Comparative kinetic and kinematic evaluation of TPLO and TPLO combined with extra‐articular lateral augmentation: A biomechanical study

Abstract

Objectives To investigate stifle kinematics and kinetics following TPLO and TPLO combined with an extra‐articular lateral augmentation (TPLO‐IB) during the tibial compression test (TCT) and the tibial pivot compression test (TPT), applied with an external (eTPT) and an internal moment (iTPT). Study design Experimental ex vivo study. Sample population Ten cadaveric hindlimbs of dogs weighing 23–40 kg. Methods 3D‐kinematic and kinetic data were collected while performing TCT, eTPT, and iTPT and compared under the conditions (1) normal, (2) CCL deficient, (3) TPLO, and (4) TPLO‐IB. Two‐way repeated‐measures ANOVA was used to examine the effect of test and treatment on kinetic and kinematic data. Results Mean ± SD preoperative TPA was 24.7° ± 1.7°, postoperative TPA was 5.9° ± 0.7°. During TCT, there was no difference in cranial tibial translation between the intact stifle and after TPLO (p = .17). In contrast, cranial tibial translation was six times larger in TPLO compared to intact when performing eTPT and iTPT (p < .001). Cranial tibial translation with TCT, eTPT and iTPT was not different between intact stifle and TPLO‐IB. Intraclass correlation coefficient for eTPT and iTPT after TPLO and TPLO‐IB was excellent being 0.93 (0.70–0.99) and 0.91 (0.73–0.99), respectively. Conclusion Whereas TCT is negative after TPLO, instability persists when a rotational moment is combined using eTPT and iTPT. TPLO‐IB neutralizes craniocaudal and rotational instability when performing TCT, eTPT, and iTPT.

Combination of TPLO, medial and lateral augmentation techniques for the treatment of traumatic stifle luxation in a cat

“…The study suggested that adding an extra-articular lateral augmentation might be more successful in re-establishing stifle kinematics than TPLO alone. 29 In the present case, a lateral augmentation suture was applied successfully to neutralise residual cranial tibial translation and internal tibial rotational instability.…”