[Radiographic location of the tibial cranial cruciate ligament attachment in middle- to large breed dogs].
OBJECTIVE
Investigation of the radiographic cranio-caudal (cc) and medio-lateral (ml) location of the tibial centroid of the attachment area of the CCL (ACCL).


METHODS
In 46 tibiae from orthopedically healthy dogs (22-50kg) the tibial plateau was stripped of all soft tissue, degreased with acetone and the contour of the ACCL was marked with ink stain. The CCL was completely resected and one pin each was placed at the most medial, lateral, cranial and caudal extensions of the ACCL. On digital images of each tibial plateau the previously marked contour of the ACCL was traced. Using custom-made image analysis software the two-dimensional centroid of the ACCL was determined and transferred to standard radiographs in two planes of each tibia. The cc location of the centroid of the ACCL was measured starting at the intercondylar tubercles. The proximal tibial extension (TibEx) was obtained and linear regression analysis was applied to develop a mathematical first order equation for the calculation of the cc location of the centroid based on the proximal tibial depth in the individual stifle. The ml location of the centroid was measured in relation to the medial intercondylar tubercle.


RESULTS
A statistically significant (p<0.001) correlation was found between the TibEx and the anatomical cc location of the centroid. Linear regression analysis revealed a first order linear equation for calculation of the individual cc location of the centroid in mm to be: 0.28 x TibEx - 4 in mm with an R2 of 0.83. The median ml location of the centroid in relation to the medial intercondylar tubercle was 0mm whereas 90% were located 1 mm medial and 1 mm lateral to the medial intercondylar tubercle.


CONCLUSIONS
The radiographic location of the centroid of the ACCL can be individually determined on standard stifle radiographs.


CONCLUSIONS
With the help of these data the location of a tibial drill tunnel in anatomic reconstruction of the ruptured CCL may be evaluated either intra-operatively with fluoroscopy or postoperatively on two plane standard stifle radiographs and the placement could be corrected when necessary.
Philipp Winkels, Klinik für Kleintiere der Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, E-Mail: winkels@kleintierklinik.uni-leipzig.de.
P
P
Winkels
V
V
Grevel
G
G
Oechtering
P
P
Böttcher