The effect of tibial tuberosity advancement on Patellar tendon force in canine stifle joint under caudal femoral drawer

Abstract

The Tibial Tuberosity Advancement (TTA) surgical technique is used in veterinary surgery to limit cranial tibial translation during canine gait, lengthening the lever arm of the quadriceps in Anterior Cruciate Ligament-deficient (ACL-deficient) stifle joints. It is know that after TTA, the patellofemoral pressure decreases, but the Patellar Tendon (PT) behavior has not been observed experimentally yet. This study measures the PT force under caudal femoral drawer at knee flexion angles from 135° to 90° in intact and pathological knee to asses the effect of TTA on the tendon. Five fresh cadaveric adult canine stifle joint were tested in an apparatus in which muscle forces of the canine hind limb were simulated. Each knee was tested in three different conditions: intact, ACL-deficient and with TTA. PT force was measured using a electrical transducer. The greater the joint flexion angles, the greater the PT force. The knee average force of the five specimens in 90º flexion were 28.4 ± 3.2 Newtons (N) for the intact, 28.2 ± 3.4 N for the ACL-deficient and 24.9 ± 2 N for the TTA knee, which decreased compared to the healthy knee, so TTA generates a loosening of the PT force. The PT force showed a fast rate of change in the operated knee because of a shift in the pattern of knee flexion, so the biomechanics of the entire joint could be influenced by the TTA technique.