Evaluation of the Leeds-Keio Synthetic Replacement for the Cranial Cruciate Ligament in Dogs: An Experimental Study

1996 ◽  
Vol 09 (02) ◽  
pp. 66-74 ◽  
Author(s):  
S. Griffey ◽  
B. J. Massat ◽  
P. B. Vasseur

SummaryEight conditioned research dogs, whose body weight was between 25 and 30 kg, had unilateral implantation of a Leeds-Keio (LK) synthetic implant (Dacron polyester) immediately after severance and removal of the cranial cruciate ligament (CCL). A rectangular- shaped autograft, composed of fascia lata, was placed within the LK implant in four of the eight dogs; the other four dogs received the LK implant only. Modified Robert Jones bandages were placed on the limbs that had been operated upon; the bandages were left in place for 48 hours. After that time the limbs were not splinted. The dogs were confined to 1.5 m X 3 m kennels, with twice daily leash walks for the duration of the study. Although the joints that received the LK implants were stable immediately after the operation, they all developed progressive effusion, crepitation and instability accompanied by clinically apparent lameness. All of the dogs were euthanatized three months after the operations. Gross examination of the eight joints that had been operated upon confirmed the presence of degenerative joint disease. Three of the eight dogs had “bucket handle” type tears of their medial meniscus in the joints with the LK implant, and the medial menisci in the other five stifle joints that received LK implants had a fibrillated surface texture. Five of the eight LK implants had either ruptured completely or were stretched and frayed to the point where mechanical testing was not justified. Mean breaking strength of the 3 intact LK implants was 6.6% of the contralateral, control CCL. Ingrowth of fibrous tissue into the LK implants was minimal. The synovium from all joints with LK implants had moderate to severely increased cellularity within the synovial villi and supporting stroma consisting predominantly of lymphocytes, plasma cells and macrophages. Multinucleated giant cells formed aggregates around irregular shaped strands of particulate material which was translucent and refractive. Under polarized light, these particles were bright yellow to green consistent with Dacron particles. It was concluded that the LK implant, as implanted in this study, was not a satisfactory replacement for the CCL in dogs.The Leeds-Keio synthetic replacement for the canine cranial cruciate ligament was implanted in eight dogs. All eight dogs developed progressive instability and secondary degenerative joint disease over a period of three months after the operation. It was concluded that the Leeds-Keio ligament, as implanted in this study, is not satisfactory for use in dogs.

2009 ◽  
Vol 22 (02) ◽  
pp. 83-86 ◽  
Author(s):  
S. Reese ◽  
K. Lorinson ◽  
D. Lorinson ◽  
E. Schnabl

SummaryThe objective of the present study was to determine the tibial plateau angle (TPA) in cats without stifle pathology and to compare it with cats suffering from an isolated cranial cruciate ligament rupture. Mediolateral radiographs of the stifle were taken and the tibial plateau angle was measured based on the method previously described by Slocum and Devine (1983) for dogs. Three observers with different levels of experience evaluated the radiographs of all of the cats in this study. The mean tibial plateau angle measured by all three observers in the cats with a rupture of the cranial cruciate ligament (CCL) was 3.1° greater than in cats without stifle pathology. Neither gender, age, body weight nor degenerative joint disease had an influence on measurement results. The authors found an inter-observer variability of ± 5.3°. Hence it can be concluded that cats with cranial cruciate ligament rupture have a greater TPA, and this at least lends some credence to the possibility of higher TPA being a predis-posing factor for cruciate injury in this species.


2016 ◽  
Vol 19 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Katja Voss ◽  
Philemon Karli ◽  
Pierre M Montavon ◽  
Hans Geyer

Objectives The aim of the study was to evaluate the prevalence, size, location and appearance of mineralisations in feline stifle joints, and to evaluate their relationship with osteoarthritis and cranial cruciate ligament (CrCL) status. Methods Presence or absence, and size of mineralisations were determined from lateral stifle radiographs of 25 cats with CrCL rupture, and 44 cat cadavers without CrCL rupture. Mineralisations were classified as small, medium or large. Prevalence was compared between the clinically affected cats and the cadavers; the cadaver group was subdivided into an age-matched and an older group. Ten stifles with varying sizes of mineralisations were prepared as whole-knee specimens for histopathology. Location and appearance of the mineralisations, and degenerative changes in the cruciate ligaments, menisci, articular cartilage and joint capsule are described. Results Prevalence of articular mineralisations was 0.76 in stifles of cats with CrCL rupture (mean ± SD age 8.6 ± 4.5 years), 0.64 in stifles of age-matched cat cadavers and 0.74 in older cat cadavers (mean ± SD age 17.0 ± 2.4 years). Cats with CrCL rupture had a higher percentage of medium and large mineralisations than cats without CrCL rupture. Microscopically, small mineralisations were calcifications usually located in the cranial horn of the medial meniscus. Larger mineralisations were found to be ossifications, commonly located in the joint capsule and fat pad. Cats with larger mineralisations showed more signs of osteoarthritis, including degenerative changes in the CrCL. Conclusions and relevance Mineralisations in feline stifle joints were found to differ in size, appearance and location. Small mineralisations were usually confined to the medial meniscus, as described previously; larger mineralisations tended to be located in the tissues cranial to the menisci and seemed to be associated with osteoarthritis and CrCL pathology. Large mineralisations in feline stifles are ossifications in periarticular tissue and are associated with degenerative joint disease.


