Quasi‐Isometric Points for the Technique of Lateral Suture Placement in the Feline Stifle Joint

Abstract

Ff-Tt provides the best quasi-isometric points for placement of lateral sutures in cats, compared with all combinations tested. Further assessments with biomechanical studies are needed to evaluate the reproducibility of these landmarks for stabilization of CCL rupture in cats.

Treatment of cranial cruciate ligament rupture in the feline stifle

“…In that study, no correlation was made between quasiisometric points and stifle joint stability. In the present study, three different arrangements of lateral sutures were tested and the results showed similar behaviour in the cranio-caudal direction, but not in the proximo-distal direction where the two techniques with insertion points distal to the most quasi-isometric points previously reported resulted in significant differences when compared to the intact cranial cruciate ligament (12).…”

“…Fabello-tibial sutures remain the most commonly accepted method of stabilization for the cranial cruciate ligament rupture in the feline stifle, and several codependant factors have been identified that contribute to the success of this surgical technique (9). Despite the popularity of quasi-isometric points for the placement of fabella-lateral sutures in dogs and cats, there are few biomechanical studies that compare different anchorage points in the lateral stifle joint through the range-ofmotion (12)(13)(14)(25)(26)(27)(28)(29)(30). In a recent feline cadaveric study, paired points located between the centre of the fabella and proxi-mo-cranial tibia provided the most quasiisometric points for the placement of a fabella-tibial suture (12).…”

“…The stifle constructs were loaded at three different joint angles: 75°, 130° and 160°. The joint angles were confirmed using a manual goniometer a (± 0.5) as previously described (12).…”

“…Critical aspects have been identified for the placement of the implant with lateral suture techniques (9). The placement of the suture between quasi-isometric points has an important role by minimizing changes in suture tension during stifle range-ofmotion and thus maintaining joint stability (2,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

“…The results of a recent cadaveric study evaluating the quasi-isometric points for the placement of a lateral suture in the feline stifle revealed that the most quasi-isometric points were located between the centre of the fabella and between tibial points immediately cranio-proximal to the extensor groove, and caudo-proximal to the insertion of the patellar ligament (12). However the authors have had some concerns from clinical cases with the laxity of the fabella-femoral ligament in cats, and have considered whether a suture anchored around this sesamoid bone would provide a suitably stable and secure attachment point.…”