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1.
Objective: To investigate the incidence of caudal cruciate ligament (CaCL) damage in dogs with cranial cruciate ligament rupture (CCLR). Study Design: Prospective clinical study. Animals: Dogs (n=24) admitted for surgical stabilization of the stifle after CCLR and 8 healthy dogs with intact cranial cruciate ligament (CCL) and CaCL studied as controls. Methods: Preoperative radiographs and stifle joint images (arthrotomy, 6; arthroscopy, 18) were collected from dogs with CCLR. Severity of arthritis, synovitis, CCL damage, and CaCL damage were assessed using numerical rating scales. The CaCL was probed to determine whether minor fraying or a full thickness defect in the ligament was present. Data collected from the study population were compared with the control population of dogs. Results: The CaCL was damaged in 21/24 (88%) of dogs with CCLR; 6/24 (25%) had a full thickness defect in the CaCL. Severity of stifle synovitis and severity of damage to the CaCL were positively correlated (P<.05). Conclusions: The CaCL is damaged in a high percentage of dogs with CCLR. A significant and positive correlation exists between the degree of synovitis present and the extent of CaCL damage. Clinical Relevance: In dogs with CCLR, cruciate ligament pathology typically involves both the CCL and CaCL. As the severity of synovitis and the extent of CaCL damage are related, this observation supports the hypothesis that stifle synovitis may contribute to CCL and CaCL degeneration and subsequent damage.  相似文献   

2.
OBJECTIVES--To investigate the effect of tibial plateau leveling (TPL) on tibial subluxation and tibial axial rotation; to determine the minimal tibial plateau rotation (MinTPR) angle that provides stifle stability; and to evaluate caudal cruciate ligament (CaCL) strain following tibial plateau rotation in cranial cruciate ligament (CrCL)-deficient stifles. ANIMALS--Fifteen canine cadaver hind limbs. METHODS--Tibial subluxation was measured from lateral radiographs in intact, loaded stifles and after sequential CrCL transection, MinTPR, TPL, and CaCL transection. The MinTPR angle was determined using a custom-made hinge plate and compared with the TPL angle. Tibial axial rotation was evaluated in CrCL-deficient stifles before and after TPL. Finally, CaCL strain was recorded in intact, loaded stifles, and following MinTPR, TPL, and tibial plateau over-rotation (MaxTPR) using a force probe. RESULTS--Cranial tibial subluxation in CrCL-deficient stifles was eliminated with TPL. Tibial plateau rotation, however, induced caudal tibial subluxation, which significantly increased from MinTPR to TPL before and after CaCL transection. The MinTPR angle was 6.5 degrees +/- 0.9 degrees less than the TPL angle (P <.05). Tibial internal rotation decreased significantly after TPL in CrCL-deficient stifles. Finally, CaCL strain increased with increasing tibial plateau rotation. CONCLUSIONS--This study suggests that, during stance phase, TPL transforms cranial tibial thrust into caudal tibial thrust, thereby stabilizing the stifle in the cranio-caudal plane via the constraint of the CaCL. The increase in CaCL stress, which results from tibial plateau rotation, could predispose the CaCL to fatigue failure and therefore would caution against tibial plateau over-rotation.  相似文献   

