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

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.

1993 ◽  
Vol 06 (02) ◽  
pp. 85-92 ◽  
Author(s):  
G. L. Coetzee

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.


2012 ◽  
Vol 81 (4) ◽  
pp. 403-407 ◽  
Author(s):  
Dávid Kňazovický ◽  
Valent Ledecký ◽  
Marián Hluchý ◽  
Marek Ďurej

The aim of this study was to evaluate if the modified Insall Salvati (IS) method can be applied for the canine patient despite differences of proximal tibial morphology, and if such potential differences are also seen in dogs with cranial cruciate ligament rupture. Insall Salvati method is a simple and convenient method for determination of the vertical position of patella, by dividing the length of patella by length of the patellar ligament. The influence of the variable proximal tibial morphology on the modified (IS) index was measured and the value of modified IS index in healthy dogs (n = 25) was compared with dogs with cranial cruciate ligament rupture (n = 26). Medio-lateral radiographs of 102 stifles were evaluated. Patellar ligament length (PLL), patellar length (PL), modified IS ratio and the height of insertion point of patellar ligament on tibial tuberosity were measured. Data of the IS ratio were compared with the value of the height of the insertion point with no significant difference (P = 0.36). There was no significant difference (P = 0.07) in the PLL:PL ratio between dogs affected or unaffected with cranial cruciate ligament rupture. Based on the results of this study we can conclude that the morphology of the cranio-proximal tibia and the height of insertion point of the patellar ligament do not have an influence on the value of the modified IS index both in healthy dogs and in dogs with cranial cruciate ligament rupture.


2020 ◽  
Vol 33 (03) ◽  
pp. 174-182
Author(s):  
Tanja V. Jensen ◽  
Signe S. Kristiansen ◽  
Lene E. Buelund ◽  
James E. Miles

Abstract Objective The aim of this study was to evaluate the ex vivo effects of sequential cranial cruciate ligament transection (CCLx), medial meniscal release (MMR) and triple tibial osteotomy (TTO) on canine stifle stability compared with the intact state, across a wide range of joint angles. Study Design Nine right hind limb preparations were instrumented to provide constant quadriceps and gastrocnemius loads in a 3:1 ratio, and extended from full flexion during fluoroscopic recording. Recordings were repeated after each of CCLx, MMR and TTO. Fluoroscopic landmarks were used to calculate tibial subluxation and patellar ligament angle. Results Medial meniscal release resulted in additional cranial tibial subluxation compared with CCLx. Triple tibial osteotomy restored stifle stability up to a joint angle of 125 degrees. The presence of the crossover angle could be inferred from the patellar ligament angle and subluxation curves. Conclusion Our results suggest that in the cranial cruciate ligament-deficient stifle, the crossover angle at which loading shifts between the caudal and cranial cruciate ligaments is dependent on both loading and integrity of the medial meniscus. Triple tibial osteotomy improves stifle stability over a wide range of joint angles under a quadricep to gastrocnemius loading ratio of 3:1 by converting cranial tibial thrust to caudal tibial thrust, due to TTO increasing the amount of joint extension required to reach the crossover angle.


2018 ◽  
Vol 38 (6) ◽  
pp. 1190-1195 ◽  
Author(s):  
Ana Flávia D.P. Arruda ◽  
Leonardo A.L. Muzzi ◽  
Antonio C.C. Lacreta Junior ◽  
Ruthnéa A.L. Muzzi ◽  
Gabriela R. Sampaio ◽  
...  

ABSTRACT: The influence of the proximal tibial angles in the cranial cruciate ligament (CCL) rupture in dogs is still controversial, and little is known regarding this topic in cats. The aim of this study was to evaluate and compare the angles of the proximal portion of the tibia in dogs and cats with and without CCL rupture. Retrospective and prospective radiographs of the stifle joints were obtained and divided into four groups. Group 1 was composed of 70 stifle joint images of dogs without orthopedic disorders (healthy dogs), group 2 had 70 stifle joint images of dogs with CCL rupture, group 3 had 50 stifle joint images of cats without orthopedic disorders (healthy cats) and group 4 had 25 stifle joint images of cats with CCL rupture. Radiographs were taken with the stifle joint in the mediolateral projection, positioned at the angle of hind limb support. Between the two groups of dogs evaluated, the dogs with CCL rupture had statistically greater tibial plateau angle (TPA) compared with healthy dogs. No difference was shown in relation to the TPA between healthy cats and cats with CCL rupture. In relation to the patellar ligament angle by tibial plateau method the values for the healthy dogs were significantly higher than those for the CCL ruptured dogs. Similarly, healthy cats had significantly higher mean values than cats with CCL rupture. In the patellar ligament angle by common tangent method there was no significantly difference between the two groups of dogs. Between the two groups of cats, animals with CCL rupture had statistically higher mean values than healthy cats. In general, the groups of dogs showed higher mean values than the groups of cats. For the patellar ligament insertion angle (PLIA) healthy dogs showed a significantly higher mean than dogs with CCL rupture. There was no significant difference between the groups of cats. In conclusion, the TPA and the PLIA possibly influence the etiology of CCL rupture in dogs but not in cats. The low patellar ligament angle measured by common tangent method may favorably influence the reduced incidence of CCL rupture in cats.


