Surgical Technique and Initial Clinical Experience with a Novel Extracapsular Articulating Implant for Treatment of the Canine Cruciate Ligament Deficient Stifle Joint.

OBJECTIVE: To describe the surgical technique, clinical efficacy, and complications using the Simitri Stable in Stride(®) extracapsular articulating implant (EAI) to treat naturally occurring stifle instability due to cranial cruciate ligament (CrCL) insufficiency. STUDY DESIGN: Prospective case series. ANIMALS: Client-owned dogs with CrCL-deficient stifles (n=60 dogs; 66 stifles). METHODS: An EAI was applied to the medial aspect of the distal femur and proximal tibia after stifle exploration and treatment of joint pathology. Outcome measures included lameness score, time to weight bearing, and bilateral assessment of stifle stability, stifle range of motion (ROM), and thigh circumference (TC). Outcome measures were determined preoperatively and at intervals from 4.5 to 16.0 months (median 8.9 months) postoperatively. Data were excluded from bilaterally affected dogs <6 months after CrCL surgery on the contralateral limb, and from dogs with contralateral limb lameness. RESULTS: Within 24 hours of EAI surgery, dogs were weight bearing on 64 of 66 limbs at the walk. Incidence of major complications requiring surgical revision was 15.3% and minor complications was 10.2%. Postoperatively, there were significant improvements in lameness scores and ROM in 34 EAI-treated limbs meeting inclusion criteria, and the mean ROM returned to within normal limits. TC did not change in the operated limb, but decreased significantly in the control limb. CONCLUSION: The EAI effectively stabilized the CrCL-deficient stifle, and significantly improved lameness scores and stifle ROM. Decreased TC in control limbs may have been due to early return to mobility and weight bearing on the EAI-treated limb.

Canine Stifle Biomechanics Associated With a Novel Extracapsular Articulating Implant Predicted Using a Computer Model.

OBJECTIVE: To evaluate the influence of the Simitri Stable in Stride™ extracapsular articulating implant (EAI) on canine stifle biomechanics in the cranial cruciate ligament (CrCL)-deficient stifle using a 3-dimensional (3D) quasi-static rigid body canine pelvic limb computer model simulating the stance phase of gait. STUDY DESIGN: Computer simulations. ANIMALS: Five-year-old neutered male golden retriever (33 kg). METHODS: The EAI was implemented in a previously developed 3D CrCL-deficient canine pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared to the CrCL-intact and CrCL-deficient stifle. RESULTS: The EAI significantly increased peak caudal cruciate and medial collateral ligament loads, significantly changed when peak lateral collateral ligament load occurred, and did not significantly affect peak patellar ligament load compared to the CrCL-intact stifle. Compared to the CrCL-deficient stifle, peak caudal cruciate, lateral collateral, and medial collateral ligament loads significantly decreased in the EAI-managed stifle. Despite decreased peak caudal cruciate ligament loading, the EAI-managed stifle generated local maxima that exceeded those of the CrCL-deficient stifle at various intervals of stance. Peak relative tibial translation and rotation significantly decreased in the EAI-managed stifle compared to the CrCL-deficient stifle. CONCLUSION: Model-predicted stifle biomechanics differed after EAI system application in the CrCL-deficient stifle, but were not restored to that of the CrCL-intact stifle.

Surgical treatment of canine stifle disruption using a novel extracapsular articulated stifle stabilizing implant.

A 5-year-old Labrador retriever mixed breed dog was presented for an acute non-weight-bearing left hind limb lameness. A stifle disruption was diagnosed. The patient was treated using a novel extracapsular articulated stifle stabilizing implant (Simitri™). Twelve weeks after surgery the patient had full range of motion of the affected stifle and had begun to return to pre-injury activity. This is the first reported case of this condition being surgically managed successfully in this manner.

Traitement chirurgical d'une perturbation du grasset canin à l'aide d'un d'implant extracapsulaire articulé de stabilisation pour le grasset innovateur. Une chienne Labrador retriever de race croisée âgée de 5 ans a été présentée pour une boiterie aiguë sans appui de la patte arrière gauche. Une perturbation du grasset a été diagnostiquée. La patiente a été traitée à l'aide d'un implant extracapsultaire articulé de stabilisation pour le grasset (SimitriMD) innovateur. Douze semaines après la chirurgie, la patiente avait une amplitude de mouvement complète du grasset affecté et avait commencé à reprendre les activités préalables à la blessure. C'est le premier cas signalé de la gestion réussie de cette affection à l'aide d'une telle chirurgie.(Traduit par Isabelle Vallières).