A Self-Locking Knot for Lateral Fabellotibial Suture Stabilisation of the Cranial Cruciate Ligament Deficient Stifle in the Dog

1999 ◽  
Vol 12 (02) ◽  
pp. 78-80 ◽  
Author(s):  
A. Miller ◽  
W. M. McKee
Keyword(s):  
Suture Material ◽  
Cruciate Ligament ◽  
Large Diameter ◽  
The Self ◽  
Cranial Cruciate Ligament ◽  
Surgical Assistance

SummaryMaintaining adequate tension when knotting large diameter monofilament sutures can be challenging, especially without surgical assistance. A self-locking knot is described for lateral fabellotibial suture stabilisation of the canine cranial cruciate ligament deficient stifle. The self-locking knot enables maintenance of tension during tying and the knot can be tied by an unassisted surgeon. The inherent ability of the knot to maintain tension on the fabellotibial suture is due to the first throw of the knot creating a locking-loop effect. Increasing the tension on the suture material is readily achieved by applying traction on the free ends and tightening the first throw of the knot to remove the slack created. When the suture is tightened sufficiently four additional square throws are applied to the knot.A self-locking knot is described for lateral fabellotibial suture stabilisation of the canine cranial cruciate ligament deficient stifle. The inherent ability of the knot to maintain tension on the suture material is due to the first throw of the knot creating a locking-loop effect. Tension on the knot can be readily adjusted and the knot may be tied by an unassisted surgeon.

Mechanical comparison of six loop fixation methods with monofilament nylon leader line

2002 ◽  
Vol 15 (04) ◽  
pp. 210-214 ◽  
Author(s):  
L. E. Peycke ◽  
S. C. Kerwin ◽  
J. B. Metcalf ◽  
G. Hosgood
Keyword(s):  
Cruciate Ligament ◽  
The Self ◽  
Careful Examination ◽  
Prosthetic Material ◽  
Traditional Methods ◽  
Cranial Cruciate Ligament ◽  
Fixation Methods ◽  
Handling Characteristics ◽  
Veterinary Surgeons ◽  
Equivalent Strength

SummaryMonofilament nylon leader line (MNL) is a popular prosthetic material used by veterinary surgeons for extra-capsular cranial cruciate ligament repair. Careful examination of MNL fixation methods has been reported, but a comprehensive comparison has not been done. This study evaluated three unpublished novel methods of MNL loop fixation [Harris wire tightener (knotter), Securos® crimp clamp system, self-locking knot] to traditional methods of MNL loop fixation (clamped square knot, sliding half hitch knot). Loops (27.3 kgt and 36.4 kgt) were distracted at 500 mm/min until failure by breaking or slipping. Ultimate force, elongation and stiffness were used for comparison of loop fixation methods. All of the loops failed by breaking within 3.0 mm of knot or clamp. The Harris knotter had significantly greater elongation than all other loops, except for the self-locking knot. The self-locking knot required the most force to failure; however, it was not superior if the doublestranded configuration was considered. If the mechanical properties of the knot method is considered in light of the subjective handling characteristics, the Securos® crimp clamp system had equivalent strength measurement for the 27.3 kgt MNL loops and was stronger than traditional methods using the 36.4 kgt MNL. The Securos® system recommends use of the larger diameter MNL and it allows a surgeon to overcome potential difficult handling characteristics previously encountered with knot formation and security.

Comparison of Fishing Line for Repair of the Cruciate Deficient Stifle

1999 ◽  
Vol 12 (03) ◽  
pp. 138-141 ◽  
Author(s):  
J. Meinen ◽  
T. Phillips ◽  
P. A. Manley ◽  
Gretchen K. Sicard
Keyword(s):  
Ethylene Oxide ◽  
Suture Material ◽  
Cruciate Ligament ◽  
Testing Machine ◽  
Materials Testing ◽  
Steam Sterilization ◽  
Cranial Cruciate Ligament ◽  
Variable Effect ◽  
Sterilization Method ◽  
Ethylene Oxide Sterilization

SummaryNumerous types of suture material have been used for extra-articular cranial cruciate ligament stabilization. Although monofilament nylon leader line is considered by some to be the most appropriate material for this procedure, monofilament nylon fishing line is a popular alternative (8, 13). The purpose of this study was to evaluate four brands of nylon fishing line in order to determine the superiority of the material as well as the sterilization method of choice. The four brands of monofilament fishing line tested were 36 kilogram test “Ande”, “Berkley”, “Hi-Seas”, and “Maxima”.“Ande” and “Maxima” proved superior in strength prior to sterilization. When the materials were sterilized by ethylene oxide, minimal elongation was observed. However, there was a significant decrease in strength for three of the four materials (“Ande”, “Hi-Seas”, and “Maxima”) when compared to unsterilized or to steam sterilized samples. Steam sterilization resulted in significant elongation of all materials tested and had a variable effect on strength (either greater, equal, or less than no sterilization). Considering all materials, “Ande” was the nylon material of choice when ethylene oxide was used for sterilization, and “Ande” or “Maxima” were the nylon materials of choice when steam sterilization was used.The strength and elongation of four brands of thirty-six-kilogram test monofilament nylon fishing line were tested using a materials testing machine without sterilization and following either steam or ethylene oxide sterilization. “Ande” was the nylon material of choice when ethylene oxide was used for sterilization and “Ande” or “Maxima” were the nylon materials of choice when steam sterilization was used.

