Evaluation of Collateral Ligament Location and Risk of Injury During Total Knee Replacement in Dogs

Introduction: Injury to the medial collateral ligament (MCL) is the most common intraoperative complication in TKR. The purpose of this study was to define the locations of the collaterals relative to the femoral bone cuts in TKR. We hypothesized that CT-based planning risks violation of the collaterals (MCL > LCL).

Materials and Methods: Paired pelvic limbs were harvested from 12 skeletally mature mixed-breed dogs (19–33.5 kg). The origins and insertions of the MCL and LCL were marked with titanium screws that could be visualized on CT. The footprints were also digitized directly using (1) a coordinate measuring machine, and (2) a white light scanner. The minimum distance from the ligament footprints to the femoral bone cuts was measured, with distances less than 5 mm being considered unsafe.

Results: MCL and LCL footprints were consistently closer to the caudal femoral cut than to the distal femoral cut (p < 0.001 for LCL, p < 0.05 for MCL). The footprints were within 5 mm of the caudal or distal ostectomy plane in 8 of 12 dogs (67%). Impingement of the MCL was seen in all eight cases, while only one case had contact with the footprint of the LCL.

Discussion/Conclusion: Care must be taken to ensure that PSGs do not violate the MCL or LCL. Mapping of collateral ligament footprints, as performed in this study, can be used to create 3D point clouds that can be incorporated into CT-based planning, allowing surgeons to optimize implant positioning without increasing the risk of inadvertent collateral ligament injury.

Acknowledgment

None.

 

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Artikel online veröffentlicht:
15. Juli 2025