Evaluation of an intracapsular technique for the treatment of cranial cruciate ligament rupture

2000 ◽  
Vol 13 (04) ◽  
pp. 197-203 ◽  
Author(s):  
J. K. Roush ◽  
J. J. Hoskinson ◽  
R. M. McLaughlin ◽  
J. J. Geels
Keyword(s):  
Surgical Repair ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Plain Film ◽  
Clinical Results ◽  
Cranial Cruciate Ligament ◽  
Plain Film Radiography ◽  
Bone Scans ◽  
Plate Analysis

SummaryTreatment of cranial cruciate ligament (CCL) rupture using fascial replacement techniques have yielded good clinical results, with 85% to 93% of dogs returning to clinical soundness or intermittent lameness as evaluated by surgeons or owners, but have not been evaluated by force plate analysis long-term. The purpose of this study is to document the long-term clinical and radiographic outcome of dogs having CCL rupture stabilized with an underand- over fascial graft technique by owner assessment, clinical examination, force plate analysis, plain film radiography, and scintigraphy. Twenty dogs with previously repaired unilateral CCL rupture were used for the study. Although client satisfaction was high, force plate analysis revealed significantly lower vertical forces and impulses in the operated versus unoperated limbs. Radiographs and bone scans revealed significant bony changes and synovitis in the operated stifle relative to the unoperated stifle at a median of 17.5 months following repair. Lameness persists in dogs having undergone CCL repair using the under-and-over fascial graft technique; whether this lameness is secondary to progression of osteoarthritis or is a result of surgical repair is unknown.The under-and-over fascial strip technique for stabilization of cranial cruciate ligament-deficient stifles has been evaluated using force plate analysis and nuclear scintigraphy. A median of 17.5 months following surgery, dogs are bearing less weight on the operated limbs as compared to the unoperated limbs. Significant synovitis and bony changes are present when compared to the unoperated limb as evaluated by scintigraphy. Despite these changes, clients are satisfied with the results of surgical repair.

scholarly journals Outcome after Modified Maquet Procedure in dogs with unilateral cranial cruciate ligament rupture: Evaluation of recovery limb function by use of force plate gait analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256011
Author(s):  
Giovanni Della Valle ◽  
Chiara Caterino ◽  
Federica Aragosa ◽  
Fabiana Micieli ◽  
Dario Costanza ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Ground Reaction Forces ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Reaction Forces ◽  
Plate Analysis ◽  
Cranial Cruciate Ligament Rupture

Introduction Cranial cruciate ligament failure is one of the principal causes of canine lameness. Several surgical procedures were proposed to achieve joint stabilisation; among these, the Modified Maquet Procedure involves using a titanium foam wedge to achieve and maintain the tibial tuberosity advancement. The force-plate analysis provides to objectively assess normal and abnormal gait and the outcome of different surgical techniques. The study evaluates the outcome of limbs that underwent Modified Maquet Procedure using land-force plate analysis comparing the operated limb with its healthy contralateral one as a control. Materials and methods Thirty-five dogs with unilateral cranial cruciate ligament rupture were evaluated. Outcome after surgery was assessed by orthopaedic and radiographic evaluations and force plate gait analysis performed before surgery, at 15, 30 and 90 days after surgery. For objective comparison of ground reaction forces, data of operated limb were compared to contralateral limb on each time control and Symmetry Index at 90 days was determined. Healing radiographic signs, minor and major complication were reported. Results A significant improvement in ground reaction forces was reached in all the treated limbs between set time intervals. The median percentage increase in ground reaction forces was constant from 15 to 90 days, with a Symmetry Index >9 in 54.2% of patients suggesting a normal gait symmetry. A complete bone healing was noticed at 90 days follow-up radiographic assessment. We experienced three major (8.5%) and one minor (2.8%) complications. Conclusions To the Authors’ knowledge, this is the first study in the veterinary literature that assessed outcomes of dogs undergoing Modified Maquet Procedure for the treatment of cranial cruciate ligament rupture using force plate gait analysis and healthy contralateral limb as a control group. Our results confirm that Modified Maquet Procedure is an effective method to stabilise the stifle joint.

scholarly journals Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs

2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Sari H Mölsä ◽  
Heli K Hyytiäinen, ◽  
Anna K Hielm-Björkman ◽  
Outi M Laitinen-Vapaavuori
Keyword(s):  
Functional Outcome ◽  
Surgical Repair ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

