagnose CCL rupture such as tibial compression radiography, but require serial radiographs that include stressed views or special positioning to perform [5,[8][9][10].…”

Evaluation of cranial tibial translation in dogs: Diagnostic accuracy of radiographic method using a simple device

“…Clinical detection of tibial translation by cranial drawer test and tibial compression test can aid revealing stifle joint instability as a result of CrCL injury. However, diagnosis of CrCL insufficiency using these tests is subjective and difficult to quantify accurately [5,6].…”

“…Bielecki et al measured tibial subluxation in normal cadavers after ligament transection and during gradually increasing tibial thrust by manual flexing the hock joint [11]. Castaneda et al used normal cadaveric canine pelvic limbs to investigate a measurement technique for assessing the degree of cranial tibial displacement, at varying degree of stifle flexion, in intact, partially and completely transected conditions while manually flexing the tarsal joint [6]. A special joint-testing machine was used ex vivo to evaluate radiographically and electromagnetically the passive laxity of normal canine stifle before and after cutting the CrCL, and also after surgical treatment [12].…”

Radiographic protocol to quantify cranial tibial translation in dogs v1

“…The detection of tibial translation can aid revealing stifle joint instability as a result of CrCL injury. However, clinical diagnosis of CrCL insufficiency is subjective and difficult to quantify accurately [5,6]. In order to thoroughly assess the joint stability as well as joint stabilization after surgery, it is imperative to quantify and compare joint stability between and within subjects over time.…”

“…In order to thoroughly assess the joint stability as well as joint stabilization after surgery, it is imperative to quantify and compare joint stability between and within subjects over time. Several studies described radiographic techniques to assess translational stifle stability and CrCL integrity [6][7][8][9][10][11][12], but they may have some limitations: tricky execution; need for complex devices; absence of validation; failure to include a specific angle or a controlled force; tested only on experimental lesion or only ex vivo; poor applicability in vivo. This protocol aims to assess the integrity of CrCL and objectively quantifying the in vivo cranial canine stifle translation using a simple, radiolucent translator device keeping fixed the joint angle during the thrust.…”