Effect of tibial subluxation on the measurements for tibial tuberosity advancement in dogs with cranial cruciate ligament deficiency

2014 ◽  
Vol 27 (06) ◽  
pp. 470-477 ◽  
Author(s):  
C. S. Schwandt ◽  
S. Scharvogel ◽  
M. J. Bielecki
Keyword(s):  
Significant Influence ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Complete Rupture ◽  
Before And After ◽  
The Impact ◽  
Radiographic Landmarks

SummaryObjectives: The main objectives were to evaluate the impact of femorotibial subluxation on the preoperative measurements for tibial tuberosity advancement (TTA) by defining radiographic landmarks and testing the repeatability for assessing cranial tibial subluxation (CTS). Also, we aimed at developing a formula to calculate the necessary adjustment in measurement of TTA in stifles with CTS.Methods: Forty stifles were used to examine the influence of CTS on preoperative TTA measurements before and after transection of the cranial cruciate ligament. Mediolateral radiographs were obtained and measurements performed by three investigators. The observed variabilities were assessed by interand intra-observer differences.Results: Measurements of CTS and preoperative TTA showed a good to excellent interand intra-observer correlation. We found a significant influence of CTS on TTA measurements and developed a formula to calculate the necessary adjustment in measurement of TTA in stifles with CTS.Conclusion: We found a correlation between the tibial subluxation and the measurements for TTA, with the latter decreasing with increasing subluxation. This has to be taken into account when measuring the advancement in stifles with complete rupture of the cranial cruciate ligament. We provided a formula to calculate the necessary addition to the measured advancement.

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.

The Modified Maquet Procedure (MMP) in Dogs: Technical Development and Initial Clinical Experience

2016 ◽  
Vol 52 (4) ◽  
pp. 242-250 ◽  
Author(s):  
Malcolm Graham Ness
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Radiographic Examination ◽  
Computer Assisted ◽  
Clinical Report ◽  
Modified Technique ◽  
Cranial Cruciate Ligament ◽  
Titanium Foam

ABSTRACT The literature about tibial tuberosity advancement surgery in dogs and humans informed the development of a version of the operation using a wedge-shaped implant of titanium foam. Computer-assisted drawing and stereolithography was used to create instruments and implants that were evaluated by cadaver surgery. A trial, involving 26 client-owned dogs with lameness due to cranial cruciate ligament failure, was started. Follow-up was done by clinical and radiographic examination after 4 wk and clinical examination again 6–11 mo after surgery. The titanium foam implant maintained tibial tuberosity advancement easily and effectively. The same major complication occurred in 2 of the first 6 cases before, a slightly modified technique was used to treat 20 dogs without complication. At mid-term follow-up (6–11 mo), 20/26 dogs (77%) had returned to full function, two dogs (7.7%) had acceptable function, two dogs (7.7%) could not be evaluated due to recent contra lateral modified Maquet procedure surgery, and two (7.7%) dogs had died for reasons unrelated to the study. This is the first clinical report of the use of titanium foam in veterinary orthopaedics. Modified Maquet procedure appears to be an effective treatment for lameness due to failure of the cranial cruciate ligament in dogs.

Conformation of the proximal tibia and cranial cruciate ligament disease in small breed dogs

2017 ◽  
Vol 30 (03) ◽  
pp. 178-183 ◽  
Author(s):  
Michal Kyllar ◽  
Duncan Midgley ◽  
Martin Owen ◽  
Jan Janovec
Keyword(s):  
Body Weight ◽  
Clinical Significance ◽  
Tibial Plateau ◽  
Proximal Tibia ◽  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Relative Body Weight ◽  
Cranial Cruciate Ligament Disease ◽  
Small Breed

SummaryObjectives: To investigate the conformation of the proximal tibia in small breed dogs with and without cranial cruciate ligament disease (CCLD) and to identify morphologic abnormalities that may predispose to development of CCLD.Methods: Mediolateral radiographs of the entire tibia of dogs <15 kg with surgically confirmed CCLD were retrospectively evaluated. Proximal tibial width (PTW), tibial plateau length (TPL), tibial plateau angle as described by Slocum and Slocum (sTPA), proximal tibial tuberosity angle (PTTA), tibial plateau angle as described by Inauen and colleagues (nTPA), and diaphyseal tibial width (DTW) were measured. The same variables were obtained from mediolateral radiographs of the entire tibia of dogs <15 kg without CCLD. In addition, a quotient nTPA/ PTW, relative tibial tuberosity width (rTTW), and relative body weight (rBW) were calculated for each dog. Independent two-sample t-test (p = 0.05) was used to compare mean ± SD of all measured variables between the two groups.Results: Gender, age, and weight mean ± SD were not significantly different between the two groups of dogs (p <0.05). Dogs with CCLD had significantly greater sTPA (p = 0.015) and rBW (p = 0.016).Clinical significance: In dogs of small breeds, a combination of an excessively steep tibial plateau and an increased relative body weight may predispose to early CCLD development. The slope of the tibial plateau was found to be caused by an abnormal caudal angulation of the proximal tibia, a phenomenon previously associated with CCLD development in small breed dogs in individual cases.

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.  

scholarly journals Use of castor bean polymer in developing a new technique for tibial tuberosity advancement for cranial cruciate ligament rupture correction in dogs

2016 ◽  
Vol 61 (No. 7) ◽  
pp. 382-388 ◽  
Author(s):  
RM Medeiros ◽  
MAM Silva ◽  
PPM Teixeira ◽  
LGGG Dias ◽  
DG Chung ◽  
...  
Keyword(s):  
Ricinus Communis ◽  
Cruciate Ligament ◽  
The Body ◽  
Tibial Tuberosity ◽  
Osteotomy Site ◽  
Cranial Cruciate Ligament ◽  
Time Points ◽  
Metallic Implants ◽  
A New Technique ◽  
Distal Fixation

The purpose of the current study was to develop a new tibial tuberosity advancement (TTA) technique, by replacing the original titanium cage with a Ricinus communis polyurethane resin-made wedge polymer. The implants were manufactured using the same size and angles of the original titanium cages, though larger distally. The modified TTA technique (TTAm) was performed in 42 knees of 35 dogs diagnosed with rupture of the cranial cruciate ligament (RCCL). Animals were submitted to radiographic and gait assessments preoperatively, early postoperatively and following 30, 60, 90 and 120 days. All animals exhibited good clinical outcome. There were no cases of impaired healing or bone resorption until 120 days postoperatively and there was no patient with patellar distress after TTAm. Scores of gait evaluation revealed differences between time points. There were also differences between the evaluations of control and pre- and post-operative times. However, there was no difference among the assessment of 30 days and the following time points. The use of the polyurethane polymer for TTAm was advantageous, not only due to biocompatibility and osseointegration, but also for providing easy handling; it can be moulded intra-operatively if necessary. Moreover, it allows precise adaptation to the osteotomy site, as opposed to the original TTA metallic implants, which cannot be moulded. It is suggested that incision lengths for TTAm are slightly shorter than those required for the conventional TTA as this requires the distal fixation of the plate at the beginning of the middle third of the body of the tibia. The TTAm does not require the use of fixation plates and it is performed only at the cranial aspect of the tibia. The method of attachment of the tibial tuberosity in the craniocaudal direction was effective. The setting associated with the use of the polyurethane polymer allowed simplification of the technique for easier implementation, and the amount of implant material required to perform TTAm was reduced in comparison to the conventional TTA. This technique can be used for treating the knees of dogs with RCCL, and provides for easy execution, less invasiveness to the tissues of the knee joint and more versatility in comparison to conventional TTA.

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.

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.

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