scholarly journals Mechanical testing of orthopaedic suture material and a crimp clamp system for the extracapsular stabilisation of canine cruciate-deficient stifles

2012 ◽  
Vol 57 (No. 11) ◽  
pp. 597-602 ◽  
Author(s):  
V. Ledecky ◽  
D. Knazovicky ◽  
M. Badida ◽  
L. Dulebova ◽  
M. Hluchy ◽  
...  
Keyword(s):  
Suture Material ◽  
Cruciate Ligament ◽  
Joint Stability ◽  
Suture Materials ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Medial Rotation ◽  
Materials Used ◽  
Knot Security

The cranial cruciate ligament (CCL) provides cranio-caudal stability, prevents hyperextension and constrains medial rotation of the tibia in the canine stifle joint and CCL rupture is the leading cause of hind leg lameness in dogs. Treatment of CCL rupture aims to resolve lameness caused by joint instability and provide good long-term function of the affected hind limb. The extracapsular technique is one of the most popular methods to restore joint stability. The technique involves a suture loop that is placed around the lateral fabella and through the tibial tuberosity. The ideal suture material should be strong, aseptic, easily handled, inexpensive, and provide excellent knot security and knot compactness. A critical property of the loop is the application of either a knot or crimp to maintain the tension on the loop. There is a variety of orthopaedic suture materials used for the extracapsular technique. Our aim was to compare the mechanical properties of four commercially available materials in pure tension. The materials tested were monofilament nylon leader (MNL) 100 lb, MNL 80 lb, Supramid and Silon. Our second objective was to compare the interoperator variability of applying either a knot or a crimp to secure the suture loop. Ultimate tensile strength was greatest with MNL 100 lb (373 N) followed by MNL 80 lb (285 N), Supramid (160 N) and Silon (103 N). Based on our results, we conclude that MNL 100 lb and MNL 80 lb are mechanically superior to Silon and Supramid. Our study also shows significant effects for the operator and method of loop fixation (P < 0.0001). Intraoperator differences were also found to be significant, for operator 1 (P < 0.0001), for operator 2 (P < 0.001) and operator 3 (P < 0.01). Our findings indicate that MNL is most suitable orthopaedic material and that loop fixation should remain the method of choice for surgeons treating CCL.

Determination of Graft Forces for Cranial Cruciate Ligament Reconstruction in the Dog

1996 ◽  
Vol 09 (04) ◽  
pp. 165-171 ◽  
Author(s):  
D. A. Hulse ◽  
M. R. Slater ◽  
J. F. Hunter ◽  
W. A. Hyman ◽  
B. A. Shelley
Keyword(s):  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Graft Fixation ◽  
Flexion Angle ◽  
Patellar Ligament ◽  
Graft Material ◽  
Test Apparatus ◽  
Cranial Cruciate Ligament ◽  
Tibial Insertion

SummaryA test apparatus that allowed the stifle to move in five degrees of freedom was used to determine the effect of graft location, graft preload, and flexion angle at the time of graft fixation on the tensile graft forces experienced by a replacement graft material used to simulate reconstruction of the cranial cruciate ligament deficient stifle. Two graft locations (tibial insertion site of the patellar ligament and tibial insertion site of the cranial cruciate ligament), two graft preloads (5 N and 20 N), and three flexion angles at the time of graft fixation (15°, 30° and 90°) were examined. The tibial insertion site and preload did not have as great an effect on graft force as did the flexion angle of the limb at time of graft fixation. Graft forces were highest when reconstructions were performed with the limb in 90° of flexion (ρ <0.0001). This study supports the notion that intracapsular grafts should be fixed with the limb in a normal standing angle.A five degree of freedom test apparatus was used to evaluate the effect of graft location, graft preload, and limb flexion angle at time of graft fixation on reconstructions of the cranial cruciate ligament deficient stifle. Our results suggest that intracapsular grafts should not be fixed with the limb in 90° of flexion, but in a normal standing angle.