Treatment of bicondylar femoral fractures complicated by concurrent ligament or tendon injuries in four dogs

2014 ◽  
Vol 27 (04) ◽  
pp. 324-332 ◽  
Author(s):  
G. H. Frydman ◽  
L. C. Cuddy ◽  
S. E. Kim ◽  
A. Pozzi
Keyword(s):  
Physical Examination ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Femoral Fractures ◽  
Tendon Injuries ◽  
Anatomical Reduction ◽  
Long Term Follow Up ◽  
Plate Analysis

SummaryObjective: Retrospective case series describing the surgical treatment and outcome in dogs with bicondylar femoral fractures complicated by ligament or tendon injuries.Methods: Medical records were reviewed for three immature and one mature dog with traumatic bicondylar fractures of the distal femur and concurrent ligament or tendon injury treated surgically. Data retrieved included physical examination, imaging, and treatment. Long-term follow-up and return to function was assessed by owner feedback, physical examination, radiology, and force plate analysis. The immediate, four-week, and two-year postoperative outcomes were described.Results: All four dogs were presented with injuries to either the cranial or caudal cruciate ligament. Only two dogs underwent surgical repair of the caudal cruciate ligament. Anatomical reduction and rigid internal fixation of the distal femoral fractures was performed using a combination of lag screws, Kirschner wires, and bone plates. At the long-term follow-up, all cases had good to excellent return to function, as assessed by force plate analysis and owner assessment of quality of life and satisfaction. Radiographs revealed evidence of complete fracture healing, with moderate to severe osteoarthritis of the stifle.Clinical significance: Bicondylar femoral fractures can be associated with ligament or tendon injuries. Anatomical reduction and internal fixation of bicondylar femoral fractures is recommended and may offer a good to excellent return function, with or without repair of associated caudal cruciate ligament injuries.

scholarly journals In dogs weighing under 15 Kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tafara Mapuvire
Keyword(s):  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Research Question ◽  
Tibial Tuberosity ◽  
Clinical Expertise ◽  
Best Interest ◽  
Bottom Line ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease

PICO question In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed There were no papers that answered the PICO question Strength of evidence Zero Outcomes reported Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg Conclusion Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

Outcome after Tibial Plateau Levelling Osteotomy and Modified Maquet Procedure in Dogs with Cranial Cruciate Ligament Rupture

2020 ◽  
Vol 33 (03) ◽  
pp. 189-197
Author(s):  
Julia Knebel ◽  
Daniela Eberle ◽  
Stephanie Steigmeier-Raith ◽  
Sven Reese ◽  
Andrea Meyer-Lindenberg
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Radiographic Evaluation ◽  
Control Group ◽  
Cranial Cruciate Ligament ◽  
Surgical Methods ◽  
Significant Difference ◽  
Reaction Forces ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective The aim of this study was to compare outcomes after tibial plateau levelling osteotomy (TPLO) and modified Maquet procedure (MMP) for the treatment of cranial cruciate ligament rupture (CCLR) in dogs using clinical and radiographic evaluation and treadmill-based force plate gait analysis. Study Design This study was a prospective, randomized, controlled study. Materials and Methods Sixty-one dogs (76 joints) with CCLR were treated with TPLO (n = 30 dogs, 41 joints) or MMP (n = 31 dogs, 35 joints) and compared with a control group of 16 healthy Labrador Retrievers. Outcomes after surgery were compared by clinical orthopaedic assessment, radiographic evaluation and force plate gait analysis performed preoperatively, and then at 6 weeks, 3 and 6 months postoperatively. For objective comparison of ground reaction forces, the data were compared with the control group. Major complications were reported. Results A significant improvement in ground reaction forces was reached in all surgically treated dogs. No significant difference was found between the surgical methods at any postoperative re-examination. With regard to peak vertical force (PVF), there were significantly more patients with TPLO within the reference range of healthy dogs at the 3 months re-examination than dogs with MMP. There was no significant difference in mean value comparisons between TPLO and control groups 6 months postoperatively. Compared with the control group, mean values of 93.9% (PVF) and 85.9% (vertical impulse [VI]) were reached by the TPLO group and 89.4% (PVF) and 79.9% (VI) by the MMP group, 6 months postoperatively.No significant differences were found regarding major complications or progression of osteoarthritis. Conclusions Although no significant differences were found between the surgical methods, TPLO patients showed superiority with regard to clinical outcome.

