Assessing the lateral fabellotibial suture technique with an assistant device for cranial cruciate ligament rupture: a cadaveric investigation of pressure mapping in small dogs

This study aimed to determine the optimal stifle joint angle for the lateral fabellotibial suture (LFTS) technique in small dogs with cranial cruciate ligament rupture (CCLR), by quantitatively assessing biomechanical parameters using pressure mapping and a 3D-printed tension assistant device. LFTS procedures were performed on 12 canine hindlimb cadaveric models divided into five groups: (1) Intact group, (2) cranial cruciate ligament-deficient (CCL) group, and (3-5) stifles fixed at 90°, 105°, and 135° (L90, L105, L135). Suture tension was quantitatively measured using a tensioner. Postoperative evaluations included pedobarography, tibial rotation angle, patellofemoral contact pressure, and femorotibial contact pressure, analyzed via force-sensitive resistors and pressure-sensitive films. Pressure mapping visualizations were used to evaluate joint mechanics and pressure distribution. Statistical analyzes were conducted using two-way ANOVA with post-hoc testing. The applied suture tension differed significantly among angle-fixed groups (P<0.05). Significant correlations were observed between experimental groups and pad pressure distribution (P<0.001). No significant difference in femorotibial contact pressure was noted between the L105 and intact groups. These results suggest that a stifle angle of 105° during LFTS most closely replicates normal joint contact mechanics, offering practical insights for optimizing tensioning protocols in small dogs.