2006 ◽  
Vol 67 (11) ◽  
pp. 1855-1860 ◽  
Author(s):  
Christian S. Schwandt ◽  
Alejandra Bohorquez-Vanelli ◽  
Slobodan Tepic ◽  
Michael Hassig ◽  
Renate Dennler ◽  
...  

2015 ◽  
Vol 67 (5) ◽  
pp. 1254-1262 ◽  
Author(s):  
A. F. D. P. Arruda ◽  
L. A. L. Muzzi ◽  
R. A. L. Muzzi ◽  
A. C. C. Lacreta Júnior ◽  
G. Oberlender ◽  
...  

ABSTRACTThe influence of the proximal tibia conformation in the rupture of the cranial cruciate ligament (CCL) in dogs is still controversial, especially in Labrador Retrievers. The aim of this study was to compare the angles of the proximal tibia between Labrador Retrievers and other large breeds of dogs, both groups with and without CCL rupture. Radiographic images of 64 stifle joints were obtained and divided into four groups of 16 images. Group 1 consisted of Labrador dogs without orthopedic disorders, group 2 consisted of Labrador dogs with CCL rupture, group 3 consisted of dogs of various large breeds without orthopedic disorders, and group 4 consisted of dogs of various large breeds with CCL rupture. The radiographs were performed in mediolateral projection with the stifle joint positioned at an approximate angle of 135°. The tibial plateau angle showed an overall average of 22.17°±4.20°, and there was no statistically significant difference between the groups. The patellar ligament angle in relation to the tibial plateau had a mean of 103°±4.20°, and there was a significant difference between groups 1 and 4. The patellar ligament angle in relation to the common tangent at the tibiofemoral contact point showed an average of 99.06°±6.08°, and there was no difference between the groups. The patellar ligament insertion angle had an overall average of 51.45°±5.06°, and there was a significant difference between the two groups of normal dogs and two groups of ruptured dogs. In conclusion, the tibial plateau angle, the patellar ligament angles and the patellar ligament insertion angle do not seem to be predisposing factors for rupture of the CCL in Labrador Retriever dogs. In general, there seems to be no relationship between the angles of the proximal tibia and the CCL rupture in dogs.


2013 ◽  
Vol 82 (2) ◽  
pp. 215-218
Author(s):  
Ladislav Stehlík ◽  
Pavel Proks ◽  
Petra Fedorová ◽  
Alois Nečas

Patellar desmopathy in dogs after tibial plateau levelling osteotomy has been described in many studies. Tibial tuberosity advancement is a biomechanically different technique. It is assumed that the patellar ligament is loaded with little force similarly as after tibial plateau levelling osteotomy. Various aspects related to secondary patellar desmopathy are not completely understood. This study deals with computed radiography measurement of patellar ligament thickness after tibial tuberosity advancement in dogs with cranial cruciate ligament rupture. The thickness of the patellar ligament in exactly predetermined locations was measured from mediolateral radiographs of stifle joints. A total of 18 dogs (20 knee joints) with cranial cruciate ligament (ligamentum cruciatum craniale) rupture underwent three radiographic examinations of the knee (preoperative examination and control examination 7 and 15 weeks after the surgery). Significant difference was found between the thickness of the patellar ligament in the first and second examinations. Some of the demographic factors possibly related to patellar ligament thickness (age, sex, body weight, type of cranial cruciate ligament rupture, arthrotomy, cage size, meniscal injury, time between surgery and radiographic examination) were analyzed. However, statistical analyses did not show any effect of these factors on the thickness of the patellar ligament, except for the time between surgery and radiographic examination. These findings can extend the surgeons’ knowledge of biomechanical aspects of tibial tuberosity advancement.


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.


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