Effect of tibial insertion points for lateral suture stabilization on the kinematics of the cranial cruciate ligament deficient-stifle during early, middle and late stance: An in vitro study

Objective: To evaluate the effect of two tibial attachment sites for lateral suture stabilization (LSS) on the kinematics of the cranial cruciate ligament-deficient (CrCL-D) canine stifle during early, middle and late stance.
Study design: In vitro biomechanical study: 32 hind limbs from 16 canine cadavers.
Methods: Limbs were mounted in a testing jig and an electromagnetic tracking system was used to determine 3-D stifle kinematics under 33% body weight load during early, middle and late stance in the following sequence: CrCL intact, CrCL-D and LSS with the distal anchor through the tibial tuberosity (LSSTT) or through the cranial eminence of the extensor groove (LSSEG). The proximal anchor point was the lateral femoro-fabellar ligament.
Results: Transection of the CrCL resulted in significant changes in stifle kinematics during early, middle and late stance. Post-LSS stifle kinematics were more comparable to normal than post-transection kinematics for both techniques. Both LSS techniques restored stifle kinematics in CrCL-D stifles to varying amounts but neither technique successfully restored normal 3-D stifle kinematics. LSSEG improved kinematics of the CrCL-D stifle in the medial-lateral direction and axial rotation but performed poorly in restoring stifle kinematics in the cranial-caudal plane as compared to LSSTT.
Clinical significance: LSSTT and LSSEG techniques failed to completely restore normal stifle kinematics in CrCL-D stifles in vitro.