Stifle joint luxation in the dog and cat: The use of temporary intraoperative transarticular pinning to facilitate joint reconstruction

Abstract

Multiple ligament injuries of the canine and feline stifle joint which result in luxation are uncommon. Two cats and one dog, that had sustained such a joint injury were surgically treated. A rupture of the cranial and caudal cruciate ligaments, and at least one collateral ligament was observed in all of the three animals. Prosthetic reconstruction was used, as previously described, in combination with a novel technique of intraoperative placement of a temporary trans-articular pin (TTP) to maintain intra-operative anatomical reduction. TTP placement facilitated maintenance of joint alignment during surgical reconstruction and aided appropriate tensioning of the prosthetic sutures, preventing collapse of femorotibial joint compartments. The TTP was removed prior to closure of the joint allowing immediate post-operative joint mobilisation. Based on assessment by their owners, all the animals made a complete recovery. TTP was considered a relatively simple and effective adjunctive aid for surgical treatment of traumatic luxation of the stifle joint.

Custom‐built constrained uniaxial and rotating hinge total knee replacement in cats: Clinical application, design principles, surgical technique, and clinical outcome

“…Most cats (8/9) in this case series presented with traumatic stifle luxation. Although good results have been reported in the literature, [9][10][11][12][13][14][15][16] albeit with subjective outcome measures, it has been the author's experience that functional outcome of extracapsular ligament replacement techniques is often fraught with challenges in attaining concomitant isometricity of all support structures, particularly when severe meniscal injury is present. In this study, some form of stifle stabilization and reconstruction was attempted in four of eight stifles before proceeding with TKR because of failure of primary stabilization (Table 1).…”

“…In the other four cats, meniscal injury was deemed too severe (complex tears) and not reconstructable, and stabilization was not deemed possible with an expectably good outcome, during stifle inspection. Although arthrodesis was a valid option, 14 TKR was deemed likely to yield superior function to stifle arthrodesis. Unconstrained or semiconstrained TKR implants were not considered because of the disruption of periarticular support structures.…”

“…[9][10][11] Reported treatments for feline stifle luxation include external coaptation, transarticular pinning, isometric ligament reconstruction with or without adjunctive transarticular external skeletal fixation, and arthrodesis. [9][10][11][12][13][14][15][16][17] Good results have been reported with most of these techniques, but there is a paucity of literature containing objective assessment of outcomes in these cases. It has been the authors' experience that the functional outcome of extracapsular ligament replacement techniques in multidirectionally unstable stifles, when associated with severe meniscal injury, can be suboptimal due to difficulties in attaining and maintaining concomitant isometricity of all support structures.…”