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1.
Andrew Mathieson MEng AMIMechE Peter Chung MPhil Mary Kate McDonald BSc BVMS Andrea Cardoni BEng Ing PhD 《Veterinary surgery : VS》2011,40(6):694-707
Objective: To test the cutting performance of 2 commercially available oscillating saws designed for use during tibial plateau leveling osteotomy (TPLO) and to evaluate the influence of saline irrigation on cutting performance. Study Design: In vitro experimental study. Sample Population: Composite polyurethane test blocks (n=40); 24 mm TPLO saw blades. Methods: Controlled force cutting tests were performed using custom‐made laminated bone substitute blocks to model the canine proximal tibia. Half of the trials were irrigated with 0.9% saline solution. Outcome measures were test block temperature (measured 1.5 mm from the cutting zone), cutting rate, and cutting surface wear. Durability was measured by recording change in performance over multiple consecutive trials. Results: The Synthes blade cut the test blocks with ～64% less heat generation and at a 63% faster cutting rate compared with the Slocum blade. Although wear of the Synthes blade was ～50% greater after 19 uses, this did not negatively impact cutting performance. Saline irrigation produced no significant effect on peak cutting temperature but significantly reduced cutting rate for both saws. Conclusions: Our results favor the Synthes blade in terms of cutting performance and the Slocum blade in terms of wear resistance. 相似文献
2.
A 7 yr old spayed female mastiff presented for examination of a left pelvic limb lameness of 3 mo duration. Six years previously, the dog had undergone tibial plateau leveling osteotomy (TPLO) surgery of the left pelvic limb for the treatment of cranial cruciate disease. On presentation, the dog had a painful and swollen proximal tibia. Following investigation, a diagnosis of osteosarcoma of the proximal left tibia at the site of the previous TPLO surgery was made. This is the first reported case of osteosarcoma following TPLO using an implant other than the Slocum plate. 相似文献
3.
Leitner M Pearce SG Windolf M Schwieger K Zeiter S Schawalder P Johnson KA 《Veterinary surgery : VS》2008,37(4):357-365
Objective— To compare locking screws with conventional screws inserted in the tibial plateau fragment for reduction and stability of the construct after tibial plateau leveling osteotomy (TPLO), using a locking TPLO plate.
Study Design— Experimental biomechanical study.
Animals— Cadaveric canine pelvic limbs (n=8 pairs).
Methods— TPLO was stabilized with either conventional cortical screws or locking screws in a compressed osteotomy model. Titanium pins inserted into the tibial plateau and proximal metaphysis were used to track bone fragment location by computed tomography (CT) imaging. CT imaging was performed after osteotomy reduction, after plate stabilization, and after 30,000 cycles of axial compression testing. After 30,000 cycles, cyclic loading was continued with monotonically increasing peak-load until failure.
Results— The magnitude of rotation about the sawing axis was significantly greater for the conventional screw group because of plate application ( P =.009). Translational movement of the tibial plateau fragment toward the plate was significantly greater for the conventional screw group ( P =.006). There were no significant differences between groups in stiffness or number of cycles to failure.
Conclusion— Maintenance of tibial plateau position was significantly superior for the locking screw group during plate application; however, screw type had no effect on fixation stability under cyclic loading.
Clinical Relevance— These results suggest that conventional screws and careful contouring of the TPLO plate can provide comparable mechanical stability to fixation with locking screws in the tibial plateau under load-sharing conditions, but potentially at the expense of osteotomy reduction. 相似文献
Study Design— Experimental biomechanical study.
Animals— Cadaveric canine pelvic limbs (n=8 pairs).
Methods— TPLO was stabilized with either conventional cortical screws or locking screws in a compressed osteotomy model. Titanium pins inserted into the tibial plateau and proximal metaphysis were used to track bone fragment location by computed tomography (CT) imaging. CT imaging was performed after osteotomy reduction, after plate stabilization, and after 30,000 cycles of axial compression testing. After 30,000 cycles, cyclic loading was continued with monotonically increasing peak-load until failure.
Results— The magnitude of rotation about the sawing axis was significantly greater for the conventional screw group because of plate application ( P =.009). Translational movement of the tibial plateau fragment toward the plate was significantly greater for the conventional screw group ( P =.006). There were no significant differences between groups in stiffness or number of cycles to failure.
Conclusion— Maintenance of tibial plateau position was significantly superior for the locking screw group during plate application; however, screw type had no effect on fixation stability under cyclic loading.