scholarly journals Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease

2008 ◽  
Vol 21 (03) ◽  
pp. 243-249 ◽  
Author(s):  
D. Damur ◽  
T. Guerrero ◽  
M. Haessig ◽  
P. Montavon ◽  
K. Voss
Keyword(s):  
Functional Outcome ◽  
Cruciate Ligament ◽  
Force Plate ◽  
Tibial Tuberosity ◽  
Ground Reaction Forces ◽  
Cranial Cruciate Ligament ◽  
Reaction Forces ◽  
Vertical Ground ◽  
Vertical Ground Reaction Forces

Summary Objective: To assess functional outcome in dogs with cranial cruciate ligament (CrCL) disease after tibial tuberosity advancement (TTA) using force plate gait analysis, and to evaluate parameters potentially influencing outcome. Study design: Prospective clinical study. Animals: Consecutive clinical patients (n=37) with CrCL-deficient stifles (n=40). Methods: The stifle joints were examined arthroscopically prior to TTA. Meniscal release was not performed if the medial meniscus was intact. Open medial arthrotomy and partial meniscectomy were performed in the presence of meniscal tears. Vertical ground reaction forces were measured preoperatively and at follow-up examinations four to 16 months postoperatively (mean: 5.9 months). The ground reaction forces of a group of 65 healthy dogs were used for the comparison. The potential effects of clinical parameters on functional outcome were evaluated statistically. Results: Complete CrCL rupture was identified in 28 joints, and partial CrCL rupture in 12 joints. The medial meniscus was damaged in 21 stifles. Vertical ground reaction forces were significantly higher at follow-up (P<0.01), but remained significantly lower than those of control dogs (P<0.01). Complications were identified in 25% of joints, and the dogs with complications had significantly lower peak vertical forces at follow-up than the dogs without complications (P=0.04). Other clinical parameters did not influence outcome. Conclusions: Tibial tuberosity advancement significantly improved limb function in dogs with CrCL disease, but did not result in complete return to function. Complications adversely affected functional outcome. Clinical significance: A return to a function of approximately 90% of normal can be expected in dogs with CrCL disease undergoing TTA.

Incidence of complications associated with tibial tuberosity advancement in Boxer dogs

2016 ◽  
Vol 29 (01) ◽  
pp. 39-45 ◽  
Author(s):  
Rui Sul ◽  
Tim Parkin ◽  
Ignacio Calvo ◽  
Brigite de Lima Dantas
Keyword(s):  
Revision Surgery ◽  
Medical Records ◽  
Odds Ratio ◽  
Surgical Repair ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
P Value ◽  
Cranial Cruciate Ligament ◽  
Cranial Cruciate Ligament Disease ◽  
Boxer Dogs

SummaryObjective: To retrospectively review and describe the incidence of complications associated with tibial tuberosity advancement (TTA) surgical procedures in a group of Boxer dogs (n = 36 stifles) and compare the data with a non-Boxer control population (n = 271 stifles).Methods: Retrospective analysis of medical records to identify all dogs that underwent TTA surgery due to cranial cruciate ligament disease. These records were categorized into two groups: Boxer dogs and non-Boxer dogs (controls – all other breeds).Results: Of the 307 stifles included, 69 complications were reported in 58 joints. The complication rate differed significantly for Boxer dogs (16/36 stifles) and non-Boxer dogs (42/271 stifles), corresponding to an odds ratio of 5.8 (confidence interval: 1.96–17.02; p-value <0.001). Boxer dogs were more likely to undergo revision surgery and to develop multiple complications. The incidence of tibial tuberosity fractures requiring surgical repair (2/36 versus 1/271) and incisional infections requiring antibiotic treatment (three in each group) was significantly higher in the Boxer group.Clinical significance: Boxer dogs had more major and multiple complications after TTA surgery than the control non-Boxer group; these complications included higher rates of revision surgery, tibial tuberosity fractures requiring stabilization, and infection related complications. The pertinence and value of breed-specific recommendations for cranial cruciate ligament disease appears to be a subject worthy of further investigation.

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