Canis ISSN: 2398-2942
Stifle: extra-articular stabilization
Synonym(s): Extra-capsular stabilization, fabellotibial suture
Contributor(s): Joseph Harari, Toby J Gemmill
Introduction
- Aim of procedure is to increase the tension in the peri-articular soft tissues and limit abnormal craniocaudal instability and excessive internal tibial rotation.
- Sutures are usually applied on the lateral aspect of the stifle, but some techniques involve both aspects of the joints.
- A number of techniques are commonly used.
- All techniques will limit normal joint motion to some degree.
- Most suture materials eventually fail and in the long term joint stability is provided by peri-articular fibrosis. Dynamic stability from the hamstring muscles may also play a part in joint stability in the long term.
Uses
Advantages
- Provides immediate joint stability.
- Foreign material placed outside the joint.
- Relatively straightforward surgery.
- Little specialized equipment needed.
- Well established and tested technique.
Disadvantages
- Dogs often relatively uncomfortable for first 1-2 weeks following surgery.
- Permanent peri-articular foreign material may increase risk of infection.
- Sutures generally fail within 6-8 weeks, and hence permanent joint stability is not restored.
- Can prevent normal internal rotation of the joint, especially during flexion.
Requirements
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Preparation
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Procedure
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Aftercare
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Outcomes
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Prognosis
- Favorable - around 90% of dogs will significantly improve following surgery and regain good use of the operated limb.
- Some future osteoarthritis is inevitable and will require long term management.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Dunn A L, Buffa E A, Marchevsky A M et al (2012) Inter- and intra-operator variability associated with extracapsular suture tensioning. An ex vivo study. Vet Comp Orthop Traumatol 12 (6), 472-477 PubMed.
- Tonks C A, Lewis D D, Pozzi A (2011) A review of extra-articular prosthetic stabilization of the cranial cruciate ligament-deficient stifle. Vet Comp Orthop Traumatol 24 (3), 167-177 PubMed.
- Cook J L, Luther J K, Beetem J et al (2010) Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs. Vet Surg 39 (3), 315-323 PubMed.
- Roe S C, Kue J, Gemma J (2008) Isometry of potential suture attachment sites for the cranial cruciate ligament deficient canine stifle. Vet Comp Orthop Traumatol 21 (3), 215-220 PubMed.