Effect of Tibial Plateau Levelling Osteotomy on Cranial Tibial Subluxation in the Feline Cranial Cruciate Deficient Stifle Joint: An Ex Vivo Experimental Study

2018 ◽  
Vol 31 (04) ◽  
pp. 273-278
Author(s):  
A. Bilmont ◽  
M. Retournard ◽  
E. Asimus ◽  
S. Palierne ◽  
A. Autefage
Keyword(s):  
Tibial Plateau ◽  
Rotation Angle ◽  
Ex Vivo ◽  
Cruciate Ligament ◽  
Tibial Rotation ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Before And After ◽  
Osteotomy Technique ◽  
Gastrocnemius Muscles

Objectives This study evaluated the effects of tibial plateau levelling osteotomy on cranial tibial subluxation and tibial rotation angle in a model of feline cranial cruciate ligament deficient stifle joint. Methods Quadriceps and gastrocnemius muscles were simulated with cables, turnbuckles and a spring in an ex vivo limb model. Cranial tibial subluxation and tibial rotation angle were measured radiographically before and after cranial cruciate ligament section, and after tibial plateau levelling osteotomy, at postoperative tibial plateau angles of +5°, 0° and –5°. Results Cranial tibial subluxation and tibial rotation angle were not significantly altered after tibial plateau levelling osteotomy with a tibial plateau angle of +5°. Additional rotation of the tibial plateau to a tibial plateau angle of 0° and –5° had no significant effect on cranial tibial subluxation and tibial rotation angle, although 2 out of 10 specimens were stabilized by a postoperative tibial plateau angle of –5°. No stabilization of the cranial cruciate ligament deficient stifle was observed in this model of the feline stifle, after tibial plateau levelling osteotomy. Clinical Significance Given that stabilization of the cranial cruciate ligament deficient stifle was not obtained in this model, simple transposition of the tibial plateau levelling osteotomy technique from the dog to the cat may not be appropriate.

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.

Modelling the Effects of Cranial Cruciate Ligament Transection, Medial Meniscal Release and Triple Tibial Osteotomy on Stability of the Canine Stifle Joint

2020 ◽  
Vol 33 (03) ◽  
pp. 174-182
Author(s):  
Tanja V. Jensen ◽  
Signe S. Kristiansen ◽  
Lene E. Buelund ◽  
James E. Miles
Keyword(s):  
Ex Vivo ◽  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Tibial Osteotomy ◽  
Joint Angles ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Wide Range ◽  
Loading Ratio ◽  
Canine Stifle

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.

scholarly journals Radiographic assessment of the proximal tibial angles in dogs and cats with and without cranial cruciate ligament rupture

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 ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Common Tangent ◽  
Cranial Cruciate Ligament ◽  
Mean Values ◽  
Stifle Joint ◽  
Significant Difference ◽  
Tangent Method ◽  
Healthy Dogs

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.

Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs

2008 ◽  
Vol 21 (01) ◽  
pp. 8-14 ◽  
Author(s):  
A. Pozzi ◽  
A. S. Litsky ◽  
J. Field ◽  
D. Apelt ◽  
C. Meadows ◽  
...  
Keyword(s):  
Pressure Distribution ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Testing Machine ◽  
Axial Loading ◽  
Fold Increase ◽  
Cranial Cruciate Ligament ◽  
Pressure Distributions ◽  
Before And After ◽  
Meniscal Surgery

Summary Objective: To evaluate the effect of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on pressure distribution in the cranial cruciate ligament (CCL) deficient canine stifle, and with tibial plateau levelling osteotomy (TPLO). Animals: Twelve adult dogs. Methods: In experiment one, six pairs of cadaveric canine stifles with an intact CCL were axially loaded with a servo-hydraulic material testing machine and pressure distributions were mapped and quantified using pressure sensitive films. Axial loading of each joint was then repeated following MMR, and again after MCH. In experiment two, six pairs of cadaveric canine stifles with or without TPLO were tested before and after CCL transection, and each MMR and MCH procedure using the same methods of experiment 1. Results: In experiment one, MMR and MCH had significant effects on the pressure distribution resulting in a 2.5-fold increase in the percentage of surface area with pressure higher than 10 MPa. In experiment two, CCL transection resulted in a significant change in pressure distribution only in the stifle without TPLO (P<0.05). Both MMR and MCH resulted in a 1.7-fold increase in the percentage of area with peak pressure in the stifle with TPLO (P<0.05). Conclusions: Meniscal surgery results in a change in pressure distribution and magnitude within the medial compartment of the stifle. Clinical relevance: Compromised function of the meniscus by either MMR or MCH result in stress concentration which may predispose to osteoarthritis.

Does a fabella-tibial suture alter the outcome for dogs with cranial cruciate ligament insufficiency undergoing arthrotomy and caudal pole medial meniscectomy?

