A multiligament, internal brace, coaptationless stifle reconstruction technique for feline stifle luxation

To describe a novel, coaptationless surgical technique for the treatment of multiligament stifle injuries (MLSI).

Retrospective case series.

A total of 23 cats presenting with a rupture of two or more ligaments stabilizing the stifle.

Specific surgical techniques were used to reconstruct each deficient ligament. The TightRope procedure was utilized to treat the cranial cruciate ligament and the lateral collateral ligament injuries. Intra-articular reconstruction was adopted for the caudal cruciate ligament. The medial collateral ligament was reconstructed using knotless anchors. Postoperative joint immobilization was not employed in any case. Clinical evaluations were performed up to 6 months postoperatively including the feline musculoskeletal pain index (FMPI).

Initial stabilization of MLSI using the described techniques was achieved in all cases. Major complications occurred in six cases: four involved recurrent caudal cruciate ligament instability, and two involved medial patellar luxation. All complications were resolved with revision surgery, except in one case where arthrodesis was required. At follow-up evaluations, lameness ranged from grade 1 to undetectable. FMPI scores ranged from 0.95 to 1.0.

The surgical technique described offers an effective approach for managing MLSI in cats without the need for temporary immobilization, provided that all injured ligaments are appropriately reconstructed. Specifically, reconstruction of the caudal cruciate ligament should be performed when deficient, as it may help mitigate the risk of postoperative complications.

This coaptationless technique allows for effective restoration of stifle stability in feline patients, with low complication rates and good clinical outcomes.