Clinical Relevance— These results suggest that conventional screws and careful contouring of the TPLO plate can provide comparable mechanical stability to fixation with locking screws in the tibial plateau under load-sharing conditions, but potentially at the expense of osteotomy reduction. 相似文献
4.
Boudrieau RJ McCarthy RJ Sprecher CM Künzler TP Keating JH Milz S 《American journal of veterinary research》2006,67(7):1258-1265
OBJECTIVE: To determine the material properties of Slocum TPLO plates and assess the soft tissue reaction adjacent to these plates in dogs that had undergone tibial plateau leveling osteotomy (TPLO). SAMPLE POPULATION: 3 new TPLO plates, 8 retrieved TPLO plates, and 1 new Synthes dynamic compression plate. PROCEDURES: Metallurgic analyses were performed. Tissue samples were obtained from areas adjacent to retrieved plates and submitted for histologic examination. RESULTS: All of the TPLO plates had a 2-phase microstructure consisting of austenite and ferrite in various amounts. Residua, inclusions, and cavities were seen during microscopic examination of the plate surface. The major differences between new and retrieved TPLO plates were the presence of small gaps separating many inclusions from the surrounding matrix and the presence of various-sized pits on the surface of the retrieved plates. The dynamic compression plate had a nearly pure austenitic structure and was largely free from residua, inclusions, and cavities. Histologic examination of tissue samples obtained from areas adjacent to retrieved TPLO plates revealed intra- and extracellular particulate debris. Two types of particles (one consisting of chromium, nickel, molybdenum, and iron and the other consisting of aluminum and silicon) were seen. CONCLUSIONS AND CLINICAL RELEVANCE: Results determined that new and retrieved TPLO plates were manufactured from 316L stainless steel and produced by a casting process, but not all plates met specifications for chemical composition of cast surgical implants (American Society for Testing Materials standard F745); tissues surrounding retrieved plates had evidence of adverse reactions, probably as a result of plate corrosion. 相似文献
5.
Histiocytic sarcoma of the stifle in a dog with cranial cruciate ligament failure and TPLO treatment
A 10-year-old spayed female Golden Retriever was admitted with chronic lameness of the right hind limb. A tibial plateau leveling osteotomy (TPLO) had been performed on this leg approximately three years previously. A progressively growing soft tissue mass, affecting the right stifle, previously treated with TPLO was biopsied and found to be a histiocytic sarcoma. Previously proposed links between the development of neoplasia in the stifle region and the presence of chronic synovitis, osteotomy, orthopaedic implants, and specifically the Slocum TPLO plate, are briefly discussed. 相似文献
6.
CARLOS CERVANTES MVZ JOHN B. MADISON VMD Diplomate ACVS GARY J. MILLER PhD ROBERT S. CASAR PE 《Veterinary surgery : VS》1996,25(1):1-5
The biomechanical characteristics of a 4-ring circular multiplanar fixator applied to equine third metacarpal bones with a 5 mm mid-diaphyseal osteotomy gap were studied. Smooth Steinmann pins, either 1/8 inch, 3/16 inch, or 1/4 inch, were driven through pilot holes in the bone in a crossed configuration and full pin fashion and fastened to the fixator rings using cannulated fixation bolts. The third metacarpal bone fixator constructs were tested in three different modes (cranial-caudal four-point bending, axial compression, and torsion). Loads of 2,000 N were applied in bending and axial compression tests and a load of 50 N ± m was applied during testing in torsion. Fixator stiffness was determined by the slope of the load displacement curves. Three constructs for each pin size were tested in each mode. Comparisons between axial stiffness, bending stiffness, and torsional stiffness for each of the three different pin sizes were made using one-way analysis of variance. There was no visually apparent deformation or permanent damage to the fixator frame, and no third metacarpal bone failure in any of the tests. Plastic deformation occurred in the 1/8 inch pins during bending, compression, and torsion testing. The 3/16 inch and 1/4 inch pins elastically deformed in all testing modes. Mean (±SE) axial compressive stiffness for the 1/8 inch, 3/16 inch, and 1/4 inch pin fixator constructs was: 182 ± 16 N/mm, 397 ± 21 N/mm, and 566 ± 8.7 N/mm; bending stiffness was 106 ± 3.3 N/mm, 410 ± 21 N/mm, and 548 ± 12 N/mm; and torsional stiffness was 6.15 ± 0.82 N.m/degree, 7.14 ± 0.0 N±m/degree, and 11.9 ± 1.0 N.m/degree respectively. For statically applied loads our results would indicate that a 4-ring fixator using two 1/4 inch pins per ring may not be stiff enough for repair of an unstable third metacarpal bone fracture in a 450 kg horse. 相似文献
7.