2009 ◽  
Vol 22 (04) ◽  
pp. 283-288 ◽  
Author(s):  
E.J. Comerford ◽  
M.R. Owen ◽  
M.S. Tivers
Keyword(s):  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Control Group ◽  
Term Outcome ◽  
Cranial Cruciate Ligament ◽  
Long Term Outcome ◽  
Stifle Joint ◽  
Medial Meniscectomy ◽  
Before And After ◽  
Clinical Records

Summary Objectives: The objective of this study was to evaluate the effects of fabella-tibial suture (FTS) on long-term outcome in dogs with cranial cruciate ligament (CCL) insufficiency and concurrent medial meniscal tear (MMT) that were managed by an open, caudal pole medial meniscectomy (CPMM). Methods: A retrospective review was performed of the clinical records of dogs treated for CCL insufficiency with concurrent MMT by open CPMM, with or without the non-random addition of a nylon FTS according to surgeon preference, during the period of 2001 to 2004. The Bristol Osteoarthritis in Dogs questionnaire was modified for owner assessment of outcome using a visual analogue scale based on several criteria: level of activity, disability, severity of lameness and frequency of lameness before and after surgery. Results: Completed questionnaires from 31 dog owners were received. A FTS was used after CPMM in 22 dogs (FTS group), but in nine dogs (control group) only a CPMM was performed. The median time to follow up was longer in the FTS group (25 months) than the control group (16 months) (P=0.03). There were not any significant differences between the two groups before and after surgery for the following: disability, activity, frequency of lameness, severity of lameness, ability to climb stairs and ability to sit down. Clinical Significance: The placement of a FTS following stifle joint arthrotomy and CPMM in dogs with CCL deficiency and concurrent MMT may not be a significant factor affecting the ultimate surgical outcome, although our study is limited by the non-randomised study design.

scholarly journals Comparison of the proximal tibial angles between Labrador Retrievers and other dog breeds with and without cranial cruciate ligament rupture

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 ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Proximal Tibia ◽  
Cruciate Ligament ◽  
Contact Point ◽  
Patellar Ligament ◽  
Cranial Cruciate Ligament ◽  
Insertion Angle ◽  
Stifle Joint ◽  
Significant Difference ◽  
Labrador Retrievers

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.

Tibial plateau levelling osteotomy in an alpaca

2009 ◽  
Vol 22 (04) ◽  
pp. 332-335 ◽  
Author(s):  
N. M. Girard ◽  
J. O’Riordan ◽  
N. Fitzpatrick ◽  
T. J. Smith
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Acute Onset ◽  
Radiographic Examination ◽  
Tibial Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Pelvic Limb ◽  
The Right

SummaryIn this report, a case of cranial cruciate ligament (CrCL) rupture treated by tibial plateau levelling osteotomy (TPLO), in a 36-month-old male breeding alpaca, is described. The alpaca was presented with the complaint of acute onset of right pelvic limb lameness. The findings of our clinical and radiographic examinations were consistent with CrCL insufficiency of the right stifle joint. The right tibial plateau angle measured prior to surgery was 19°. A TPLO was performed and this eliminated cranial tibial thrust. Culture of a swab taken from the surgical site prior to wound closure was positive for Pseudomonas aeruginosa. Enrofloxacin was administered parenterally for two weeks postoperatively. There were not any clinical signs of infection noted. Outcome assessments included veterinary examination (two and six weeks) and owner assessment (28 months). At two weeks the animal walked with a grade 2/5 lameness, and at six weeks radiographic examination showed progression of bone healing at the site of tibial osteotomy. A return to full breeding fitness occurred by eight weeks after the surgery. The alpaca remained free from lameness 28 months later, according to the owner.

Use of a custom-made limb-press model to assess intra- and extracapsular techniques for treating cranial cruciate ligament rupture in cats

2017 ◽  
Vol 20 (4) ◽  
pp. 271-279 ◽  
Author(s):  
Wolfgang Kneifel ◽  
Danilo Borak ◽  
Barbara Bockstahler ◽  
Eva Schnabl-Feichter
Keyword(s):  
Body Weight ◽  
Cruciate Ligament ◽  
Surgical Techniques ◽  
Reference Points ◽  
Joint Angles ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Custom Made ◽  
Before And After ◽  
Cranial Cruciate Ligament Rupture

Objectives This study aimed to compare the under-and-over technique, a type of intracapsular treatment, and the standard fabella–tibial suture, a method for extracapsular treatment, in achieving immediate, postoperative stifle stability after cranial cruciate ligament (CrCL) rupture by using a feline, custom-made limb-press model. Methods Cadaveric feline hindlimb specimens (n = 14) were positioned in the limb press at predefined joint angles (stifle joint: 120°; hock joint: 120°), and vertical loads of 5%, 10%, 20% and 30% body weight were applied statically. Mediolateral radiographic views were obtained of the stifles under each load before and after CrCL transection, as well as after treatment with either of the two surgical techniques, and differences in distance between two predefined radiographic points for each radiograph were analysed. Results The general linear model showed a significant effect of load ( P <0.01) and technique ( P = 0.004) and a significant interaction between load and technique ( P = 0.006) regarding craniocaudal stifle stability. Distances between predefined tibial and femoral reference points were consistently higher in transected CrCLs than in intact stifles. All standard fabella–tibial suture-treated stifles (n = 7) were stable at all loads tested. Of the seven under-and-over technique-treated stifles, one was unstable at 20% body weight load and three at 30% body weight load. Conclusions and relevance Our model, which appropriately reproduced certain aspects of domestic shorthair cat stifle mechanics, indicated that a 40 lb monofilament nylon prosthesis, tightened at 20 N, produces more favourable biomechanical stabilisation of craniocaudal cruciate-related stifle instability than a 0.5 cm wide strip of fascia lata applied intracapsularly.

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