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

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 This study evaluated three unpublished novel methods of MNL loop fixation [Harris wire tightener (knotter), Securos® crimp clamp system, self-locking knot] to traditional methods of MNL loop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.

1999 ◽  
Vol 12 (02) ◽  
pp. 78-80 ◽  
Author(s):  
A. Miller ◽  
W. M. McKee

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.


2018 ◽  
Vol 31 (S 02) ◽  
pp. A1-A25
Author(s):  
Jennifer Eiermann ◽  
Kristin Kirkby-Shaw ◽  
Richard Evans ◽  
Sebastian Knell ◽  
Michael Kowaleski ◽  
...  

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.


1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis

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.


1996 ◽  
Vol 09 (01) ◽  
pp. 10-3 ◽  
Author(s):  
D.N. Aron ◽  
R. Roberts ◽  
J. Stallings ◽  
J. Brown ◽  
C.W. Hay

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.


1991 ◽  
Vol 4 (04) ◽  
pp. 144-149 ◽  
Author(s):  
M. S. Bauer ◽  
W. E. Blevins ◽  
W. R. Widmer ◽  
Jaqueline Davidson ◽  
S. W. Aiken ◽  
...  

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.


Author(s):  
Kimberly A. Agnello ◽  
Kei Hayashi ◽  
Dorothy Cimino Brown

Abstract Objective This study aimed to evaluate frequency, location and severity of cartilage pathology in dogs with naturally occurring cranial cruciate ligament (CCL) disease. Study Design Stifle arthroscopic video recordings (n = 120) were reviewed. A modified Outerbridge classification system (MOCS) (0–4) was used to score cartilage at 10 locations in the femorotibial (medial and lateral femoral condyles and tibial plateaus) and patellofemoral compartments (proximal, middle and distal locations of the patella and femoral trochlear groove) of the stifle joint. Synovial pathology was scored and the presence of a medial meniscal tear was recorded. A Kruskal–Wallis test was used to evaluate association of location and synovitis with cartilage score; and presence of meniscal tear with cartilage and synovitis scores. Bonferroni correction was utilized and p < 0.05 was considered significant. Results Cartilage pathology and synovitis were identified in all joints. Overall cartilage severity scores were low (median MOCS 1). The median MOCS of the proximal trochlear groove (2) was significantly higher than all other locations evaluated. Higher synovitis scores were significantly associated with higher cartilage severity scores and a medial meniscal tear had no association with cartilage severity scores or synovitis. Conclusion Arthroscopic articular cartilage lesions are common in dogs with CCL disease at the time of surgical intervention, although the severity of cartilage damage is mild. The proximal trochlear groove of the femur had the most severe cartilage score in the stifle joint.


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