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Stabilisation of the canine stifle using extra-articular sutures

Stabilisation of the canine stifle using extra-articular sutures is a well established technique, although recent evidence suggests that outcome with TTA and TPLO procedures is superior. Various suture material and methods of securing the material have been used. Research to define ISOMETRIC points around the stifle has been generated by separate research by Don Hulse (2010) and Simon Rowe (2008) but it is unlikely that truly isometric points can be established; rather quasi-isometric points. Nonetheless, Hulse established that there was minimal change in distance between two points defined as: 1. close to the distal pole of the lateral fabella 2. the caudal border of the extensor fossa on the lateral aspect of the proximal tibia. Rowe found that the femoral point was critical and was defined as the very caudal edge of the lateral femoral condyle adjacent to the distal border of the lateral fabella. The tibial point was less critical as long as it was placed proximally. These findings were incorporated in an extra-articular technique developed by James Cook, when a braided woven polyester tape was placed through bone tunnels and secured on the medial aspect of the femur and tibia (TightRope© technique).

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