3.
OBJECTIVE: To evaluate the effect of tibial plateau leveling on the biomechanics of the canine stifle. STUDY DESIGN: Analysis of a 3-dimensional (3-D) anatomically accurate theoretical model of the canine stifle. METHODS: A 3-D, 3-segment mathematical model of the normal canine stifle was modified to simulate the effect of rotation of the tibial plateau during tibial plateau leveling osteotomy (TPLO). The model examined the normal stifle, the stifle with a tibial plateau angle (TPA) of 0 degrees, and the stifle with a TPA of 5 degrees. Analysis of the models at 10 consecutive equally spaced positions during the stance phase yielded data such as ligament forces and joint reaction forces at each position. RESULTS: Rotation of the tibial plateau to a TPA of 0 degrees almost eliminates forces in the cranial cruciate ligament (CCL) throughout the stance phase. Rotation to a TPA of 5 degrees did not, however, substantially decrease the load in the CCL. Both procedures increased the load in the caudal cruciate ligament (CaCL). CONCLUSIONS: Cranial tibial thrust (CTT) is converted into caudal tibial thrust when the TPA is 0 degrees ; however, rotating the plateau to a TPA of 5 degrees does not eliminate the CTT. CLINICAL RELEVANCE: The TPLO procedure performed as currently recommended (rotating the tibial plateau to a TPA of 5 degrees) may not eliminate the CTT, but only reduce it. Both TPLO procedures evaluated here were found to increase the load in the CaCL.  相似文献   

4.
One of the possible initiating factors in canine cranial cruciate ligament (CCL) rupture could be an abnormal pattern of ligament cell death. This study compared apoptotic cell death in sections of ruptured CCLs and normal controls, and examined nitric oxide (NO) production in joint tissues and correlated this to apoptosis. CCLs and cartilage from the lateral femoral condyle were harvested from 10 healthy dogs and 15 dogs with CCL rupture and ligaments were further processed to detect cleaved caspase-3 and to determine supernatant NO production in explant cultures. Apoptotic activity was greater in ruptured ligaments compared to controls. NO in ligaments showed a moderate but significant positive correlation with caspase-positive cells. The results suggest that increased apoptosis has a role in CCL rupture and that apoptosis may be influenced by local NO production.  相似文献   

5.
Fourteen dogs were presented with caudal cruciate ligament (CaCL) rupture without concurrent cranial cruciate ligament (CrCL) rupture. The history usually included moderate to severe trauma. Presenting signs included lameness, positive drawer sign, and additional orthopedic injuries. A final diagnosis of CaCL rupture was made during surgical exploration of the joint in 12 of the dogs. In nine of the dogs, this diagnosis was not included in the preoperative differential diagnoses, and seven of the dogs were misdiagnosed as sustaining CrCL rupture. Methods of treatment included intracapsular and extracapsular stabilization. Follow-up time ranged from 3 weeks to 7 years. Function of the limbs was good regardless of surgical procedure chosen and did not appear to depend upon stifle stability.  相似文献   

6.
Osteoarthritis due to cranial cruciate ligament (CCL) rupture or hip dysplasia is one of the most important causes of chronic lameness in dogs. This study aimed at comparing nitric oxide (NO) production by the CCL with that of the femoral head ligament (FHL) and the medial collateral ligament (MCL), and investigating the pathway of NO production and the concomitant metalloproteinase (MMP) activity in the presence or absence of an inflammatory stimulus. Ligaments of normal dogs were subjected to different stimuli, and NO and MMP activity from explant culture supernatants were compared. The results showed that in explant cultures of the canine CCL more NO was produced than in those of the other two ligaments. A higher level of NO was produced when CCLs were exposed to the inducible nitric oxide synthase (iNOS)-inducing cocktail TNF/IL-1/LPS, and NO synthesis could be inhibited by both l-NMMA, a general nitric oxide synthase (NOS) inhibitor and l-NIL, a specific iNOS inhibitor. However, a correlation between NO synthesis and iNOS expression levels as determined by immunohistochemistry was not observed. In contrast to CCL, no evidence for iNOS-dependent NO synthesis was observed for MCL and FHL. The CCL produced less MMP than MCL and FHL, and no correlation between MMP and NO could be demonstrated. MMP activity in the CCL increased significantly after 48 h of incubation with the inflammatory stimulus. The results suggest that in canine osteoarthritis NO synthesized by canine CCL plays a more important role in the pathogenesis of osteoarthritis of the stifle than that synthesized by FHL and MCL.  相似文献   

