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ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE. LIGA-FIBA ISO-TOGGLE PROSTHESIS. 250 lb Liga-Fiba. Toggle. Tie-down button. Threading needle with nylon loop. Demonstration on Plastic Model. Drilling the femoral isometric tunnel. Demonstration on Plastic Model.
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Threading needle with nylon loop
Drilling the femoral isometric tunnel
Drilling the tibial isometric tunnel
The implant: 250 or 500lb LIGAFIBA; UHMWPE
(ultra high molecular weight polyethylene) buttons
Push- Pull graft passer or threading needle is used to pass the graft
A 250lb LIGAFIBA loop secured over an UHMWPE toggle on the medial aspect of the femur
A 250lb LIGAFIBA loop tied over an UHMWPE button on the medial aspect of the tibia. Note that the loop can either pass over or under the LDE.
Note the orientation of the 250lb LIGAFIBA loop
Compression of the LDE tendon (X) is a theoretical problem and placing the material under the tendon is an alternative
Lateral parapatellar approach with reflection of the fascia.
the femoral ISOMETRIC point, which is just cranial to the distal pole of the lateral
Drilling the femoral tunnel from the femoral isometric point
Lateral view of the stifle
the femoral ISOMETRIC point emerging on the medial side of the femur under the caudal edge of the medial vastus muscle
Cranial view of the stifle on completion of the femoral tunnel
Identifying the tibial isometric point on the lateral
aspect of the tibia
the tibial ISOMETRIC point, which is the tubercle on the cranial aspect of the extensor fossa
Drilling the tibial tunnel from the isometric point
the tibial ISOMETRIC point, directed in a lateral to medial direction emerging on the medial aspect of the proximal tibial
Cranial view of the stifle on completion of the tibial tunnel
Long threading needle and nylon loop used to pass the prosthesis through the tibial tunnel
Cranial view showing the start of threading the 250 lb Liga-Fiba loop
starting on the medial aspect of the tibia
threaded through the tibial tunnel in a medial to lateral direction
Cranial view showing the 250 lb Liga-Fiba loop
threaded through the femoral tunnel
Toggle to be inserted
Cranial view showing completion of inserting the 250 lb Liga-Fiba loop
but before insertion of the toggle and tensioning.
Cranial view showing the insertion of the toggle and the start of
tensioning the 250 lb Liga-Fiba loop.
the 250 lb Liga-Fiba loop before and after tying off.
Medial view of the tibia showing the
the 250 lb Liga-Fiba loop being tensioned prior to tying down
the 250 lb Liga-Fiba loop secured by tying over the button
and the ends cut