Measurement of the patellar tendon-tibial plateau angle and tuberosity advancement in dogs with cranial cruciate ligament rupture

Millet, M.; Bismuth, Camille; Labrunie, Anaïs; Marin, Benoît; Filleur, A.; Pillard, Paul; Sonet, Juliette; Cachon, Thibaut; Etchepareborde, S.

doi:10.3415/vcot-13-01-0018

Cited by 32 publications

(20 citation statements)

References 32 publications

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“…The ICD measurement reported in this study was obtained by measuring the distance between the TMA and FCA. Clinical studies evaluating osteophytosis within the stifle joint noted that osteophytosis does not affect the identification of the intercondylar eminences which are both utilized in the determination of the TMA [20, 21]. Additionally, calculation of the FCA described in our study should not be affected by degenerative changes in the stifle joint.…”

Section: Discussionmentioning

confidence: 81%

Ex vivo preliminary investigation of radiographic quantitative assessment of cranial tibial displacement at varying degrees of canine stifle flexion with or without an intact cranial cruciate ligament

Castaneda¹,

Hudson²,

Beale³

2018

BMC Vet Res

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BackgroundThe presence of cranial tibial subluxation can aid in the detection of joint instability as a result of CrCL injury. Detection of cranial tibial subluxation has been described using the tibial compression test (TCT) and cranial drawer test (CDT); however, diagnosis of CrCL insufficiency by assessing cranial subluxation motion of the tibia is subjective and difficult to quantify accurately. The aim of this study was to investigate a measurement technique to assess the degree of cranial tibial displacement relative to the femoral condyles on mediolateral projection stifle radiographs at varying degrees of stifle flexion (90°, 110°, and 135°) in CrCL intact, partially, and completely transected conditions. Radiographic measurements included: CrCL length and intercondylar distance (ICD), defined as the distance between the tibial mechanical axis (TMA) and the femoral condylar axis (FCA). The influence of CrCL status, stifle flexion angle, and measurement type on measured distance was evaluated. The relationship between CrCL length and ICD measurement was also assessed.ResultsComplete transection of the CrCL resulted in significant cranial tibial displacement. Stifle flexion angle affected ICD, but not CrCL length. Normalized measured CrCL length and ICD were significantly different; however, no differences existed between the change in distance detected by CrCL length and ICD measurements as CrCL transection status changed. Correlation coefficients detected a significant positive correlation between measured CrCL and ICD.ConclusionThe ICD measurement technique was able to quantify tibial displacement at various stifle flexion angles in the intact and completely transected CrCL conditions. The ICD measurement was more affected by stifle flexion angle than was the CrCL length.Electronic supplementary materialThe online version of this article (10.1186/s12917-018-1599-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 81%

Ex vivo preliminary investigation of radiographic quantitative assessment of cranial tibial displacement at varying degrees of canine stifle flexion with or without an intact cranial cruciate ligament

Castaneda¹,

Hudson²,

Beale³

2018

BMC Vet Res

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“…We chose the Blackburne and Peel [26] method because it has been shown to have less interobserver error when compared to other commonly used techniques [27]. With the specimen in a fixed position between radiographs the common tangent of the femoro-tibial articulation was considered a consistent reference from which to measure [21, 28, 29]. We found excellent interobserver agreement using this method.…”

Section: Discussionmentioning

confidence: 99%

“…The positioning was readjusted until the limbs were deemed to have minimal femoral or tibial rotation. The required cage size was determined using both the tibial plateau and the common tangent method [21]. If the two measurements indicated cage sizes that differed by two sizes based on manufacturer recommendations6, a cage of intermediate size was used (for example a 10.5mm cage was used if the common tangent method indicated a 9mm cage and tibial plateau slope indicated a 12mm cage).…”

Section: Methodsmentioning

confidence: 99%

“…The consequence of this is a potential failure to achieve a 90 0 PLA postoperatively [20]. Discrepancies have also been noted between the tibial plateau slope and common tangent methods of determining PLA at varying degrees of stifle extension [21]. This highlights the importance of consistent limb positioning in assuring the accuracy of these measurements [21–25].…”

Section: Introductionmentioning

confidence: 99%

“…Discrepancies have also been noted between the tibial plateau slope and common tangent methods of determining PLA at varying degrees of stifle extension [21]. This highlights the importance of consistent limb positioning in assuring the accuracy of these measurements [21–25]. The effect of proximalization of the tibial tuberosity during advancement on postoperative PLA is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

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Effect of proximal translation of the osteotomized tibial tuberosity during tibial tuberosity advancement on patellar position and patellar ligament angle

et al. 2016

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BackgroundCranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients. This cadaveric and radiographic study was performed with the aim of determining the effect of proximal translation of the tibial tuberosity during tibial tuberosity advancement (TTA) on patellar position (PP) and patellar ligament angle (PLA).ResultsDisarticulated left hind limb specimens harvested from medium to large breed canine cadavers (n = 6) were used for this study. Limbs were mounted to Plexiglass sheets with the stifle joint fixed in 135° of extension. The quadriceps mechanism was mimicked using an elastic band. Medio-lateral radiographs were obtained pre-osteotomy, after performing TTA without proximal translation of the tibial tuberosity, and after proximal translation of the tibial tuberosity by 3mm and 6mm. Radiographs were blinded to the observer for distance of tibial tuberosity proximalization following radiograph acquisition. Three independent observers recorded PP and PLA (tibial plateau method and common tangent method). Comparisons were made between the stages of proximalization using repeated measures ANOVA. Patellar position was found to be significantly more distal than pre-osteotomy, if the tibial tuberosity was not translated proximally (P = 0.001) and if it was translated proximally by 3mm (P = 0.005). The difference between pre-osteotomy PP and 6mm proximalization was not significant. The PLA was significantly larger if the tibial tuberosity was not translated proximally compared to tibial tuberosity proximalization of 6mm using the tibial plateau and the common tangent methods (P = 0.006 and P = 0.015 respectively).ConclusionsProximalizing the tibial tuberosity during TTA helps in maintaining vertical position of the patella in the patellar groove. Proximalization of the tibial tuberosity reduces PLA when compared to TTA without tibial tuberosity proximalization.

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Tibial Tuberosity Advancement

Boudrieau

2017

Advances in the Canine Cranial Cruciate Ligament

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Measurement of the patellar tendon-tibial plateau angle and tuberosity advancement in dogs with cranial cruciate ligament rupture

Abstract: Given its poor reliability, the CT method is not recommended.

Cited by 32 publications

References 32 publications

Ex vivo preliminary investigation of radiographic quantitative assessment of cranial tibial displacement at varying degrees of canine stifle flexion with or without an intact cranial cruciate ligament

Ex vivo preliminary investigation of radiographic quantitative assessment of cranial tibial displacement at varying degrees of canine stifle flexion with or without an intact cranial cruciate ligament

Effect of proximal translation of the osteotomized tibial tuberosity during tibial tuberosity advancement on patellar position and patellar ligament angle

Tibial Tuberosity Advancement

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