In vivo three‐dimensional isometry analysis of suture attachment sites for extracapsular suture stabilization of the canine stifle

Abstract

Background The study aimed to perform isometry analysis of a selection of suture attachment points for extracapsular stabilization with three‐dimensional (3D) measurements and normal gait kinematics of the stifle joint. Methods Thirteen client‐owned dogs were recruited. Fluoroscopic images of the stifle during treadmill walking and computed tomography of the same joint were acquired. Stifle kinematics were reconstructed using 3D model‐based fluoroscopic analysis. Variability of the distance between the femoral and tibial attachment sites across gait cycles was evaluated. The maximum length variation (MLV) and maximum length percent variation (MLPV) were quantified and used to determine the level of isometry of the attachment site combinations. Results A selection of combinations with lower mean MLV (<2.5 mm) or MLPV (<8%) was identified from 315 combinations, and all the combinations involved femoral attachment sites near the distal pole of the lateral fabella. The combinations also involving tibial attachment sites near the proximal tibial crest showed improved isometry, with an MLPV < 6%. Conclusion Combinations using attachment sites around the distal pole of the lateral fabella and proximal tibial crest or caudal to the long digit extensor groove appeared to have improved isometry.

Ex vivo biomechanical evaluation of extracapsular stabilization with quasi-isometric points in canine cranial cruciate ligament-deficient stifles

“…Several preceding studies have revealed notable cranial tibial subluxation after CCLD progression [ 1 – 3 , 24 , 28 – 30 ], but only a few studies have assessed and compared the CTT between different pairs of quasi-IPs [ 19 , 24 , 31 , 32 ]. It is expected that suturing at different positions affects the resistance capability in tibial cranial translation, as sutures with alignment closer to the craniocaudal direction can contribute a greater tensile force component to counteract tibial cranial translational forces [ 12 ]. However, only a few studies reported that suturing at T1 was found to be more effective in resisting CTT than suturing at T2 or T3 [ 19 , 24 ].…”

“…According to the suggestions in previous studies [ 12 , 20 ], at the lateral condyle of the femur, the point distal to the lateral femoral fabella (F2) was chosen for the suture attachment site. The site was paired with the point located approximately 4–5 mm caudal to the insertion point of the patellar ligament (equivalent to T1 in Hulse et al [ 20 ] and referred to as ECS-IP1 in the present study, Fig.…”

“…Some recent evidence showed that the corrective tibial osteotomy procedures, particularly tibial plateau leveling osteotomy, showed better postoperative outcomes than other treatments in terms of functional recovery and halting OA progression [ 6 – 10 ]. In contrast, while ECS procedures were shown to yield comparable or inferior postoperative outcomes [ 9 – 11 ], they remained common surgical options for CCL diseases due to the lower costs and technical demands [ 1 , 3 , 12 ]. The ECS procedures were also advantageous to enable the provision of immediate internal rotation (IR) stability [ 13 ].…”

“…Moreover, the shortened lifespan of the ECS may lead to premature failure before periarticular fibrosis develops, thereby potentially compromising the long-term outcome. Most quasi-isometric point pairs on the stifle have been assessed for over a decade [ 1 , 12 , 18 , 20 , 22 – 24 ], but there are controversial results, possibly due to inconsistent evaluation approaches, prosthetic materials, and surgical techniques used. Nonetheless, in recent years, the points distal to the lateral femoral fabella, near the insertion of the patella tendon at the tibial crest, and at the tubercle caudal to the long digital extensor groove were the most recognized potential quasi-isometric points in ex vivo and in vivo gait studies [ 1 , 12 , 18 – 20 , 23 ].…”

Estimation of footprints of the canine stifle ligaments using deformable shape templates of bones

“…To build statistical shape models (SSMs) for the femur and tibia, the training dataset was created by retrospectively collecting CT data from our former studies 17 – 19 . This dataset comprised CT data from a total of 40 dogs, with an average body weight of 22.7 ± 4.6 kg and an age of 3.6 ± 1.7 years.…”