7.
Objective— To investigate the use of computed tomography (CT) arthrography in cadaveric canine stifles with particular emphasis on the diagnosis of meniscal injury.
Study Design— Prospective cadaver study.
Sample Population— Pelvic limbs from adult Beagles (n=10).
Methods— After survey CT scan of each stifle oriented in the dorsal plane, positive contrast stifle CT arthrogram (CTA) was performed using the same slice orientation. Each stifle was then randomly allocated into 1 of 2 treatment groups: group A—arthrotomy, cranial cruciate ligament (CCL) transection and simulated injury to the caudal horn of the medial meniscus; group B—arthrotomy and CCL transection only. CT scan was repeated as before and post-arthrotomy images were interpreted by a radiologist unaware of treatment grouping.
Results— The cranial and caudal cruciate ligaments, medial and lateral menisci, menisco-femoral ligament, and long digital extensor tendon were all identifiable on CTA images. CTA was 90% sensitive and 100% specific for diagnosing simulated caudal horn meniscal injury.
Conclusions— Stifle CTA enables identification of intra-articular structures within the stifle and is a reliable method for identifying simulated meniscal injuries in a cadaver model.
Clinical Relevance— CTA imaging of the canine stifle has potential clinical value for detection of meniscal injury.  相似文献   

8.
Computed tomographic (CT) imaging of eight normal cadaveric canine stifles was performed before and after intra-articular administration of iodinated contrast medium. Transverse CT images were reconstructed in dorsal, parasagittal, and oblique planes. The following ligamentous structures were identified on transverse CT images in all stifles: cranial cruciate ligament, caudal cruciate ligament, medial meniscus, lateral meniscus, and the medial and lateral collateral ligaments. The following ligamentous structures were identified on transverse computed tomographic arthrography (CTA) images in all stifles: cranial cruciate ligament, caudal cruciate ligament, medial meniscus, lateral meniscus, meniscofemoral ligament, cranial meniscotibial ligaments, caudal meniscotibial ligaments, intermeniscal (transverse) ligament, and the medial and lateral collateral ligaments. The patellar tendon was identified on transverse and reconstructed dorsal and sagittal CT and CTA images in all stifles. Multiplanar reconstructions enabled further evaluation of the continuity of the cranial and caudal cruciate ligaments and menisci. The medial and lateral collateral ligaments were not clearly identified on CT or CTA multiplanar reconstructed images.  相似文献   

9.
OBJECTIVE: To evaluate the effect of tibial plateau leveling on joint motion in canine stifle joints in which the cranial cruciate ligament (CCL) had been severed. STUDY DESIGN: In vitro cadaver study. ANIMALS: Six canine cadaver hind legs. METHODS: Radiographs of the stifle joints were made to evaluate the tibial plateau angle with respect to the long axis of the tibia. The specimens were mounted in a custom-made testing device to measure cranio-caudal translation of the tibia with respect to the femur. An axial load was applied to the tibia, and its position was recorded in the normal stifle, after transection of the CCL, and after tibial plateau leveling. Further, the amount of caudal tibial thrust was measured in the tibial plateau leveled specimen while series of eight linearly increasing axial tibial loads were applied. RESULTS: Transection of the CCL resulted in cranial tibial translation when axial tibial load was applied. After tibial plateau leveling, axial loading resulted in caudal translation of the tibia. Increasing axial tibial load caused a linear increase in caudal tibial thrust in all tibial plateau-leveled specimens. CONCLUSIONS: After tibial plateau leveling, axial tibial load generates caudal tibial thrust, which increases if additional axial load is applied. CLINICAL RELEVANCE: Tibial plateau leveling osteotomy may prevent cranial translation during weight bearing in dogs with CCL rupture by converting axial load into caudal tibial thrust. The amount of caudal tibial thrust seems to be proportional to the amount of weight bearing.  相似文献   

