Effect of the Centre of Rotation in Tibial Plateau Levelling Osteotomy on Quadriceps Tensile Force: An Ex Vivo Study in Canine Cadavers

2019 ◽  
Vol 32 (02) ◽  
pp. 117-125 ◽  
Author(s):  
Yoshiyuki Ochi ◽  
Tom Ichinohe ◽  
Takaharu Hakozaki ◽  
Shuji Suzuki ◽  
Yasuji Harada ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tensile Force ◽  
Patellar Ligament ◽  
Tibial Rotation ◽  
Vertical Force ◽  
Cranial Cruciate Ligament ◽  
Flexor Muscles ◽  
The Mean ◽  
Centre Of Rotation

Objective The aim of this study was to determine the effect of the centre of rotation in tibial plateau levelling osteotomy (TPLO) on the tensile force of the quadriceps. Materials and Methods Tibial plateau levelling osteotomy was performed on the left pelvic limbs from 20 normal adult Beagle cadavers. To replicate the tensile force of the quadriceps, gastrocnemius and stifle flexor muscles, these muscles were replaced with wires. The tensile force of each wire, cranial tibial displacement and internal tibial rotation were measured under the following conditions: intact cranial cruciate ligament, transected cranial cruciate ligament, ideally centred osteotomy TPLO (ICO group) and distally centred osteotomy TPLO (DCO group). The ratios of the tensile forces for the wires divided by the vertical force were used for analyses. Results The mean intact and post-TPLO tibial plateau angles (TPA) in the ICO group were 30.3° ± 1.9° and 6.1° ± 1.6°, respectively, and those in the DCO group were 29.8° ± 2.4° and 6.8° ± 0.9°, respectively. The mean quadriceps tensile force after TPLO was significantly greater in the DCO group (3.9 ± 0.3) than the ICO group (3.3 ± 0.4) (p = 0.006). Both groups exhibited tibial caudal displacement after TPLO. Clinical Relevance The tensile force of the quadriceps muscles changed in accordance with the centre of the osteotomy in TPLO. The DCO group had increased tensile force, which may cause patellar ligament thickening after TPLO. Setting the postoperative TPA at 6° may cause excessive rotation in patients with a normal tensile force of the stifle flexor muscles.

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.

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.

Angle between the patellar ligament and tibial plateau in dogs with partial rupture of the cranial cruciate ligament

2006 ◽  
Vol 67 (11) ◽  
pp. 1855-1860 ◽  
Author(s):  
Christian S. Schwandt ◽  
Alejandra Bohorquez-Vanelli ◽  
Slobodan Tepic ◽  
Michael Hassig ◽  
Renate Dennler ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Patellar Ligament ◽  
Partial Rupture ◽  
Cranial Cruciate Ligament

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.

scholarly journals Radiographic changes of the patellar ligament in dogs after tibial tuberosity advancement

2013 ◽  
Vol 82 (2) ◽  
pp. 215-218
Author(s):  
Ladislav Stehlík ◽  
Pavel Proks ◽  
Petra Fedorová ◽  
Alois Nečas
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Radiographic Examination ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Rupture

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.

Tibial tuberosity advancement in 65 canine stifles

2006 ◽  
Vol 19 (04) ◽  
pp. 219-227 ◽  
Author(s):  
J. M. Miller ◽  
C. P. Ober ◽  
O. I. Lanz ◽  
R. A. Martin ◽  
P. K. Shires ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Degenerative Joint Disease ◽  
Activity Level ◽  
Tibial Tuberosity ◽  
Joint Disease ◽  
Patellar Ligament ◽  
Cranial Cruciate Ligament ◽  
The Mean ◽  
Owner Satisfaction

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.

Lateral and medial tibial plateau angles in normal dogs

2014 ◽  
Vol 27 (02) ◽  
pp. 135-140 ◽  
Author(s):  
M. K. Ocal ◽  
S. S. Sabanci
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Axial Rotation ◽  
T Test ◽  
Medial Tibial Plateau ◽  
Lateral Tibial Plateau ◽  
Cranial Cruciate Ligament ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

SummaryTo measure lateral and medial tibial plateau angle values in isolated canine tibiae and to compare lateral and medial tibial plateau angle values between dogs based on sex and breed.Tibiae of 90 dogs from 24 different breeds were used. Photographs were taken of the medial and lateral aspects of the tibiae for measurement of the medial and lateral tibial plateau angles. Additionally, the medial tibial plateau angle was measured from radiographs of the tibiae. Two-way analysis of variance was used to test the effects of side, sex and breed on the medial and lateral tibial plateau angles as measured from photographs as well as the medial tibial plateal angles as measured from radiographs. The photographic and radiographic medial tibial plateau angles were compared by paired t-test, whereas the medial and lateral photographic tibial plateau angles were compared by t-test.When all dogs were included in the analysis, the difference between the mean medial tibial plateau angle (24.0 ± 3.19°) and the mean lateral tibial plateau angle (25.5 ± 3.84°) as measured from photographs was significant (p <0.05). The difference in the photographic medial tibial plateau angle between male and female dogs was significant (p <0.05), whereas the difference in the photographic lateral tibial plateau angle between sexes was not significant. There was a significant difference between the medial and lateral tibial plateau angles as measured from photographs in male dogs (p <0.05) but not in female dogs. Breed comparisons also showed significant differences for the photographic lateral tibial plateau angle (p <0.05).The axial rotation of the femoral condyles on the tibial plateau is probably affected by the discrepancy between the medial and lateral tibial plateau angles, and this difference in certain breeds might influence the prevalence of cranial cruciate ligament disease.

