Objective: To evaluate the effects of tibial tuberosity advancement (TTA) on canine biomechanics in the cranial cruciate ligament (CrCL)-deficient stifle using a 3-dimensional quasi-static rigid body pelvic limb computer model simulating the stance phase of gait. Study Design: Computer simulations. Animals: A 5-year-old neutered male Golden Retriever weighing 33kg. Methods: A TTA was implemented in a previously developed canine pelvic limb computer model using the tibial plateau slope and common tangent planning techniques. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared to CrCL-intact and CrCL-deficient stifles. Results: The TTA significantly decreased peak caudal cruciate ligament load, significantly increased peak lateral collateral ligament load, and significantly changed peak medial collateral ligament load occurrence, while there was no significant difference in peak patellar ligament load compared to the CrCL-intact stifle. Compared to the CrCL-deficient stifle, peak caudal cruciate, lateral collateral and medial collateral ligament loads significantly decreased, while peak patellar ligament load was similar, peak relative tibial translation significantly decreased and peak relative tibial rotation was converted to external rotation in the TTA-treated stifle. Each TTA planning technique generated similar caudal cruciate, medial collateral, and patellar ligament loading as well as relative tibial translation, but lateral collateral ligament loading and occurrence of relative tibial rotation differed significantly across the techniques. Conclusions: Model-predicted stifle ligament loads improved following TTA compared to the CrCL-deficient stifle, but TTA did not restore CrCL-intact stifle biomechanics. The TTA effectively reduced tibial translation, but tibial rotation was not stabilized.
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