Avulsion fracture of the tibial tuberosity with patellar ligament rupture in an adolescent patient

Patellar desmopathy in dogs after tibial plateau levelling osteotomy has been described in many studies. Tibial tuberosity advancement is a biomechanically different technique. It is assumed that the patellar ligament is loaded with little force similarly as after tibial plateau levelling osteotomy. Various aspects related to secondary patellar desmopathy are not completely understood. This study deals with computed radiography measurement of patellar ligament thickness after tibial tuberosity advancement in dogs with cranial cruciate ligament rupture. The thickness of the patellar ligament in exactly predetermined locations was measured from mediolateral radiographs of stifle joints. A total of 18 dogs (20 knee joints) with cranial cruciate ligament (ligamentum cruciatum craniale) rupture underwent three radiographic examinations of the knee (preoperative examination and control examination 7 and 15 weeks after the surgery). Significant difference was found between the thickness of the patellar ligament in the first and second examinations. Some of the demographic factors possibly related to patellar ligament thickness (age, sex, body weight, type of cranial cruciate ligament rupture, arthrotomy, cage size, meniscal injury, time between surgery and radiographic examination) were analyzed. However, statistical analyses did not show any effect of these factors on the thickness of the patellar ligament, except for the time between surgery and radiographic examination. These findings can extend the surgeons’ knowledge of biomechanical aspects of tibial tuberosity advancement.

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Does Osgood-Schlatter Disease exist in the dog?

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-08-09-0094 ◽

2009 ◽

Vol 22 (04) ◽

pp. 257-263 ◽

Cited By ~ 12

Author(s):

C. E. DeCamp ◽

K. L. Diegel ◽

P. A. Gholve ◽

C. W. Probst ◽

L. M. Déjardin ◽

...

Keyword(s):

Conservative Treatment ◽

Classification System ◽

Avulsion Fracture ◽

Clinical Signs ◽

Proximal Part ◽

Tibial Tuberosity ◽

Patellar Ligament ◽

New Classification ◽

Apophyseal Plate ◽

Bone Fragments

SummaryOsgood-Schlatter disease (OSD) is a condition affecting human adolescents in which there is partial separation of bone fragments from the tibial tuberosity at the site of insertion of the patellar ligament to the tibial tuberosity. Tensile trauma seems to be the most likely aetiology. Clinical signs in people consist of swelling and pain at the proximal part of the tibial tuberosity and around the distal end of patellar ligament. Radiographs frequently show small ossicles at the patellar ligament insertion. Conservative treatment is usually curative. The term OSD has also been used for the canine patient. However, radiographs of these patients typically show an enlarged radio-lucent line at the apophyseal plate of the tibial tuberosity. This finding is consistent with a mild avulsion fracture of the canine tibial tuberosity. Based on the radiographic differences between the two species, it seems more appropriate to use the term OSD only for people. The purpose of this paper is to review the literature on OSD in people and the reports of injuries to the proximal tibial tuberosity in dogs. In addition, a new classification system for tibial tuberosity avulsion injuries in the immature dog is proposed, with an algorithm for management of this injury.

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An Alternative Technique for Repair of Patellar Ligament Ruptures with Associated Tibial Tuberosity Avulsion Fracture

International Journal of Orthopaedics ◽

10.17554/j.issn.2311-5106.2016.03.191 ◽

2016 ◽

Vol 3 (5) ◽

pp. 647-649 ◽

Cited By ~ 1

Author(s):

Aniruddha Pendse ◽

◽

David Bruce ◽

Ramesh Chennagiri ◽

Raghubir Kankate

Keyword(s):

Avulsion Fracture ◽

Tibial Tuberosity ◽

Patellar Ligament ◽

Alternative Technique

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Augmented primary repair of patellar ligament rupture in three dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632652 ◽

2000 ◽

Vol 13 (03) ◽

pp. 154-157 ◽

Cited By ~ 9

Author(s):

J. J. de Haan ◽

J. Peck ◽

S. N. Madden ◽

M. E. H. Smith

Keyword(s):

Surgical Repair ◽

Primary Repair ◽

Tibial Tuberosity ◽

Patellar Ligament ◽

Ligament Rupture ◽

Level Of Activity

Treatment of unilateral patellar ligament rupture resulting from laceration is described in three large dogs. Surgical repair involved debridement and suturing of the ligament ends. Augmentation was provided with encircling loops of 27 kg test monofilament nylon passed through transverse holes drilled in the patella and proximal tibial tuberosity. All of the dogs returned to a pre-injury level of activity without any lameness being observed when they were reevaluated five to 24 months after their operation. The method described is a useful technique for repair of patellar ligament rupture that produced excellent and enduring results in these cases.

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Effect of Suture Type on Stifle Joint Biomechanics After Extra-Articular Repair of Cranial Cruciate Ligament Transection in the Dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633270 ◽

1991 ◽

Vol 4 (04) ◽

pp. 144-149 ◽

Cited By ~ 4

Author(s):

M. S. Bauer ◽

W. E. Blevins ◽

W. R. Widmer ◽

Jaqueline Davidson ◽

S. W. Aiken ◽

...