2006 ◽  
Vol 19 (04) ◽  
pp. 219-227 ◽  
Author(s):  
J. M. Miller ◽  
C. P. Ober ◽  
O. I. Lanz ◽  
R. A. Martin ◽  
P. K. Shires ◽  
...  

SummaryThe tibial tuberosity advancement (TTA) procedure was developed to treat dogs with cranial cruciate ligament deficient stifles. A retrospective, descriptive study was performed on 57 dogs that underwent unilateral or bilateral TTA. Medical records were reviewed and pre-, postoperative and follow-up radiographs were evaluated for patellar ligament-tibial plateau angle (α), distance of the tibial tuberosity advancement and progression of degenerative joint disease. A questionnaire was sent to all owners to obtain their assessment of the procedural outcome. Sixty-five stifles in 57 dogs received a TTA. Mean age was 5.2 ± 2.5 years while mean weight was 39.7 ± 11.9 kg. Eighteen breeds were represented with Labrador retrievers and mixed breeds predominating. The mean duration of lameness prior to surgery was 6.2 ± 6.7 months, with a median lameness score of 3/4. Fifty-nine percent of cases encountered complications, the majority of which were minor. Major post-operative complications were uncommon but consisted of implant failure, tibial crest displacement and medial meniscal tears. The mean radiographic preoperative angle α was 100°, while the postoperative was 95.5°. Mean osteoarthrosis scores were significantly different between preoperative and follow-up radiographs with 67% of cases showing radiographic progression. Seventy percent of owners responded to the survey with overall outcome considered good to excellent in 90%. Activity level was improved in 90% of responses. TTA subjectively appears to be a useful alternative in the management of cranial cruciate ligament disease. Few severe complications were encountered. Good clinical outcome and owner satisfaction was reported with the procedure in this set of cases.


1996 ◽  
Vol 32 (3) ◽  
pp. 247-255 ◽  
Author(s):  
AE Chauvet ◽  
AL Johnson ◽  
GJ Pijanowski ◽  
L Homco ◽  
RD Smith

Sixty-one large dogs (weighing 22.7 kg or more) with cranial cruciate ligament ruptures (CCLRs) were treated with either fibular head transpositions (FHTs; n = 22 stifles), lateral fabellar sutures (LFSs; n = 39 stifles), or conservatively (CT; n = 11 stifles) with rest and aspirin. Based on owner evaluation, dogs treated with FHTs or CT did not perform as well as dogs treated with LFSs (p less than 0.05). There was no difference in owner evaluation scores for the dogs treated with FHTs or CT. Thirty dogs were reevaluated by investigators. No differences between treatment groups regarding age, sex, or time until diagnosis were noted. No differences in scores for lameness, stifle instability, or forceplate analysis among the treatment groups were observed. Degenerative joint disease progressed or remained severe regardless of treatment, based upon radiographic evidence.


2017 ◽  
Vol 38 (1) ◽  
pp. 321
Author(s):  
Danilo Roberto Custódio Marques ◽  
José Fernando Ibañez ◽  
Juliana Fonseca Monteiro ◽  
Ana Carolina Valentim Hespanha ◽  
Mayara Eggert ◽  
...  

Cranial cruciate ligament rupture is the major cause of lameness and degenerative joint disease in the canine stifle. The cause of this disease is multifactorial, especially involving degenerative and inflammatory changes. Many techniques have been described for the management of this condition, and current recommendations include the use of corrective osteotomies, most recently using the Maquet (or modified Maquet) procedure. This technique is fundamentally similar to the classical tibial tuberosity advancement (TTA), but without the use of the bone plate. The main advantages of using this technique are a shorter operative time and less use of implants. The main complication of this technique is an increased risk of tibial crest fracture. This report describes the Maquet technique for the treatment of a three-year-old male West White Terrier dog with rupture of the cranial cruciate ligament. Cruciate ligament rupture was diagnosed by a positive cranial tibial drawer test. Mediolateral stifle radiography performed under anesthesia with the stifle in 135° of extension demonstrated a tibial plateau angle of 22°. A cage of six millimeters was necessary to allow advancement. The Maquet technique produced excellent post-operative results, including early weight-bearing and neutralization of the cranial tibial drawer. The consolidation time of the osteotomy was 63 days.


