Sagittal joint instability in the cranial cruciate ligament insufficient canine stifle

2014 ◽  
Vol 42 (03) ◽  
pp. 151-156 ◽  
Author(s):  
J. Rey ◽  
M. S. Fischer ◽  
P. Böttcher
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Motion Pattern ◽  
Cranial Cruciate Ligament ◽  
Sound Control ◽  
In Vitro Simulation ◽  
Canine Stifle

Summary Objective: This in vivo study qualitatively describes the sagittal motion pattern of the cranial cruciate ligament (CrCL) insufficient canine stifle in operated and unoperated joints with cranio-caudal laxity on palpation. Material and methods: Sagittal stifle kinematics were recorded in vivo in dogs (> 15 kg BW) with unilateral (n = 7) or bilateral (n = 6) complete CrCL rupture and positive cranial drawer test as well as two sound control dogs using uniplanar fluoroscopic kinematography with the dogs walking on a treadmill. Stifle stability and sagittal motion pattern of the femur and the tibia were determined by visual inspection of the fluoroscopic video sequences. Results: Control dogs showed no cranio-caudal instability, identical to the contralateral stifles of the dogs with unilateral rupture. All unoperated stifles with CrCL rupture (n = 6) showed caudal slippage of the femur at the beginning of the stance phase. Of the 13 operated stifles (TightRope: n = 1, tibial tuberosity advancement, TTA: n = 6, tibial plateau leveling osteotomy, TPLO: n = 5, cranial closing wedge osteotomy, CCWO: n = 1) nine were unstable, showing the same motion pattern as the unoperated stifles. Conclusion: In the CrCL insufficient stifle with in vivo cranio-caudal instability caudal slippage of the distal femur at tow touch is the predominant motion pattern. Clinical significance: The discrepancy between in vivo motion pattern and in vitro simulation of CrCL insufficiency in which cranial tibial subluxation is the predominant sagittal motion pattern warrants further studies.

Reducing susceptibility artefacts in magnetic resonance images of the canine stifle following surgery for cranial cruciate ligament deficiency

2012 ◽  
Vol 25 (06) ◽  
pp. 488-497 ◽  
Author(s):  
J. Grierson ◽  
C. R. Lamb ◽  
F. H. David
Keyword(s):  
Magnetic Resonance ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Magnetic Resonance Images ◽  
Proton Density ◽  
Mr Images ◽  
Cranial Cruciate Ligament ◽  
Metallic Implants ◽  
Image Ranking ◽  
Canine Stifle

SummaryBackground: Magnetic resonance (MR) images of the postoperative canine stifle are adversely affected by susceptibility artefacts associated with metallic implants.Objectives: To determine empirically to what extent susceptibility artefacts could be reduced by modifications to MR technique.Methods: Three cadaveric limbs with a tibial plateau levelling osteotomy (TPLO), tibial tuberosity advancement (TTA), or extra-capsular stabilization (ECS) implant, respectively, were imaged at 1.5T. Series of proton density and T2-weighted images were acquired with different combinations of frequency-encoding gradient (FEG) direction and polarity, stifle flexion or extension, echo spacing (ES), and readout bandwidth (ROBW), and ranked. The highest rank (a rank of 1) corresponded to the smallest artefact.Results: Image ranking was affected by FEG polarity (p = 0.005), stifle flexion (p = 0.01), and ROBW (p = 0.0001). For TPLO and TTA implants, the highest ranked images were obtained with the stifle flexed, lateromedial FEG, and medial polarity for dorsal images, and craniocaudal FEG and caudal polarity for sagittal images. For the ECS implant, the highest ranked images were obtained with the stifle extended, a proximodistal FEG and proximal polarity for dorsal images, and craniocaudal FEG and cranial polarity for sagittal images.Clinical significance: Susceptibility artefacts in MR images of postoperative canine stifles do not preclude clinical evaluation of joints with ECS or TTA implants.Part of this study was presented at the Annual Meeting of the American College of Veterinary Radiology, Albuquerque, NM, October 2011.

scholarly journals Biomechanical Effects of Tibial Plateau Levelling Osteotomy on Joint Instability in Normal Canine Stifles: An In Vitro Study

2020 ◽  
Vol 33 (05) ◽  
pp. 301-307
Author(s):  
Masakazu Shimada ◽  
Tetsuya Takagi ◽  
Nobuo Kanno ◽  
Satoshi Yamakawa ◽  
Hiromichi Fujie ◽  
...  
Keyword(s):  
Joint Instability ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Biomechanical Testing ◽  
In Vitro Study ◽  
Axial Rotation ◽  
Testing System ◽  
Compression Tests ◽  
Cranial Cruciate Ligament

