Treatment of cranial cruciate ligament rupture with the ligament augmentation and reconstruction system (LARS) in dogs: An in vitro study

Abstract

Objective: To describe the technique and to assess the efficacy of the ligament augmentation and reconstruction system (LARS) in treating cranial cruciate ligament (CCL) deficient stifle joints in dogs. Study design: In vitro study. Animals: Eight hind limbs from four canine cadavers. Methods: Translation measurements in knee specimen at a standing angle of 135 degrees were performed. Translation of the tibial plateau was measured clinically with the drawer test and assessed radiographically with the use of the tibial compression test. In addition, the surgical procedure was evaluated by assessing the position of the bone tunnels in the femur and the tibia and comparing them with the anatomic origin and insertion of the CCL. Results: Clinical tests showed decreased translation values after treatment with the LARS CCL implant in comparison with the CCL deficient stifles. Radiographic imaging showed a difference between the intact CCL and the LARS CCL implant in the distance between the centre of the humeral condyle and the centre of the tibial plateau. The LARS CCL implant did not result in a normal position of the tibial plateau. Scoring of the placement of the bone tunnels in the femur and tibia showed no difference between placement of the bone tunnels in the femur or tibia. Conclusion: Despite the limitations of this study, it can be concluded that the surgical procedure of placing a LARS CCL implant is technical possible, but the procedure results in a small cranial displacement of the tibial plateau. The LARS CCL implant may prove to be of use in patients with CCLD but additional clinical in vivo studies are required.