OBJECTIVE: To describe a surgical technique, and outcome, for treatment of cranial cruciate ligament (CrCL) deficient stifle joints with excessive tibial plateau angle (TPA) by combined tibial plateau leveling osteotomy and cranial closing wedge osteotomy (TPLO/CCWO). STUDY DESIGN: Retrospective clinical study. ANIMALS: Fifteen client-owned dogs (18 stifle joints). METHODS: Medical records of dogs that had TPLO/CCWO were reviewed. Pre- and postoperative TPA, CCWO technique, method of fixation and complications were recorded. In-hospital re-evaluation of limb function and length of time to radiographic healing was reviewed. Long-term outcome was assessed by owner telephone interview. RESULTS: Mean pre- and postoperative TPA was 42 degrees and 8 degrees, respectively. The Slocum biradial saw was used to create the CCWO in 4 stifle joints (mean postoperative TPA, 16 degrees) and a sagittal saw was used in 14 stifle joints (mean postoperative TPA, 5 degrees). Postoperative surgical complications were documented in 77.8% of cases; including patellar tendon thickening (61.1%), and implant loosening or breakage (27.8%), seroma formation (11.1%), and local irritation (11.1%). A second surgical procedure was performed in one-third of cases primarily to retrieve implants. Mean time to documented radiographic healing was 18 weeks. Final in-hospital re-evaluation of limb function (mean, 23 weeks postoperatively) was recorded as no lameness in 73.3% and mild lameness in 26.7%. All interviewed owners were satisfied with outcome and 90.9% reported marked improvement or a return to preinjury status. CONCLUSIONS: Long-term clinical outcome of TPLO/CCWO was very good in dogs with excessive TPA, with high owner satisfaction. Longer healing times and a higher complication rate were observed compared with TPLO alone. CLINICAL RELEVANCE: TPLO/CCWO of the tibia in stifle joints with excessive TPA allows for full correction of the TPA to 5 degrees without eliminating buttress support of the tibial tuberosity. 相似文献
8.
Objectives— To compare in vitro monotonic biomechanical properties of an equine spoon plate (ESP) with an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws (DCP‐TLS) inserted in lag fashion for equine proximal interphalangeal (PIP) joint arthrodesis. Study Design— Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Animal Population— Cadaveric adult equine forelimbs (n=18 pairs). Methods— For each forelimb pair, 1 PIP joint was stabilized with an ESP (8 hole, 4.5 mm) and 1 with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion. Six matching pairs of constructs were tested in single cycle to failure under axial compression with load applied under displacement control at a constant rate of 5 cm/s. Six construct pairs were tested for cyclic fatigue under axial compression with cyclic load (0–7.5 kN) applied at 6 Hz; cycles to failure were recorded. Six construct pairs were tested in single cycle to failure under torsional loading applied at a constant displacement rate (0.17 radians/s) until rotation of 0.87 radians occurred. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results— Mean yield load, yield stiffness, and failure load for ESP fixation were significantly greater (for axial compression and torsion) than for DCP‐TLS fixation. Mean (± SD) values for the ESP and DCP‐TLS fixation techniques, respectively, in single cycle to failure under axial compression were: yield load 123.9 ± 8.96 and 28.5 ± 3.32 kN; stiffness, 13.11 ± 0.242 and 2.60 ± 0.17 kN/cm; and failure load, 144.4 ± 13.6 and 31.4 ± 3.8 kN. In single cycle to failure under torsion, mean (± SD) values for ESP and DCP‐TLS, respectively, were: stiffness 2,022 ± 26.2 and 107.9 ± 11.1 N m/rad; and failure load: 256.4 ± 39.2 and 87.1 ± 11.5 N m. Mean cycles to failure in axial compression of ESP fixation (622,529 ± 65,468) was significantly greater than DCP‐TLS (95,418 ± 11,037). Conclusion— ESP was superior to an axial 3‐hole narrow DCP with 2 abaxial transarticular screws inserted in lag fashion in resisting static overload forces and cyclic fatigue. Clinical Relevance— In vitro results support further evaluation of ESP for PIP joint arthrodesis in horses. Its specific design may provide increased stability without need for external coaptation support. 相似文献
9.