scholarly journals Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation

2016 ◽  
Vol 29 (06) ◽  
pp. 536-540 ◽  
Author(s):  
Katherine Leonard ◽  
Michael Kowaleski ◽  
William Saunders ◽  
Robert McCarthy ◽  
Randy Boudrieau
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Frontal Plane ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Fixation Method ◽  
Term Outcome ◽  
Cranial Cruciate Ligament ◽  
Additional Surgery

SummaryObjectives: To describe the surgical technique and report short-term outcome for combined tibial plateau levelling osteotomy and tibial tuberosity transposition (TPLO-TTT) as an option in the treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation.Methods: Medical records were reviewed (2011–2013) of dogs that underwent a standard tibial plateau levelling osteotomy followed by a tibial tuberosity transposition in the frontal plane and stabilized with pin and tension-band wire fixation as a component of surgical treatment for combined cranial cruciate ligament insufficiency and medial patellar luxation. Signalment, fixation method together with any ancillary procedures, function at the in-hospital follow-up examinations, and any complications were recorded. Healing was assessed retrospectively based on the grading criteria of the International Society Of Limb Salvage.Results: Fifteen stifle joints in 11 dogs were identified; 13 stifles were available for in hospital follow-up. All 13 achieved union (3 with grade III/IV and 10 with grade IV/IV radiographic healing scores); mean time to healing was 10.6 (± 2.9) weeks. Patellar ligament thickening was also identified radio-graphically in seven of the 13 of stifle joints. All dogs were reported to have mild or no lameness at their last follow-up examination. No catastrophic or major postoperative complications occurred that required additional surgery. Patellar re-luxation did not occur in any of the 13 stifles available for in-hospital follow-up.Clinical significance: The TPLO-TTT was found to be a reliable and effective technique when used as a part of the treatment of combined cranial cruciate ligament insufficiency with concomitant medial patellar luxation in this series of dogs.Supplementary Material to this article is available online at http://dx.doi.org/10.3415/VCOT-15-12-0195.

Comparative Analysis of Vertical Forces in Dogs Affected with Cranial Cruciate Ligament Disease and Tibial Plateau Angles Greater or Less than 25 Degrees

2020 ◽  
Vol 33 (06) ◽  
pp. 387-390
Author(s):  
Cássio Ricardo Auada Ferrigno ◽  
Alexandre Navarro Alves de Souza ◽  
Márcio Poletto Ferreira ◽  
Valentine Verpaalen ◽  
Julia Maria Matera
Keyword(s):  
Body Weight ◽  
Retrospective Study ◽  
Kinetic Data ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Vertical Force ◽  
Meniscal Lesion ◽  
Cranial Cruciate Ligament ◽  
Significant Difference ◽  
Cranial Cruciate Ligament Disease

Abstract Objective Our objective was to compare the peak vertical force (PVF) and vertical impulse (VI) between dogs with cranial cruciate ligament disease and a tibial plateau angle (TPA) greater or less than 25 degrees. Methods A retrospective study was performed in 18 dogs with cranial cruciate ligament disease in which kinetic gait data were obtained with a pressure walkway system. Dogs were distributed in two groups: dogs with a TPA ≤ 25 degrees (n = 8) and dogs with a TPA > 25 degrees (n = 10). Mean PVF and VI in per cent of body weight (%BW) were compared between groups with an unpaired t-test (p < 0.05). Results Mean PVF and VI for the cranial cruciate ligament disease limb were 14.39%BW and 3.57%BWs for dogs with a TPA >25 degrees and 14.44%BW and 3.47%BWs for dogs with a TPA ≤ 25 degrees. There was no significant difference in mean PVF and VI between the groups. Conclusion The results suggest that there is no difference in kinetic data between dogs with cranial cruciate ligament disease and a TPA greater or less than 25 degrees. Other factors such as body weight, time of injury or meniscal lesion could be more related to the magnitude of cranial cruciate ligament disease lameness.

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
Keyword(s):  
Degrees Of Freedom ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Graft Fixation ◽  
Flexion Angle ◽  
Patellar Ligament ◽  
Graft Material ◽  
Test Apparatus ◽  
Cranial Cruciate Ligament ◽  
Tibial Insertion

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.

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