Métodos de mensuração radiográfica do avanço da tuberosidade tibial na técnica de TTA-Maquet: estudo ex-vivo em cães

Abstract

The cranial cruciate ligament (CCL) has the main functions to prevent cranial translation of the tibia and to limit medial rotation of the tibia during stifle flexion. The rupture/deficiency of the CCL generates instability in the stifle joint that compromises the locomotor function of the pelvic limb and this is a very common disease in dogs. Although this disorder may be associated with traumatic episodes, studies suggest that genetic factors in susceptible breeds and the biomechanics of the canine stifle predispose to chronic intrinsic ligament degeneration. On orthopedic examination, abnormal cranial movement of the tibia in the drawer and tibial compression tests confirms the diagnosis of rupture/deficiency of the CCL. Radiographic examination supports the diagnosis of the disease and changes such as capsular thickening, joint effusion and signs of degenerative joint disease suggest the presence of joint instability. Surgical treatments aim to restore stifle joint stability in different ways and three groups of techniques have been described: intracapsular, extracapsular and tibial osteotomies. Techniques of tibial osteotomy, such as tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA), modify the biomechanics of the stifle in order to eliminate joint shear forces. The TTA technique consists of performing linear osteotomy in the tibial tuberosity to provide its cranial advancement together with the insertion of the patellar ligament, which promotes the dynamic stabilization of the stifle joint. Currently, the improvement of surgical techniques for the treatment of CCL rupture/deficiency is the object of study by several researchers in the field of small animal orthopedics.