During tibial plateau leveling osteotomy (TPLO) the saw blade produces frictional heat. The purpose of this study was to evaluate and compare heat generated by two TPLO blade designs (Slocum Enterprises [SE] and New Generation Devices [NDG]), with or without irrigation, on cadaveric canine tibias. Thirty-six paired tibias were used to continuously measure bone temperatures during osteotomy through both cortices (i.e., the cis and trans cortices). Each pair was assigned to either an irrigation or nonirrigation group during osteotomy, and each tibia within a pair was osteotomized using a different saw blade design. Saw blade temperatures were recorded and temperatures were compared for all combinations of blade type, cortex, and irrigation. In the cis cortex group, the SE blade generated more bone heat than the NGD blade (P=0.0258). Significant differences in temperature generation between saw blade types were seen only when the osteotomy site was not irrigated (P=0.0156). For all variables measured, bone and saw blade temperature generation was lower with irrigation (P<0.05). None of the osteotomies performed with either saw blade produced a critical duration of damaging temperature ranges in this study. Although saw blade design and irrigation influence heat generation during the TPLO, the potential for bone thermal damage during TPLO is low. The use of the NGD blade with irrigation is recommended. 相似文献
10.
JOHN C. JANICEK DVM MS Diplomate ACVS DAVID A. WILSON DVM MS Diplomate ACVS WILLIAM L. CARSON PhD JOANNE KRAMER DVM Diplomate ACVS 《Veterinary surgery : VS》2009,38(6):719-731
Objective— To compare stiffness and strength of a dynamic condylar screw plate combined with dorsal broad dynamic compression plate (DCS–bDCP) fixation with double broad dynamic compression plate (dbDCP) fixation used to repair oblique distal fractures of adult equine radii. Study Design— Experimental. Sample Population— Adult equine radii (n=10 pair). Methods— An unconstrained three‐dimensional loading–measurement system was used to determine stiffness of a 50 mm long intact, and then DCS–bDCP or dbDCP‐plated osteotomized/ostectomized segment of radii when subjected to a nondestructive sequence of compression, torsion, and lateral‐to‐medial (LM), medial‐to‐lateral (ML), cranial‐to‐caudal (CrCa), and caudal‐to‐cranial (CaCr) bending. Uniform load over the entire length of construct identified its weakest characteristics during torsion and LM and CrCa bending to failure. Results— No difference was observed between osteotomized/ostectomized DCS–bDCP and dbDCP construct stiffness for all 6 loading modes, and strength for all 3 failure loads. Ostectomized DCS–bDCP and dbDCP construct stiffness was significantly lower than osteotomized radii, the latter approaching intact for axial, LM, and CrCa bending. Most frequent failure was bone fracture through exit site of a screw located adjacent to osteotomy/ostectomy. Conclusions— DCS–DCP and dbDCP constructs had comparable strength and stiffness when repairing osteotomies/ostectomies in equine adult radius bone. Fracture reduction increased stiffness that approached intact bone for loads that placed the unplated side in compression. Clinical Relevance— DCS–bDCP and dbDCP constructs are comparable in stiffness and strength when applied to oblique distal diaphyseal osteotomies/ostectomies in equine radius bone. However, the DCS's localized effect on distal epiphyseal structure because of additional bone removal remains to be investigated under in vivo articular loading conditions. 相似文献
11.
JUSTIN M. UHL MS BERNARD SEGUIN DVM MS Diplomate ACVS AMY S. KAPATKIN DVM MS Diplomate ACVS KURT S. SCHULZ DVM MS Diplomate ACVS TANYA C. GARCIA MS SUSAN M. STOVER DVM PhD Diplomate ACVS 《Veterinary surgery : VS》2008,37(7):663-673
Objectives— To compare (1) pullout properties between 3.5 mm cortical and locking screws, and (2) mechanical properties and gap displacements between the 3.5 mm broad limited‐contact dynamic compression plate (LC‐DCP), broad dynamic compression plate (DCP), and narrow locking compression plate (LCP), during axial loading of plate‐stabilized diaphyseal fragments with an interfragmentary gap. Study Design— In vitro mechanical testing of implanted polyurethane foam (PUF) hollow cylinders that simulated compact or osteopenic diaphyseal bone. Sample Population— (1) Five cortical and locking screws and (2) 4 PUF‐plate constructs for each plate type; using high‐ and low‐density (0.8 and 0.32 g/cm3) cylinders. Methods— (1) Screws were completely extracted at 5 mm/min. (2) Plated constructs were axially compressed at 300 N/s for 10 cycles from 5 to 355 N to determine gap displacement during physiologic loading, followed by single cycle increasing load to failure. Results— Pullout properties were not different between screw types. All plate constructs had yield loads over 3 times trotting loads. Gap closure occurred with LC‐DCP and DCP constructs, but not LCP constructs. LCP construct properties were most similar to LC‐DCP and DCP construct properties in the low‐density model. Conclusion— All plate systems sustained physiologic limb loads. Only LCP constructs maintained some gap integrity, although LC‐DCP and DCP screws were placed in neutral position. Clinical Relevance— The LCP system is more likely than LC‐DCP and DCP systems, with neutrally positioned screws, to maintain a planned interfragmentary gap, although gap strains range from 0% to 15% across the 2 mm gap during a trot load. 相似文献
12.
