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Mazdarani et al: Effect of center of rotation of angulation‐based leveling osteotomy on ex vivo stifle joint stability following cranial cruciate ligament transection and medial meniscal release with and without a hamstring load
Veterinary Surgery 6, 2022

🔍 Key Findings

  • CBLO reduced tibial plateau angle (TPA) from a mean of 28.1° to 9.7°, aligning with its goal of flattening the tibial slope.
  • CBLO eliminated cranial tibial translation (CTT) following CCL transection and meniscal release at all angles except 140° without hamstring load.
  • Hamstring loading (20% quadriceps load) significantly reduced or delayed the onset of CTT, improving stifle stability.
  • Medial meniscus was confirmed as a secondary stabilizer; its release (MMR) caused more CTT than CCLx alone.
  • PTA (patellar tendon angle) increased with joint extension; CBLO shifted the PTA curve lower and parallel to intact values, suggesting effective flexion of the joint.
  • Combined CBLO and hamstring loading resulted in the most stable joints, especially from 50° to 135° joint angles.
  • Residual CTT occurred in CBLO-only limbs at higher extension angles (e.g., 140°), but hamstring load mitigated this.
  • Stifle stability post-CBLO is multifactorial, depending on joint angle, meniscal integrity, and hamstring activation.

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Mazdarani et al: Effect of center of rotation of angulation‐based leveling osteotomy on ex vivo stifle joint stability following cranial cruciate ligament transection and medial meniscal release with and without a hamstring load
Veterinary Surgery 6, 2022

🔍 Key Findings

  • CBLO reduced tibial plateau angle (TPA) from a mean of 28.1° to 9.7°, aligning with its goal of flattening the tibial slope.
  • CBLO eliminated cranial tibial translation (CTT) following CCL transection and meniscal release at all angles except 140° without hamstring load.
  • Hamstring loading (20% quadriceps load) significantly reduced or delayed the onset of CTT, improving stifle stability.
  • Medial meniscus was confirmed as a secondary stabilizer; its release (MMR) caused more CTT than CCLx alone.
  • PTA (patellar tendon angle) increased with joint extension; CBLO shifted the PTA curve lower and parallel to intact values, suggesting effective flexion of the joint.
  • Combined CBLO and hamstring loading resulted in the most stable joints, especially from 50° to 135° joint angles.
  • Residual CTT occurred in CBLO-only limbs at higher extension angles (e.g., 140°), but hamstring load mitigated this.
  • Stifle stability post-CBLO is multifactorial, depending on joint angle, meniscal integrity, and hamstring activation.

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Multiple Choice Questions on this study

In Mazdarani 2022 et al., on CBLO and stifle biomechanics, when did cranial tibial translation (CTT) occur after CBLO **without** hamstring loading?

A. Only during flexion below 60°
B. At all angles from 50° to 140°
C. Only at 90° and above
D. Only at 140°
E. CTT was completely eliminated

Answer: Only at 140°

Explanation: CBLO eliminated CTT at all angles **except 140°** in the absence of hamstring load.
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, what was the **mean postoperative tibial plateau angle (TPA)** achieved after CORA-based leveling osteotomy (CBLO)?

A. 5.0°
B. 8.2°
C. 9.7°
D. 12.5°
E. 15.0°

Answer: 9.7°

Explanation: CBLO reduced the mean TPA from 28.1° to 9.7°, consistent with the surgical goal of flattening the tibial slope.
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, what was the effect of adding **hamstring loading (29 N)** in CCLx or MMR limbs?

A. It worsened CTT across all joint angles
B. It improved CTT only in full extension
C. It delayed or prevented CTT, improving stability
D. It had no measurable effect on PTA
E. It increased joint instability at low flexion

Answer: It delayed or prevented CTT, improving stability

Explanation: Hamstring load reduced or delayed onset of CTT, enhancing stifle stability, especially following MMR.
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, which statement best describes the **patellar ligament angle (PTA)** after CBLO?

A. It followed the intact PTA curve
B. PTA increased significantly at all angles
C. PTA was unchanged
D. PTA was consistently lower than intact, mimicking flexion
E. PTA increased at 140° only

Answer: PTA was consistently lower than intact, mimicking flexion

Explanation: CBLO resulted in a parallel but lower PTA curve, indicating effective flexion induced by the osteotomy.
In Mazdarani 2022 et al., on CBLO and stifle biomechanics, the release of the medial meniscus (MMR) led to which of the following?

A. Increased TPA
B. Reduced patellar tendon angle (PTA) at all joint angles
C. Increased cranial tibial translation (CTT) earlier than CCLx
D. No measurable change in stability
E. Improved stifle extension mechanics

Answer: Increased cranial tibial translation (CTT) earlier than CCLx

Explanation: MMR led to earlier and more severe CTT than CCLx alone, highlighting the meniscus as a secondary stabilizer.

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Effect of center of rotation of angulation‐based leveling osteotomy on ex vivo stifle joint stability following cranial cruciate ligament transection and medial meniscal release with and without a hamstring load