Abstract Objective The aim of the study was to determine the changes in biomechanical characteristics following tibial plateau levelling osteotomy (TPLO) using simulated manual tests. Study Design Twenty-one stifles from healthy Beagle dogs that had undergone TPLO or had not (control) were first tested in the intact form, and then the cranial cruciate ligament (CrCL) was transected in each to provide four test situations: control-intact, control-CrCL-transected, TPLO-intact and TPLO-CrCL-transected. The stifles were then analysed using a robotic joint biomechanical testing system. The craniocaudal drawer, axial rotation and proximal compression tests were applied. Results The craniocaudal displacement during the drawer test was not significantly different between the control-intact and TPLO-intact. However, the displacement was significantly greater in the TPLO-CrCL-transected than in the control-intact. In the axial rotation test, the internal–external (IE) rotation was significantly greater in the TPLO-intact than in the control-intact. Similarly, the IE rotation was significantly greater in the TPLO-CrCL-transected than in the control-CrCL-transected. In the proximal compression test, craniocaudal displacement was not significantly different among the control-intact, TPLO-intact and TPLO-CrCL-transected. Conclusion These findings suggest that TPLO influences the tension of the collateral ligaments and might generate laxity of the tibiofemoral joint. Instability after the osteotomy might be associated with the progression of osteoarthritis.

A comparison of outcomes following tibial plateau levelling osteotomy and cranial tibial wedge osteotomy procedures

2007 ◽  
Vol 20 (04) ◽  
pp. 312-319 ◽  
Author(s):  
C. Brown ◽  
S. A. Corr
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Small Sample ◽  
Wedge Osteotomy ◽  
Complication Rates ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Rupture

SummaryThe objective of this study was to determine whether clinical outcomes were superior and complication rates were lower in dogs that had had a cranial cruciate ligament rupture treated by tibial plateau levelling osteotomy (TPLO), compared to those dogs that had been treated using the original cranial tibial wedge osteotomy (CTWO) procedure. Thirty-seven client-owned dogs with cranial cruciate ligament rupture were included in the study: 19 dogs underwent a TPLO procedure, and 18 dogs underwent a CTWO procedure. The study was retrospective, with the data being obtained from medical records and a review of radiographs. The long-term outcome was assessed by means of an owner questionnaire using a visual analogue scale. For the majority of factors that were reviewed, there was not a significant difference in outcome between the dogs that had a TPLO or those that had undergone a CTWO. All of the dogs showed a rapid return to weight bearing after surgery, and at the six week re-examination, the majority of the dogs did not have any pain on stifle palpation. They displayed a good stifle range of motion and significantly lower lameness scores than those prior to surgery. The complication rates did not differ between the procedures, however, within this small sample of dogs, complications following a CTWO were more likely to require revision surgery.

DEVELOPMENT OF A CANINE STIFLE COMPUTER MODEL TO EVALUATE CRANIAL CRUCIATE LIGAMENT DEFICIENCY

2013 ◽  
Vol 13 (02) ◽  
pp. 1350043 ◽  
Author(s):  
NATHAN P. BROWN ◽  
GINA E. BERTOCCI ◽  
DENIS J. MARCELLIN-LITTLE
Keyword(s):  
Computer Model ◽  
Cruciate Ligament ◽  
Contact Forces ◽  
Model Verification ◽  
Tibial Rotation ◽  
Cranial Cruciate Ligament ◽  
Load Bearing ◽  
Tibial Translation

The objective of this study was to develop a three-dimensional (3D) quasi-static rigid body canine pelvic limb computer model simulating a cranial cruciate ligament (CrCL) intact and CrCL-deficient stifle during walking stance to describe stifle biomechanics. The model was based on a five-year-old neutered male Golden Retriever (33 kg) with no orthopedic or neurologic disease. Skeletal geometry and ligament anatomy determined from computed tomography (CT), optimized muscle forces, motion capture kinematics, and force platform ground reaction forces were used to develop the model. Ligament loads, tibial translation, tibial rotation, and femoromeniscal contact forces were compared across the intact and CrCL-deficient stifle. The CrCL was found to be the primary intact stifle load-bearing ligament, and the caudal cruciate ligament was the primary CrCL-deficient stifle load-bearing ligament. Normalized tibial translation and rotation were 0.61 mm/kg and 0.14 degrees/kg, respectively. Our model confirmed that the CrCL stabilizes the intact stifle and limits tibial translation and rotation. Model verification was confirmed through agreement with experimentally measured kinematics and previous in vivo, in vitro, and mathematical model studies. Parametric analysis indicated outcome measure sensitivity to ligament pre-strain. Computer modeling could be useful to further investigate stifle biomechanics associated with surgical stabilization techniques.

scholarly journals Use of a Modified Tibial Plateau Levelling Osteotomy with Double Cut and Medial Crescentic Closing Wedge Osteotomy to Treat Dogs with Cranial Cruciate Ligament Rupture and Tibial Valgus Deformity