10.
The caudal cruciate ligament (CaCL) of one stifle joint in seven dogs was transected and a 2 to 4 mm section was removed. Six months after surgery, none of the dogs were lame. Thigh muscle circumference, stifle range of motion, and internal tibial rotation in the operated limb were not significantly different from the preoperative measurements or the contralateral, unoperated limb. A caudal drawer motion was consistently present in the stifle joints with a transected CaCL. A radiographic evaluation of the operated stifle joints did not reveal osteoarthritic changes; four of seven stifle joints had an irregular fat pad 6 months after surgery. Results of a joint fluid analysis revealed a slight increase in synovial cells within treated stifle joints; inflammatory cells were not observed. The only gross morphologic change in stifle joints with a severed ligament was enlarged knobby remnants of the CaCL. Articular cartilage defects or osteophytes were not observed. Results of a histologic examination of the CaCL remnants revealed synovial cellular capping and intraligamentous fibroplasia. Based on a limited number of dogs, it was concluded that isolated transection of the CaCL produced minimal clinical and pathologic changes in the stifle joint during a 6 month period.  相似文献   

11.
Objectives: To (1) describe vascular distribution in the grossly intact canine cranial cruciate ligament (CCL) using immunohistochemical techniques specific to 2 components of blood vessels (factor VIII for endothelial cells, laminin for basement membrane); and (2) compare the vascularity in different areas of interest (craniomedial versus caudolateral bands; core versus epiligamentous regions; and proximal versus middle versus distal portions) in the intact normal canine CCL. Study Design: In vitro study. Animals: Large, mature dogs (n=7) of breeds prone to CCL disease that were euthanatized for nonorthopedic conditions. Methods: Intact CCL were collected from fresh canine cadavers free from stifle pathology. CCL tissue was processed for immunohistochemistry and stained for factor VIII and laminin. Vascular density was determined by histomorphometric analysis. Results: Specific vascular staining was sparsely identified throughout the CCL; however, the proximal portion of the CCL appears to have a greater number of vessels than the middle or distal portion of the ligament. Conclusions: The CCL is a hypovascular tissue and its vascular distribution is not homogeneous.  相似文献   

12.
OBJECTIVE: To localize cathepsin K and tartrate-resistant acid phosphatase (TRAP) in synovium and cranial cruciate ligament (CCL) of dogs with cruciate disease. ANIMALS: Dogs (n=15) with cruciate disease and ruptured CCL, and 12 dogs with intact CCL. METHODS: Synovium and CCL were examined histologically and cells containing cathepsin K or TRAP were identified immunohistochemically and histochemically, respectively. RESULTS: Increased cellular localization of cathepsin K and TRAP was detected in synovium and ruptured CCL in dogs with cruciate disease, when compared with tissues from dogs with intact CCL. Inflammation of synovium with TRAP+ macrophage-like cells was seen in 73% of dogs with CCL disease, but was not seen in dogs with intact CCL. The presence of cathepsin K and TRAP protein in synovium and CCL tissues was significantly correlated in dogs with CCL rupture. CONCLUSION: Inflammation of the epiligament of ruptured CCL with cathepsin K+ and TRAP+ macrophage-like cells forms part of a similar, more generalized chronic inflammatory change within the periarticular tissues of the stifle of a large proportion of dogs with CCL rupture. CLINICAL RELEVANCE: Production of matrix-degrading enzymes by the synovium may induce progressive pathologic rupture of the CCL. Therefore, these collagenolytic pathways may offer a novel target for medical therapy of joint inflammation in canine patients with cruciate disease.  相似文献   

13.
Multiple ligamentous injuries of the canine stifle are uncommon. In this study, they affected mainly adult, male, working or sporting dogs and occurred secondary to severe trauma, or where chronic joint infection had weakened the supporting structures. Rupture of the cranial cruciate, caudal cruciate and lateral collateral ligaments was the most common injury observed and this occurred after catching the limb in a fence or gate. Reconstruction of the collateral and cranial cruciate ligaments, and careful repair of damaged menisci and joint capsule, was an effective method of treatment for medium- and large-size dogs. Reconstruction of the caudal cruciate ligament and postoperative limb support was not found to be essential. All dogs with subluxated stifles had good to excellent limb function with minimal loss of mid-thigh circumference or stifle joint range of motion at follow-up. Less favourable results were achieved where there was stifle joint luxation with extensive disruption to secondary joint restraints.  相似文献   