A Biomechanical Evaluation and Assessment of the Accuracy of Reduction of Two Methods of Acetabular Osteotomy Fixation in Dogs 总被引：1，自引：0，他引：1
W. PRESTON STUBBS DVM Diplomate ACVS DANIEL D. LEWIS DVM Diplomate ACVS GARY J. MILLER PhD CHARLES QUARTERMAN BS GISELLE HOSGOOD BVSc MS Diplomate ACVS 《Veterinary surgery : VS》1998,27(5):429-437
Objective—To compare the accuracy of reduction, biomechanical characteristics, and mode of failure of two methods of acetabular osteotomy repair. Study Design—Acetabular osteotomies were created in 16 paired hemipelves and stabilized with a screw/wire/polymethylmethacrylate composite fixation technique (SWP) or a 2-mm veterinary acetabular plate (VAP). Eight intact hemipelves were used as controls. Sample Population—Twelve canine cadavers. Methods—Accuracy of osteotomy reduction was evaluated grossly and by measurement of articular incongruencies formed in polyvinylsiloxane impression casts. Acetabula were loaded in modified bending until failure using a universal testing machine. Data from load-deformation curves were used to determine the biomechanical characteristics of the repaired and intact acetabula. Mode of failure was evaluated grossly and radiographically. Results—Osteotomy reduction was superior in acetabula stabilized with SWP. Mean values ± standard deviation for load at failure and stiffness of the intact acetabula were 2,796 ± 152.9 N and 267.5 ±61.9 N/mm. Corresponding values for SWP and VAP were 1,192 ± 202.7 N and 136.3 ± 76.5 N/mm, and 1,100.5 ± 331.6 N and 110.0 ± 51.3 N/mm, respectively. The mean load at failure and stiffness of intact acetabula was significantly greater than acetabula stabilized with SWP or VAP. There was no significant difference between SWP and VAP for load at failure or stiffness. Failure of acetabula stabilized with SWP occurred by fracture of the polymethylmethacrylate and ventrolateral bending of the wires. Acetabula stabilized with VAP failed by ventrolateral twisting of the plate and bending of the caudal screws. Conclusions—SWP and VAP provide comparable rigidity, however, the SWP facilitates more accurate osteotomy reduction. Clinical Relevance—These findings support the use of the SWP technique as an alternative method of acetabular fracture repair. 相似文献
13.
Schmerbach KI Boeltzig CK Reif U Wieser JC Keller T Grevel V 《Veterinary surgery : VS》2007,36(2):156-163
OBJECTIVE: To evaluate the influence of a tibial plateau leveling jig on osteotomy orientation, fragment reduction, and postoperative tibial plateau angle (TPA) during tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: In vitro experimental study. ANIMALS: Large-breed canine cadavers (n=20). METHODS: TPLO was performed on 40 hindlimbs using 4 methods. Group 1: Jig; dogs in dorsal recumbency with the osteotomy parallel to the distal jig pin. Groups 2-4: No jig; dogs in lateral recumbency with the osteotomy in a vertical orientation (group 2: tibia parallel to the table top; group 3: controlled superimposition of the femoral condyles; group 4: internal rotation of the tibia). Postoperative TPA, fragment reduction, and osteotomy orientation relative to the tibial plateau were compared. Positive or negative values denoted deviation from parallel relative to the tibial plateau. RESULTS: Postoperative TPA, fragment reduction, and proximodistal osteotomy orientation were not significantly different between groups. Craniocaudal osteotomy orientation was significantly different (P<.005) from the tibial plateau. Median deviations were -4.0 degrees (group 1), 11.8 degrees (group 2), 11.2 degrees (group 3), and 0.2 degrees (group 4). Group 1 was not significantly different from group 4. CONCLUSIONS: A jig is not essential for osteotomy orientation, tibial plateau rotation, or fragment reduction. Comparable results were achieved performing a vertical osteotomy with the tibia slightly internally rotated (10 degrees -15 degrees) and parallel to the table surface. CLINICAL RELEVANCE: TPLO without use of a jig reduces surgical trauma, is less time consuming, and reduces cost. 相似文献
14.