2019 ◽  
Vol 33 (01) ◽  
pp. 059-065
Author(s):  
Luca Vezzoni ◽  
Sara Bazzo ◽  
Silvia Boiocchi ◽  
Aldo Vezzoni
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Closing Wedge Osteotomy ◽  
Ligament Rupture ◽  
Closing Wedge ◽  
Cruciate Ligament Rupture ◽  
Tibial Valgus ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective The aim of this study was to report efficacy of a modified tibial plateau levelling osteotomy (TPLO) with double cut and medial crescentic closing wedge osteotomy (TPLO/MCCWO) to treat dogs with cranial cruciate ligament rupture and concurrent tibial valgus. Study Design This study was a cases series. Materials and Methods Medical records of dogs that had TPLO with medial crescentic closing wedge osteotomy were reviewed. Data collected included signalment, body weight, pre- and postoperative tibial valgus angle, tibial plateau angle (TPA), surgical planning, corrective osteotomy technique, method of fixation, complications, and length of time to radiographic healing. Results Fifty-two surgical procedures performed in 45 dogs (7 bilateral) were included in the study. Mean age at surgery was 54 months, and body weight ranged from 5 to 63 kg (mean: 36.5 kg). Mean pre- and postoperative mechanical medial proximal tibial angle were 101° (98°–107°) and 92.80° (88°–97°) respectively. The mean pre- and postoperative TPA were 27.80° (16–35°) and 6.50° (3–11°) respectively. Intraoperative complications occurred in two stifles: in one stifle over-rotation of the proximal tibial segment resulted in a TPA of –8°, with immediate revision to a 5° TPA; in the second stifle a fissure of the lateral tibial cortex developed during insertion of a screw and required adjunctive fixation. No postoperative complications were recorded and all osteotomies healed uneventfully. Conclusions Tibial plateau levelling osteotomy/medial crescentic closing wedge osteotomy is an effective treatment for dogs with cranial cruciate ligament rupture and tibial valgus allowing accurate correction of the tibial deformity with a low complication rate.

Geometric implications of the tibial wedge osteotomy for the treatment of cranial cruciate ligament disease in dogs

2007 ◽  
Vol 20 (03) ◽  
pp. 169-174 ◽  
Author(s):  
B. A. Smith ◽  
A. P. Black ◽  
C. J. Bailey
Keyword(s):  
Surgical Technique ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Wedge Osteotomy ◽  
Ligament Injuries ◽  
Cranial Cruciate Ligament ◽  
Tibial Plateau Slope ◽  
Cranial Cruciate Ligament Disease ◽  
Preoperative Radiograph

SummaryThe tibial wedge osteotomy (TWO), a procedure that reduces the tibial plateau slope, has become an established surgical technique for the treatment of cranial cruciate ligament injuries in dogs, yet variation from the desired postoperative tibial plateau slope of 6° has been noted. The objectives of this study were to investigate the geometric implications of this procedure and to identify factors that affect the postoperative angles. The records of 35 consecutive cases that had a TWO performed were reviewed and comparisons were made between the alignment of the cortices and level of the osteotomy using duplicated tracings of a preoperative radiograph. The existing method for calculating the size of wedge to be removed was found to result in a postoperative slope greater than the expected 6°. Our results indicate that the desired postoperative angle is more likely to be achieved if the cranial cortices are aligned and the osteotomy is performed proximally.

Biomechanical Evaluation of the Suitability of Monofilament Nylon Fishing and Leader Line for Extra-articular Stabilisation of the Canine Cruciate-deficient Stifle

1996 ◽  
Vol 09 (03) ◽  
pp. 126-33 ◽  
Author(s):  
S. C. Roe ◽  
T. M. Caporn
Keyword(s):  
Mechanical Performance ◽  
Cruciate Ligament ◽  
Attachment Site ◽  
Clinical Situation ◽  
Cranial Cruciate Ligament ◽  
Failure Loads ◽  
Biomechanical Evaluation ◽  
Nylon Line ◽  
Canine Stifle

SummaryThe use of monofilament nylon line for extra-articular stabilisation of the cruciate deficient canine stifle is widespread in veterinary surgery. The purpose of this study was twofold: 1) to examine the mechanical behaviour of two forms of monofilament line - standard nylon fishing line (NFL) and nylon leader line (NLL) - when sterilised by steam or ethylene oxide and formed into loops approximating their use in the clinical situation; 2) to compare the mechanical performance of the canine fabellar attachment site to the steel hooks used in the first part of the study.It was found that NLL loops were not affected by sterilisation and had higher failure loads and stiffness than NFL loops. Further testing of 27-kilo - gram-test (kgt) and 36 kgt steam-sterilised NFL and NLL found that of the materials tested, NLL 27 kgt was most suitable as an extra-articular stabiliser of the canine stifle. The performance of the fabellar attachment site was superior to the steel hooks when cycled to 50 N and inferior when cycled to 100 N.The suitability of monofilament nylon fishing line (NFL) and monofilament nylon leader line (NLL) for use as lateral fabel-lotibial sutures (LFTS) in canine cranial cruciate ligament repair was investigated. In vitro testing of loops of the materials was performed with steel hook and fabellar attachment points. Twenty-seven-kilogram test NLL was found to be the most suitable nylon line from which to construct an LFTS.

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