Extracapsular Stabilization

Tinga, Selena; Kim, Stanley E.

doi:10.1002/9781119261728.ch25

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…[4][5][6][7] High rates of premature graft failure and poor limb function have resulted in intra-articular techniques falling out of favor. 4,[6][7][8][9][10][11][12][13] Similarly, extracapsular suture techniques have been shown to have a poorer functional outcome when compared to tibial osteotomies. 7,[13][14][15] In order to improve the functional outcome of extracapsular suture techniques, the isometric principle has been extrapolated to the lateral aspect of the joint where it is thought that placing a prosthesis close to isometric points will result in improved outcome.…”

Section: Introductionmentioning

confidence: 99%

“…4,[6][7][8][9][10][11][12][13] Similarly, extracapsular suture techniques have been shown to have a poorer functional outcome when compared to tibial osteotomies. 7,[13][14][15] In order to improve the functional outcome of extracapsular suture techniques, the isometric principle has been extrapolated to the lateral aspect of the joint where it is thought that placing a prosthesis close to isometric points will result in improved outcome. Several studies have identified isometric points on the lateral aspects of the femur and tibia using a variety of techniques.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have identified isometric points on the lateral aspects of the femur and tibia using a variety of techniques. [16][17][18][19] However, it has been shown that although a good functional outcome can be expected using isometric points, 13,17,18,20 the techniques do not restore normal stifle biomechanics, 21 and the occurrence of implant failure remains high. 16,17,22 Significant instability also persists in dogs treated with tibial osteotomies, 23,24 and although these dogs often do not show clinical lameness, failure to restore normal stifle biomechanics results in late meniscal damage, 25,26 and progressive osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

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Determination of Isometric Points in the Stifle of a Dog Using a 3D Model

Yair

Yiapanis

Ben‐Amotz

et al. 2023

Vet Comp Orthop Traumatol

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Objective The aim of this study was to develop a three-dimensional (3D) model to identify the isometric component of the cranial cruciate ligament (CCL) in dogs. Methods A static 3D model of the specimen was generated from a computed tomography scan of the stifle of a dog and a kinematic model was generated from data collected, every 5 degrees from full extension (131 degrees) through 80 degrees of stifle flexion, from four sensors attached to the tibia. Kinematic data were superimposed on the static model by aligning the points of interest, which were defined for both models. This allowed the tibia to rotate and translate relative to the femur based on the kinematic data. The contours of the distal femur and proximal tibia were converted into point clouds and the distance between each point in the femoral point cloud and all the points in the tibial point cloud were measured at each of the 15 positions. The difference between the maximum and minimum distances for each pair of points was calculated, and when it was less than 0.2 mm, points were illustrated as two red dots connected by a line at their locations on the femur and tibia. Results A total of 3,681 pairs of isometric points were identified and were located at the origin and insertion of the CCL and on the lateral aspect of the stifle. Conclusion Isometric areas are present at the origin and insertion of the CCL and lateral aspect of the stifle. Better understanding of these locations may lead to refinements in techniques to replace the ruptured CCL.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Determination of Isometric Points in the Stifle of a Dog Using a 3D Model

Yair

Yiapanis

Ben‐Amotz

et al. 2023

Vet Comp Orthop Traumatol

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In vivo three‐dimensional isometry analysis of suture attachment sites for extracapsular suture stabilization of the canine stifle

Lin

Wang

et al. 2021

Veterinary Record

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Background The study aimed to perform isometry analysis of a selection of suture attachment points for extracapsular stabilization with three‐dimensional (3D) measurements and normal gait kinematics of the stifle joint. Methods Thirteen client‐owned dogs were recruited. Fluoroscopic images of the stifle during treadmill walking and computed tomography of the same joint were acquired. Stifle kinematics were reconstructed using 3D model‐based fluoroscopic analysis. Variability of the distance between the femoral and tibial attachment sites across gait cycles was evaluated. The maximum length variation (MLV) and maximum length percent variation (MLPV) were quantified and used to determine the level of isometry of the attachment site combinations. Results A selection of combinations with lower mean MLV (<2.5 mm) or MLPV (<8%) was identified from 315 combinations, and all the combinations involved femoral attachment sites near the distal pole of the lateral fabella. The combinations also involving tibial attachment sites near the proximal tibial crest showed improved isometry, with an MLPV < 6%. Conclusion Combinations using attachment sites around the distal pole of the lateral fabella and proximal tibial crest or caudal to the long digit extensor groove appeared to have improved isometry.

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Ex vivo biomechanical evaluation of extracapsular stabilization with quasi-isometric points in canine cranial cruciate ligament-deficient stifles

Hsu¹,

Lin²,

Sun³

et al. 2023

BMC Vet Res

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Background Cranial cruciate ligament (CCL) disease is one of the most common causes of lameness in dogs. The extracapsular stabilization (ECS) utilizing bone anchors and monofilament nylon leader was an alternative treatment for CCL-deficient (CCLD) dogs. However, the biomechanical response of the canine stifle to such a surgical repair strategy in conjunction with the use of recently reported quasi-isometric anchoring points remains unclear. The objectives of the study were to evaluate the mobility and stability of CCL-intact, CCLD, and CCLD stifles repaired with ECS at two different pairs of quasi-isometric points (quasi-IPs). Methods Twelve stifle specimens from 7 dogs underwent mobility and stability tests under 4 different conditions, namely, CCL-intact, CCLD, and ECS-repaired at 2 different pairs of quasi-IPs (referred to as ECS-IP1 and ECS-IP2). The mobility tests evaluated 6 degrees-of-freedom stifle kinematics during flexion and extension. The stability tests involved cranial drawer and tibial internal rotation (IR) tests at various stifle opening angles and quantifying the cranial tibial translation (CTT) and tibial IR angles under constantly applied loadings. Results The ECS repaired at quasi-IPs was shown to restore cranial instability of the stifles with averaged CTT magnitudes < 1.4 mm. During the tibial IR test, the ECS treatments resulted in significantly less tibial IR compared to those in intact CCL stifles. The mobility tests showed similar results. Conclusion The 2 chosen pairs of quasi-IPs were shown to effectively correct the excessive CTT caused by CCLD stifles, whereas the excessive tibial external rotation in comparison to those of intact stifles should be considered for its subsequent influence on joint alignment and the contact pressure applied to the stifle joint.

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Extracapsular Stabilization

Cited by 3 publications

References 44 publications

Determination of Isometric Points in the Stifle of a Dog Using a 3D Model

Determination of Isometric Points in the Stifle of a Dog Using a 3D Model

In vivo three‐dimensional isometry analysis of suture attachment sites for extracapsular suture stabilization of the canine stifle

Ex vivo biomechanical evaluation of extracapsular stabilization with quasi-isometric points in canine cranial cruciate ligament-deficient stifles

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