1. ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE

2. Threading needle with nylon loop
LIGA-FIBA ISO-TOGGLE PROSTHESIS
250 lb
Liga-Fiba
Toggle
Tie-down
button
Threading needle with nylon loop

3. Demonstration on Plastic Model
Drilling the femoral isometric tunnel

4. Demonstration on Plastic Model
Drilling the tibial isometric tunnel

5. Demonstration on Plastic Model
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

6. Demonstration on Plastic Model
A 250lb LIGAFIBA loop secured over an UHMWPE toggle on the medial aspect of the femur

7. Demonstration on Plastic Model
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.

8. Demonstration on Plastic Modelx
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

9. ISO-TOGGLE SYSTEM USING 250 lb LIGA-FIBA
Pointer on
the lateral
fabella
Lateral parapatellar approach with reflection of the fascia.

10. 2.5-3.0mm drill bit and drill guide positioned on
the femoral ISOMETRIC point, which is just cranial to the distal pole of the lateral
fabella
Drilling the femoral tunnel from the femoral isometric point
Lateral view of the stifle

11. Cranial view of the stifle on completion of the femoral tunnel
mm drill bit from
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

12. The pointer is on the cranial aspect of the tibial extensor fossa.
Identifying the tibial isometric point on the lateral
aspect of the tibia

13. 2.5-3mm drill bit and drill guide positioned on
the tibial ISOMETRIC point, which is the tubercle on the cranial aspect of the extensor fossa
Drilling the tibial tunnel from the isometric point

14. Cranial view of the stifle on completion of the tibial tunnel
2.5-3mm drill bit from
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

15. Cranial view showing the start of threading the 250 lb Liga-Fiba loop
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

16. Cranial view showing the 250 lb Liga-Fiba loop
threaded through the tibial tunnel in a medial to lateral direction

17. Cranial view showing the 250 lb Liga-Fiba loop
Tie-down button
Threading
needle
Cranial view showing the 250 lb Liga-Fiba loop
threaded through the femoral tunnel

18. Cranial view showing completion of inserting the 250 lb Liga-Fiba loop
Threading
needle removed.
Toggle to be inserted
Cranial view showing completion of inserting the 250 lb Liga-Fiba loop
but before insertion of the toggle and tensioning.

19. Cranial view showing the insertion of the toggle and the start of
inserted
Cranial view showing the insertion of the toggle and the start of
tensioning the 250 lb Liga-Fiba loop.

20. Lateral view showing the isometric position of
the 250 lb Liga-Fiba loop before and after tying off.

21. Medial view of the tibia showing the
Tie-down
button
Medial view of the tibia showing the
the 250 lb Liga-Fiba loop being tensioned prior to tying down

22. Medial view of the tibia showing the
the 250 lb Liga-Fiba loop secured by tying over the button
and the ends cut