Simitri Stable in Stride is a three part modular

surgical implant An implant is a medical device manufactured to replace a missing biological structure, support a damaged biological structure, or enhance an existing biological structure. Medical implants are man-made devices, in contrast to a transplant, whi ...

used during surgery performed on dogs to stabilize the

stifle joint The stifle joint (often simply stifle) is a complex joint in the hind limbs of quadruped mammals such as the sheep, horse or dog. It is the equivalent of the human knee and is often the largest synovial joint in the animal's body. The stifle jo ...

(knee) after rupture of the

cranial cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. ...

(CrCL) which is analogous to the anterior cruciate ligament (ACL) in humans. The canine cranial cruciate ligament performs two main functions: it limits cranial tibial translation (forward movement of the

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

hin Hin or HIN may refer to: People * Cornelis Hin (1869–1944), Dutch Olympic sailor * Frans Hin (1906–1968), Dutch Olympic sailor * Johan Hin (1899–1957), Dutch Olympic sailor Science and technology * Hin recombinase, a protein * Hin, an anc ...

relative to the

femur The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates wit ...

high High may refer to: Science and technology * Height * High (atmospheric), a high-pressure area * High (computability), a quality of a Turing degree, in computability theory * High (tectonics), in geology an area where relative tectonic uplift to ...

and internal tibial rotation (inward twisting of the shin relative to the femur). As the CrCL tears, the ability to provide translational and rotational stability is lost. As a result, the knee becomes progressively unstable causing pain, lameness, loss of range of motion and progressive

degenerative joint disease Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the ...

(also known as arthritis). The cause of the CrCL tearing is multifactorial (having many causes) and we don’t yet have a clear picture as to why it occurs. Obesity, conformation, inflammatory conditions of the joint and genetics are all included under the multifactorial umbrella. Genetic factors are undoubtedly important, which would help explain why certain breeds are predisposed, including Labrador and Golden Retrievers, Mastiffs, Rottweilers, Boxers, Staffordshire Terriers, West Highland White Terriers and Newfoundland dogs. In a Simitri Stable in Stride surgical procedure, unlike tibial-plateau-leveling osteotomy (TPLO) and

tibial tuberosity advancement Tibial Tuberosity Advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This procedure was developed by Dr. Slobodan Tepic and Professor Pierre Montavon at the School ...

(TTA), no

osteotomy An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is ...

(cutting of bone) is required making this a much less invasive procedure. A surgical incision is made on the inside of the affected leg and the Simitri implant is positioned over the center of the stifle (knee) joint. All components of the implant remain under the skin but outside the knee Joint. The architecture of the affected joint is unchanged and the biomechanics are not significantly altered. The implant is fixed in place with six cortical locking screws and once implanted provides immediate and continuous translational and rotational stability throughout the entire range of motion. Dogs are almost always able to weight bear on their surgical leg within 24 hours and are expected to begin a comprehensive rehabilitation program, including controlled leash walks the day they go home. Lameness scores and stifle range of motion improve improve rapidly and significantly. Most dogs are expected to recover within four months of surgery.Clinical Evaluation of a Novel Extracapsular Articulating Implant for the Surgical Treatment of Canine Stifle Instability caused by Cranial Cruciate Ligament Disease. NA Embleton, VJ Barkowski. 43rd Annual Veterinary Orthopaedic Society Conference, Big sky, Montana. 2016

Alternative procedures

* Tibial-plateau-leveling osteotomy *

Tibial tuberosity advancement Tibial Tuberosity Advancement (TTA) is an orthopedic procedure to repair deficient cranial cruciate ligaments in dogs. It has also been used in cats. This procedure was developed by Dr. Slobodan Tepic and Professor Pierre Montavon at the School ...

* Tightrope CCL * Triple tibial osteotomy

References

Veterinary procedures Dog health