14.
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.  相似文献   

15.
Computed tomographic arthrography (CTA) of four cadaveric canine stifles was performed before and after partial cranial cruciate ligament rupture in order to verify the usefulness of CTA examination for the diagnosis of partial cranial cruciate ligament rupture. To obtain the sequential true transverse image of a cranial cruciate ligament, the computed tomography gantry was angled such that the scanning plane was parallel to the fibula. True transverse images of cranial cruciate ligaments were identified on every sequential image, beginning just proximal to the origin of the cranial cruciate ligament distal to the tibial attachment, after the administration of iodinated contrast medium. A significant decrease in the area of the cranial cruciate ligament was identified on CTA imaging after partial surgical rupture of the cranial cruciate ligament. This finding implies that CTA can be used for assessing partial cranial cruciate ligament ruptures in dogs.  相似文献   

16.
OBJECTIVE: To investigate the potential of doxycycline to reduce stromelysin and inducible nitric oxide synthase (iNOS) activity in dogs with osteoarthritis (OA) secondary to spontaneous cranial cruciate ligament (CCL) rupture. STUDY DESIGN: Prospective, clinical study. ANIMALS: Eighty-one dogs with OA secondary to CCL rupture and 54 normal dogs. METHODS: Dogs with OA secondary to CCL rupture were divided into 2 groups before surgery. The Doxy-CCl group received 3 to 4 mg/kg doxycycline orally every 24 hours for 7 to 10 days (n = 35). The CCL group received no treatment (n = 46). Synovial fluid, articular cartilage, synovial membrane, and CCL samples were collected during surgery (Doxy-CCL group and CCL group) or immediately after euthanasia from healthy dogs (control group). Synovial fluid samples were examined cytologically. Total nitric oxide (NOt) concentrations were measured in the supernatant of explant cultures of all tissue samples, and stromelysin activity was measured in the supernatant of explant cultures of cartilage. RESULTS: NOt concentrations measured in cartilage were significantly lower in the Doxy-CCL group than in the CCL group, but were not different from those measured in the control group. Doxycycline treatment did not have a significant effect on cartilage stromelysin levels. CONCLUSION: The findings in this study indicate that doxycycline inhibits NO production in cartilage in dogs with CCL rupture. CLINICAL RELEVANCE: Doxycycline may have a role in the treatment of canine OA by inhibiting NO production.  相似文献   

17.
The purpose of this study was to evaluate the utility of single-detector computed tomographic arthrography (CT arthrography) for the diagnosis of cranial and caudal cruciate ligament and meniscal lesions in the dog stifle. Four normal and 25 abnormal stifle joints, determined to have lesions related to intra-articular ligamentous insufficiency based on clinical history, orthopedic examination, and survey orthogonal radiographs, were imaged using a previously developed CT arthrography protocol. Surgery was performed immediately following the CT procedure. Three board-certified radiologists inexperienced at interpreting CT stifle arthrograms reviewed all CT studies independently, and then as a group, without knowledge of surgical or necropsy findings. Sensitivity, specificity, positive predictive value, and negative predictive value for determination of cranial and caudal cruciate and meniscal tears were calculated for each individual reviewer and based on group consensus. All reviewers identified the normal canine stifle joints imaged correctly. Reviewers did well in discriminating normal from torn cranial cruciate ligaments, with sensitivities of 96–100% and specificities of 75–100%. No reviewer correctly identified the solitary caudal cruciate ligament tear and specificity ranged from 89.3% to 100%. Reviewers were less adept at discriminating normal from torn meniscal fibrocartilage, with sensitivities of 13.3–73.3% and specificities of 57.1–100%. Interpretive accuracy improved slightly when consensus scores were compared with surgical findings. Single-detector CT arthrography may be useful for identifying pathology of the canine cruciate ligaments but is of limited value for assessing the menisci.  相似文献   