Keyword(s):

Cruciate Ligament ◽

Tibial Tuberosity ◽

Cranial Cruciate Ligament ◽

Stifle Joint ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Before And After ◽

Joint Biomechanics ◽

Cranial Cruciate Ligament Rupture

SummaryThe effect of two suture types, monofilament polybutester and braided polyester, on stifle joint biomechanics after extra-articular repair of cranial cruciate ligament rupture was evaluated by analysis of the instant centre of motion. The instant centres of motion and resulting velocity vectors were determined radiographically on both stifles of eight fresh canine cadavers before and after cranial cruciate ligament transection. After ligament transection, all 16 stifles were repaired with an extra-articular technique utilizing a double strand of suture placed between the lateral fabella and the tibial tuberosity. One stifle on each cadaver was repaired with each suture type. The instant centres of motion and resulting velocity vectors were re-evaluated post repair. All stifles had normal instant centres of motion prior to transection of the cranial cruciate ligament. Neither ligament transection nor extra-articular repair with either suture type resulted in an abnormal change in the instant centre of motion.

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Proximodistal and caudocranial position of the insertion of the patellar ligament on the tibial tuberosity and patellar ligament length of normal stifles and stifles with grade II medial patellar luxation in small‐breed dogs

Veterinary Surgery ◽

10.1111/vsu.13661 ◽

2021 ◽

Author(s):

Liene Feldmane ◽

Lars F. H. Theyse

Keyword(s):

Tibial Tuberosity ◽

Ligament Length ◽

Patellar Ligament ◽

Grade Ii ◽

Small Breed

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Use of the modified Insall Salvati method for determination of vertical patellar position in dogs with and without cranial cruciate ligament rupture considering the morphology of the cranio-proximal tibia

Acta Veterinaria Brno ◽

10.2754/avb201281040403 ◽

2012 ◽

Vol 81 (4) ◽

pp. 403-407 ◽

Cited By ~ 1

Author(s):

Dávid Kňazovický ◽

Valent Ledecký ◽

Marián Hluchý ◽

Marek Ďurej

Keyword(s):

Cruciate Ligament ◽

Patellar Ligament ◽

Insertion Point ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Significant Difference ◽

Healthy Dogs ◽

Cranial Cruciate Ligament Rupture

The aim of this study was to evaluate if the modified Insall Salvati (IS) method can be applied for the canine patient despite differences of proximal tibial morphology, and if such potential differences are also seen in dogs with cranial cruciate ligament rupture. Insall Salvati method is a simple and convenient method for determination of the vertical position of patella, by dividing the length of patella by length of the patellar ligament. The influence of the variable proximal tibial morphology on the modified (IS) index was measured and the value of modified IS index in healthy dogs (n = 25) was compared with dogs with cranial cruciate ligament rupture (n = 26). Medio-lateral radiographs of 102 stifles were evaluated. Patellar ligament length (PLL), patellar length (PL), modified IS ratio and the height of insertion point of patellar ligament on tibial tuberosity were measured. Data of the IS ratio were compared with the value of the height of the insertion point with no significant difference (P = 0.36). There was no significant difference (P = 0.07) in the PLL:PL ratio between dogs affected or unaffected with cranial cruciate ligament rupture. Based on the results of this study we can conclude that the morphology of the cranio-proximal tibia and the height of insertion point of the patellar ligament do not have an influence on the value of the modified IS index both in healthy dogs and in dogs with cranial cruciate ligament rupture.

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Tibial Tuberosity Transposition Fixation with a Locking Plate during Medial Patellar Luxation Surgery: An Ex Vivo Mechanical Study

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0041-1736217 ◽

2021 ◽

Author(s):

Esa V. Eskelinen ◽

Ari P. Suhonen ◽

Juha V. Virolainen ◽

William D. Liska

Keyword(s):

Phase I ◽

Phase Ii ◽

Locking Plate ◽

Ex Vivo ◽

Tibial Tuberosity ◽

Tension Band ◽

Patellar Ligament ◽

Raccoon Dog ◽

Tension Band Wire ◽

Lower Load

Abstract Objectives The purpose of this study was to compare the load at failure, stiffness and mode of failure between three types of tibial tuberosity transposition fixation techniques: (a) pin and figure-8 tension band wire (Pin-TBW), (b) locking plate with pin and a tension band wire (Plate-Pin-TBW) and (c) locking plate with a pin (Plate-Pin). Methods Six pairs of raccoon dog cadaveric tibiae were tested in Phase I Pin-TBW versus Plate-Pin-TBW and seven pairs in Phase II Plate-Pin-TBW versus Plate-Pin. One limb of each pair was randomly assigned to one of two groups for each phase. A tensile force was applied to the patellar ligament until construct failure. Results Pin-TBW (342N ± 54.7N) failed at a lower load than Plate-Pin-TBW (469N ± 77.3N), p = 0.00748, with all Pin-TBW failing by fracture and the majority of Plate-Pin-TBW failing by rupture of patellar ligament. Pin-TBW group Phase I, normalized with Plate-Pin-TBW Phase I, failed at a lower load than Plate-Pin group Phase II, normalized with Plate-Pin-TBW Phase II, p = 0.00467. There was no significant difference in mean load at failure, stiffness or mode at failure between the groups in the Phase II study. Clinical Significance Although ex vivo mechanical testing does not replicate the postoperative live dog or cat, these results demonstrate lower construct strength of the Pin-TBW construct compared with the Plate-Pin construct in the raccoon dog cadaver model.

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