2013 ◽  
Vol 49 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Dena Lodato ◽  
Jennifer Wardlaw ◽  
Dennis Rowe

Cranial cruciate ligament rupture (CCLR) is the most common cause of degenerative joint disease (DJD) in the stifle of adult dogs. Over the last several years, a new generation of nonabsorbable, multifilament, polyblend polyethylene orthopedic suture materials have been evaluated for use in the lateral fabellar suture (LFS) technique for surgical treatment of CCLR. This retrospective study compared the short-term outcome of 16 dogs that were treated using the LFS technique using either a proprietary polyblend polyethylene orthopedic suture material (FW) or monofilament nylon leader line (NLL). The FW was significantly more likely to fail compared with the NLL (P = 0.0379). Specifically, the FW was 14.667 times likelier to fail than the NLL. When one and two strands of NLL were compared with FW, the FW was 6 times more likely to fail than one strand of NLL and 32 times more likely to fail than two strands of NLL. To the authors’ knowledge, this is the first study comparing the two materials used in the LFS procedure performed in clinical cases.


1994 ◽  
Vol 07 (01) ◽  
pp. 14-17
Author(s):  
L. A. Thomson ◽  
J. E. F. Houlton ◽  
N. Rushton ◽  
M.J. Allen

SummaryUnilateral cranial cruciate ligament (CCL) resection was performed in six goats. Controls for this procedure included the contralateral (non-operated) joints and six normal joints. All CCL-deficient joints had a positive cranial drawer movement throughout the study, whereas all other joints were stable.None of the joints showed gross evidence of degenerative joint disease at necropsy 52 weeks after the operation. In addition, there were no statistically significant differences between either the frequency or severity of radiographic abnormalities in the two groups of joints.Despite long-term joint instability, degenerative joint disease did not develop in the CCL-deficient caprine stifle joint. When the goat is used as a model for anterior cruciate ligament-deficiency in man, the significance of any results should be assessed in the light of these findings.The long-term effects of experi-mentally induced cranial cruciate ligament (CCL) deficiency were studied in goats. All CCL-deficient joints had a positive cranial drawer movement, both immediately after surgery and at the end of the 52 week study. However, there was no evidence of cartilage or meniscal damage at postmortem examination, and stifle radiographs did not reveal evidence of degenerative joint disease.


2002 ◽  
Vol 32 (5) ◽  
pp. 793-798 ◽  
Author(s):  
André Luis Selmi ◽  
João Guilherme Padilha Filho ◽  
Glenda Ramalho Barbudo ◽  
Luiz Eduardo Carvalho Buquera ◽  
Júlio Carlos Canola

Clinical and radiographic findings after intra-articular replacement of cranial cruciate ligament with a polyester prosthesis using a modified over-the-top technique were evaluated in six dogs. Seven surgeries were done due to bilateral involvement of the cranial cruciate ligament in one dog. Clinical evaluation was performed on postoperative days 3, 10 and 40, and radiographic evaluation was done at 5 and 24 months after surgery in five dogs, where signs of progressive degenerative joint disease were confirmed. Resolution of clinical signs was observed from 25 to 68 days after surgery as evaluated by dog owners. Overall function of joint movement after surgery was classified as good. Two dogs presented fraying of the implant after surgery. It was concluded that the polyester prosthesis, as implanted in these dogs, was not a satisfactory replacement for the injured ligament, as better results may be obtained with less invasive and simpler techniques.


2018 ◽  
Vol 39 (2) ◽  
pp. 593
Author(s):  
Tiago Carmagnani Prada ◽  
Anderson Coutinho da Silva ◽  
Bruno Watanabe Minto

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed suture rupture after 15 days and other had suture infection after 30 days. In Group C, dogs recovered normal limb function without complications. Therefore, surgical toggle associated with polyester yarn was better than the other studied materials.


1999 ◽  
Vol 276 (3) ◽  
pp. R745-R752 ◽  
Author(s):  
Jason J. McDougall ◽  
William R. Ferrell ◽  
Robert C. Bray

It has been speculated that joint instability resulting from anterior cruciate ligament (ACL) rupture could be exacerbated by changes in vasomotor activity in the remaining supporting structures. In this study, the effect of ACL transection on medial collateral ligament (MCL) basal perfusion and its responsiveness to calcitonin gene-related peptide (CGRP) and sympathetic adrenergic influences was examined. Using urethan-anesthetized rabbits, we tested the effects of CGRP and its antagonist CGRP-(8—37) by topical application of these agents to the exposed knee while sympathetic influences were tested by electrically stimulating the saphenous nerve. It was found that MCL basal perfusion was elevated in ACL-sectioned joints; however, this effect was abrogated by prior resection of the articular nerve supply. At the doses tested, the normal vasodilator response to CGRP was abolished in ACL-sectioned joints, whereas the response to CGRP-(8—37) was attenuated. Even under the influence of increased constrictor tone, MCL and capsule blood vessels still showed substantially reduced responses to exogenous CGRP administration. By contrast, nerve-mediated constrictor responses were mostly unaffected by joint instability. This study suggests that posttraumatic knee joint hyperemia is neurogenically mediated, possibly by increased secretion of CGRP.


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