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Use of Blumensaat's line for assessment of cranial tibial subluxation in dogs with cranial cruciate ligament deficiency
Author(s) -
Prior Sebastian,
Silveira Francisco,
Pappa Lida,
López Pablo Pérez,
Quinn Robert,
Barnes Darren
Publication year - 2022
Publication title -
veterinary record
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 99
eISSN - 2042-7670
pISSN - 0042-4900
DOI - 10.1002/vetr.1680
Subject(s) - cruciate ligament , subluxation , stifle joint , medicine , radiography , tibia , anterior cruciate ligament , patellar ligament , anatomy , orthodontics , surgery , pathology , patellar tendon , alternative medicine
Background This study aimed to determine whether Blumensaat's line, a consistently present radiographic feature delineating the peak of the femoral intercondylar fossa, could be used to assess for cranial tibial subluxation in canine stifles with cranial cruciate ligament disease. Methods Thirty sequential, neutrally positioned, standing‐angle stifle radiographs were taken from dogs presenting to a specialist referral centre for treatment of cruciate ligament disease. Thirty similarly positioned radiographs of healthy canine stifles were used as a control group. The radiographs were anonymised and submitted to blinded observers for measurement of the tibial plateau angle, patella tendon angle, Blumensaat's line length and the length of Blumensaat's line cranial to the tibial mechanical axis. Results Finding that the tibial mechanical axis intersects Blumensaat's line cranial to its midpoint, as a marker of cranial tibial subluxation, had a positive predictive value of 76% for subsequent surgical identification of cruciate ligament disease. Conclusions Tibial cranial subluxation is detectable and quantifiable radiographically using the intersection of the tibial mechanical axis and Blumensaat's line. Once quantified, this measurement could be used both as a radiographic marker of cruciate ligament disease and to adjust tibial osteotomy procedures to minimise the risk of under advancement of the tibial tuberosity resulting in a persistently unstable stifle.