Omini procedure, a modified over-the-top approach for the reconstruction of the cranial cruciate ligament in the dog using an artificial implant: a cadaveric study

Objective: to describe and evaluate a new intra-articular approach for the treatment of cranial cruciate ligament insufficiency in dogs using an artificial ligament and new bone anchors. Study design: ex vivo study. Animals: twelve canine cadavers weighting between 26 and 45 kg. Methods: a cranio-lateral approach was made to the stifle joint. An 8 mm hole was drilled in the tibia in the center of the insertion area of the cranial cruciate ligament. A helicoil with a modified tibial screw connected to an artificial ligament were inserted in the hole and the ligament was passed through the stifle in accordance with the “over-the-top” procedure. A second 8 mm tunnel was drilled in the distal femur and a helicoil and a modified femoral screw was inserted. The artificial ligament was inserted in the eyelet of the femoral screw, tensioned and fixed in place. After apposing the soft tissues, the cranial drawer sign and the cranial tibial thrust were tested and medio-lateral and a cranio-caudal projection radiographs were performed. Results: post-operative assessment showed a negative cranial drawer test and a negative cranial tibial thrust, with good limb alignment and a normal ROM of the stifle joint. The radiographic control showed correct insertion of both tibial and femoral implants in all cases. Conclusions: this novel technique did not require a long learning curve and these initial mechanical tests of the new implant are encouraging. Further studies are necessary to investigate the effectiveness of this procedure “in vivo”