Extra-Articular Fascial Strip Repair of the Cranial Cruciate Deficient Stifle: Technique and Results in Seven Dogs

S. W. Aiken; M. S. Bauer; J. P. Toombs

doi:10.1055/s-0038-1633102

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 1992; 05(04): 145-150
DOI: 10.1055/s-0038-1633102

Original Research

Schattauer GmbH

Extra-Articular Fascial Strip Repair of the Cranial Cruciate Deficient Stifle: Technique and Results in Seven Dogs

Authors

S. W. Aiken

¹Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
M. S. Bauer

¹Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
J. P. Toombs

¹Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA

Abstract

Summary

An extra-articular fascial strip technique, for stabilization of the cranial cruciate deficient stifle, is described and evaluated in a series of seven dogs suffering from rupture of the cranial cruciate ligament. The technique was easily performed and resulted in normal stifle joint bio-mechanics, as determined by evaluation of the instantaneous centre of motion. Cranial drawer motion was eliminated immediately after the operation and, after a partial loss of stability at four weeks, six stifles had normal or possessed less than 3.0 mm of cranial drawer motion in either flexion or extension at 26 weeks after the operation. At subsequent examinations, six dogs were free of clinical lameness, and one had a mild intermittent lameness with exercise at 26 weeks after the operation. The extra-articular fascial strip technique is an alternative to lateral retinacular suture techniques for stabilization of the cranial cruciate deficient stifle in dogs weighing less than 15 kg.

An extra-articular fascial strip technique for stabilization of the cranial cruciate deficient stifle is described and evaluated. The technique was easily performed and resulted in normal stifle joint biomechanics, as determined by evaluation of the instantaneous centre of motion. All of the dogs performed well and six of seven were free of lameness 26 weeks after the operation.

Keywords

Cruciate ligament - extra-articular repair - fascial strip - instant centre of motion

Full Text

References

REFERENCES
1 Arnoczky SP. The cruciate ligaments: the enigma of the canine stifle. J Small Anim Pract 1988; 29: 71-90.
2 Brinker WO, Piermattei DL, Flo GL. Handbook of Small Animal Orthopedics and Fracture Treatment. Philadelphia: WB Saunders; 1990: 397-415.
3 Pond MJ, Cambell JR. The canine stifle joint. I. Rupture of the anterior cruciate ligament. An association of conservative and surgical treatment. J Small Anim Pract 1972; 13: 1-10.
4 Flo GL. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975; 11: 570-6.
5 DcAngelis M, Lau RE. A lateral retinacular imbrication technique for the surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970; 157 (Suppl. 01) 79-84.
6 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: 33-8.
7 Hulse DA, Michaleson F, Johnson C. et al. A technique for reconstruction of the anterior cruciate ligament in the dog: Preliminary report. Vet Surg 1980; 9: 135-40.
8 DeYoung DJ, Flo GL, Tvedten H. Experimental medial meniscectomy in dogs under-going cranial cruciate ligament repair. J Am Anim Hosp Assoc 1980; 16: 639-45.
9 Dulish ML. Suture reaction following extra-articular stifle stabilization in the dog -Part I: A retrospective study of 161 stifles. J Am Anim Hosp Assoc 1981; 17: 569-71.
10 Johnson SG, Hulse DA, Hogan HA. et al. System behavior of commonly used cranial cruciate ligament reconstruction autografts. Vet Surg 1989; 18 (Suppl. 06) 459-65.
11 Butler DL, Hulse DA, Kay MK. et al. Biomechanics of cranial cruciate ligament reconstruction in the dog. II: Mechanical properties. Vet Surg 1983; 12 (Suppl. 03) 113-8.
12 Piermattei DL, Greeley RG. An Atlas of Surgical Approaches to the Bones of the Dog and Cat. Philadelphia: WB Saunders; 1979: 164-5.
13 Hulse DA, Shires PK. Observation of the posteromedial compartment of the stifle joint. J Am Anim Hosp Assoc 1981; 17: 575-8.
14 Hosgood G, Toombs JP. The suture snare technique for passage of tissue strips or flaps. J Am Anim Hosp Assoc 1990; 26: 322-3.
15 Aron DN. A new tendon stitch. J Am Anim Hosp Assoc 1981; 17: 587-91.
16 Prostredny JM, Bauer MS, Blevins WE. et al. Effect of suture type on stifle biomechanics after extra-articular repair of cranial cruciate ligament transection in the dog. VCOT 1991; 4: 144-9.
17 Mitton GR, Ireland WP, Runyon CL. Evaluation of the instantaneous centers of rotation of the stifle before and after repair of torn cruciate ligament by the use of the over-the top technique in dogs. Am J Vet Res 1991; 52 (Suppl. 10) 1731-7.
18 Ireland J, Trickey EL. Macintosh tenodesis for anteriolateral instability of the knee. J Bone Joint Surg 1980; 62B (Suppl. 03) 340-5.
19 Wilson WJ, Scranton PE. Combined reconstruction of the anterior cruciate ligament in competitive athletes. J Bone Joint Surg 1990; 72A: 742-8.
20 Knecht CD, Chaffee VW, Bunch SE. et al. Evaluation of a lateral retinacular fascia technique for cranial cruciate ligament rupture in the dog. Am J Vet Res 1977; 38: 1873-5.
21 Pichler ME, Bacon JP, Evans JA. The fascia lata as a replacement for the cranial cruciate ligament: Two new surgical techniques. J Am Anim Hosp Assoc 1982; 18 (Suppl. 05) 779-84.
22 Hulse DA, Butler DL, Kay MD. et al. Biomechanics of cranial cruciate ligament reconstruction in the dog. I: In vitro laxity testing. Vet Surg 1983; 12 (Suppl. 03) 109-12.
23 Mullen HS, Matthcisen DT. Complications of transpositions of the fibular head for stabilization of the cranial cruciate deficient stifle in dogs: 80 cases (1982-1986). J Am Vet Med Assoc 1989; 195 (Suppl. 09) 1267-71.
24 Arnoczky SP, Torzilli PA, Marshall JL. Biomechanical evaluation of anterior cruciate ligament repair in the dog: An analysis of the instant center of motion. J Am Anim Hosp Assoc 1977; 13: 553-8.
25 Dulish ML. Suture reaction following extra-articular stifle stabilization in the dog -Part II: A prospective study of 66 stifles. J Am Anim Hosp Assoc 1981; 17: 572-4.
26 Wendelberg K, Smcak DD, Kowalski JJ. Chlorhexidinc wound lavage and suture soaking for prevention of suture related infections. VCOT 1988; 3: 122-9.