18.
Inhibition of collagen fragment generation in canine cranial cruciate ligament (CCL) explant cultures by the matrix metalloprotease inhibitor (6-demethyl)-6-deoxy-4-dedimethylamino tetracycline (COL-3) was studied. Cranial cruciate ligament specimens were collected from dogs with inflammatory stifle arthritis/CCL rupture and dogs with normal stifles. Explant cultures from each CCL specimen included one COL-3 treated explant and a baseline control; explants from 12 ruptured CCLs were prepared in triplicate and a protease inhibitor cocktail positive control was used. Explant supernatants were analyzed for generation of collagen fragments after two days. Treatment of ruptured CCL explants with 10(-4)M COL-3 decreased generation of collagen fragments. The extent of this inhibition was increased in explants treated with a protease inhibitor cocktail. Generation of collagen fragments was increased in ruptured CCLs, when compared with intact CCLs. It is concluded that generation of collagen fragments was increased in pathological ruptured CCL explants. This degradation could be significantly inhibited in vitro by 10(-4)M COL-3.  相似文献   

19.
OBJECTIVES: To determine changes to the cells and collagenous and amorphous extracellular matrix (ECM) structure in ruptured canine cranial cruciate ligaments (CCL). STUDY DESIGN: Prospective clinical study. ANIMALS: CCL specimens obtained from 29 dogs with ruptured CCL and 6 young dogs with intact CCL. METHODS: Ligament fibroblast number density and phenotype were determined in the core and epiligamentous regions. ECM birefringence and crimp structure in the core region were also studied. RESULTS: Loss of fibroblasts from the core region of ruptured CCL was seen (P <.001), whereas, in the epiligamentous region, cell number densities were similar in ruptured and intact CCL (P =.7). In ruptured CCL, numbers of typical ligament fibroblasts (fusiform and ovoid cells) were decreased, and numbers of cells exhibiting chondroid transformation (spheroid cells) were increased in the core region (P <.001). Expansion of the volume of the epiligamentous region was also seen, although bridging scar tissue was not seen between the ends of ruptured CCL. The structure of the ECM collagen in the core region was extensively disrupted in ruptured CCL. This was, in part, because of decreased birefringence and elongation of the crimp in the remaining collagen fibers when compared with intact CCL (P <.01). CONCLUSIONS: Extensive alterations to the cell populations and collagenous ECM structure were seen in ruptured CCL. Although a proliferative epiligamentous repair response was seen in ruptured CCL, there was a lack of any bridging scar between the ruptured ends of the CCL. CLINICAL RELEVANCE: The cellular and ECM changes in ruptured CCL that we have described appear to result from the cumulative effects of remodeling and adaptation to mechanical loading and microinjury. Treatment of early cruciate disease in dogs will need to inhibit or reverse these progressive changes to CCL tissue, which are directly associated with partial or complete structural failure of the CCL under conditions of normal activity.  相似文献   

20.
The purpose of this study was to evaluate the effect of the canine cranial cruciate ligament repair system on laryngeal hemiplegia in heavy draft horses. Twenty-four heavy draft horses diagnosed with grade 4 laryngeal hemiplegia were allocated to either the prosthetic laryngoplasty (PL) group (n=14) or a canine cranial cruciate ligament repair system (CCCLRS) group (n=10). Right to left angle quotients (RLQs) of abductions of the arytenoid cartilages were endoscopically evaluated before and after surgery. Post-operative RLQs in the CCCLRS group were significantly lower than those of the PL group (P<0.01). The canine cranial cruciate ligament repair system was revealed to be a good surgical procedure for laryngeal hemiplegia in heavy draft horses.  相似文献   

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