An in vitro Comparison of Two Replacement Techniques Utilizing Fascia Lata after Cranial Cruciate Ligament Transection in the Dog

1993 ◽  
Vol 06 (02) ◽  
pp. 85-92 ◽  
Author(s):  
G. L. Coetzee
Keyword(s):  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Maximum Load ◽  
Fascia Lata ◽  
Patellar Ligament ◽  
Cross Sectional ◽  
Cranial Cruciate Ligament ◽  
Replacement Technique ◽  
Over The Top

SummaryThe immediate postoperative biomechanical properties of an “underand-over” cranial cruciate ligament (CCL) replacement technique consisting of fascia lata and the lateral onethird of the patellar ligament, were compared with that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The right CCL in twelve adult dogs was dissected out and replaced with an autograft. The contralateral, intact CCL served as the control. In group A, the graft was secured to the lateral femoral condyle with a spiked washer and screw. In group B the intracapsular graft was secured to the lateral femoro-fabellar ligament, and the remainder to the patellar tendon. Both CCL replacement techniques exhibited a 2.0 ± 0.5 mm anterior drawer immediately after the operation. After skeletonization of the stifles, the length and cross-sectional area of the intact CCL and CCL substitutes were determined. Each bone-ligament unit was tested in linear tension to failure at a fixed distraction rate of 15 mm/s with the stifle in 120° flexion. Data was processed to obtain the corresponding material parameters (modulus, stress and strain in the linear loading region, and energy absorption to maximum load).The immediate postoperative structural and material properties of the “under-and-over” cranial cruciate ligament replacement technique with autogenous fascia lata, were compared to that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The combined UOT T technique was slightly stronger (6%), but allowed 2.8 ± 0.9 mm more cranial tibial displacement at maximum linear force.

Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Biomechanical Properties ◽  
Fibular Head ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

Evaluation of Positive Contrast Arthrography in Canine Cranial Cruciate Ligament Disease

1996 ◽  
Vol 09 (01) ◽  
pp. 10-3 ◽  
Author(s):  
D.N. Aron ◽  
R. Roberts ◽  
J. Stallings ◽  
J. Brown ◽  
C.W. Hay
Keyword(s):  
Articular Surface ◽  
Cruciate Ligament ◽  
Positive Contrast ◽  
Joint Effusion ◽  
Radiographic Evaluation ◽  
Cranial Cruciate Ligament ◽  
Joint Pathology ◽  
Meniscal Pathology ◽  
Cranial Cruciate Ligament Disease ◽  
Better Than

SummaryArthrographic and intraoperative evaluations of stifles affected with cranial cruciate disease were compared. Arthrography did not appear to be helpful in predicting cranial cruciate ligament pathology. The caudal cruciate ligament was consistently not visualized in the arthrograms and was normal at surgery. The menisci were visualized consistently in the arthrograms, but conclusions could not be made as to the benefit of arthrography in predicting meniscal pathology. Arthrography was not helpful in predicting joint capsule and femoral articular surface pathology. Survey radiographic evaluation was better than arthrography in evaluating joint pathology. When cruciate injury is suspected, after history and physical examination, survey radiographs are better than positive contrast arthrograms at supporting the diagnosis.Positive contrast arthrography was evaluated as a diagnostic aid in canine cranial cruciate ligament disease. It did not appear to be useful in predicting joint pathology. With arthrography, both menisci could be visualized and evaluated for abnormalities. Joint effusion and presence of osteophytes evaluated on survey radiographs was better than arthrography in evaluating joint pathology.

Effect of Suture Type on Stifle Joint Biomechanics After Extra-Articular Repair of Cranial Cruciate Ligament Transection in the Dog

1991 ◽  
Vol 4 (04) ◽  
pp. 144-149 ◽  
Author(s):  
M. S. Bauer ◽  
W. E. Blevins ◽  
W. R. Widmer ◽  
Jaqueline Davidson ◽  
S. W. Aiken ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Before And After ◽  
Joint Biomechanics ◽  
Cranial Cruciate Ligament Rupture

SummaryThe effect of two suture types, monofilament polybutester and braided polyester, on stifle joint biomechanics after extra-articular repair of cranial cruciate ligament rupture was evaluated by analysis of the instant centre of motion. The instant centres of motion and resulting velocity vectors were determined radiographically on both stifles of eight fresh canine cadavers before and after cranial cruciate ligament transection. After ligament transection, all 16 stifles were repaired with an extra-articular technique utilizing a double strand of suture placed between the lateral fabella and the tibial tuberosity. One stifle on each cadaver was repaired with each suture type. The instant centres of motion and resulting velocity vectors were re-evaluated post repair. All stifles had normal instant centres of motion prior to transection of the cranial cruciate ligament. Neither ligament transection nor extra-articular repair with either suture type resulted in an abnormal change in the instant centre of motion.

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