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

Authors

  • LYNNE A. SNOW DVM,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • RICK WHITE DVM,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • SCOTT GUSTAFSON DVM, MS, Diplomate ACVS,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • LIN XIE BS,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • GISELLE HOSGOOD BVSc, MS, PhD, Diplomate ACVS,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • W. TODD MONROE PhD, PE,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • JOHN P. CASEY BS,

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • MANDI J. LOPEZ DVM, MS, PhD, Diplomate ACVS

    1. Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
    2. Cedar Mill Veterinary Hospital, Portland, OR
    3. VCA Raleigh Hills Animal Hospital, Portland, OR
    4. Biological & Agricultural Engineering, LSU Agricultural Center, Louisiana State University, Baton Rouge, LA
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  • The work was completed at Louisiana State University, Baton Rouge, LA in the Laboratory for Equine and Comparative Orthopedic Research.

  • Presented in part at the Louisiana State University School of Veterinary Medicine Phi Zeta Research Emphasis Day, September 26, 2007 and at the 2008 American College of Veterinary Surgeons Symposium on October 23–25, 2008 in San Diego, CA.

  • Rick White has a patent pending on the referencing instrument described in the manuscript.

Corresponding author: Lynne Snow DVM, Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803. E-mail: lsnow@vetmed.lsu.edu.

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.

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