RUTH J. LAMBERT DVM KIRK L. WENDELBURG DVM Diplomate ACVS 《Veterinary surgery : VS》2010,39(2):181-186
Objective— To assess whether there is a difference in the mechanical medial proximal tibial angle (mMPTA) measured on a tangential caudocranial (tCdCr) radiographic projection versus a straight caudocranial (sCdCr) projection before and after inducing a varus deformity in the proximal tibia. Study Design— In vitro study. Sample Population— Cadaveric canine tibiae (n=4 pair). Methods— For each tibia, a mediolateral radiographic projection was performed and the tibial plateau angle was measured. sCdCr and tCdCr radiographic projections were obtained and the mMPTA measured. A varus deformity was created in the proximal aspect of the tibia and sCdCr and tCdCr projections were repeated and mMPTA measured. Results— mMPTA for tCdCr was statistically different from mMPTA for the sCdCr projection for the varus tibiae (P<.05). There was no significant difference in the mMPTA measured on the sCdCr projections before and after creation of a varus deformity (P>.05). There was a significant difference in mMPTA measured on the tCdCr projection before and after creation of a varus deformity (P<.05). Conclusion— Varus deformity in the mMPTA was identified on tCdCr projections of the varus tibiae whereas it was not identified on sCdCr projections. Clinical Relevance— Tangential radiographic projections of the tibial plateau may be useful for evaluating varus deformities involving the articular surface of the tibia and should be performed during preoperative evaluation of angular limb deformities involving the proximal aspect of the tibia and for tibial plateau leveling osteotomy (TPLO) planning. 相似文献
15.
Johnson K Lanz O Elder S McLaughlin R Werre S Harper T 《The Canadian veterinary journal. La revue veterinaire canadienne》2011,52(9):961-966
This study was designed to determine the ability of tibial plateau leveling osteotomy (TPLO) to eliminate cranial tibial translation (CTT) through a loaded range of motion. Twenty-four large-breed canine cadaver limbs were compared. Each limb was placed in a custom designed jig at 120° of stifle extension under an axial load of 20% body weight. A force of approximately 10 N/s mimiced the action of the quadriceps muscle and allowed the limb to move from 120° to maximal extension. Positional data were acquired using electromagnetic motion-tracking sensors. Each limb was tested under normal, cranial cruciate ligament (CrCL)-deficient, and TPLO-treated conditions. Cranial tibial translation significantly increased after transection of the CrCL. The TPLO failed to normalize CTT within the CrCL deficient stifle; however, values trended towards intact values throughout the range of motion. The TPLO was more effective at higher angles of flexion. These altered biomechanics may help explain the continued progression of osteoarthritis in TPLO repaired stifles. This loaded model may serve as a method for future evaluation of other surgical techniques. 相似文献
16.
Objectives : To evaluate a novel surgery aimed at managing concurrent medial patellar luxation (MPL) and cranial cruciate ligament (CCL) ruptures in dogs weighing more than 30 kg. Methods : Tibial plateau levelling osteotomy (TPLO) and femoral trochleopasty were performed. The principal tibial fragment was laterally translated by 3 to 6 mm and was externally and abaxially rotated to create a wedge measuring 1·5 to 2·5 mm at the medial and cranial aspect and 1 to 3 mm at the medial and distal aspect of the tibial plateau fragment. The fragments were stabilised with a narrow TPLO plate. Results : Thirteen surgeries were performed in 12 dogs with a mean weight of 39·8 kg. The mean postoperative tibial plateau slope was 8·1°. Additional surgery was required in two cases, one due to failure of fixation and another due to screw breakage. The mean lameness score was 3·5 (out of 5) before surgery, 0·7 after 8 to 12 weeks, and 0·3 at final follow-up. Median follow-up was 1115 days (range, 270 to 2040 days). No patella luxated after surgery. Clinical Significance : MPL and CCL ruptures may be successfully managed by performing a TPLO and simultaneously altering the relationship of the principal and tibial plateau fragments during surgery. 相似文献
17.
Objective— To evaluate factors that predispose to tibial tuberosity (TT) fracture after tibial plateau leveling osteotomy (TPLO) in dogs.
Study Design— Retrospective study.
Animals— Dogs (n=182) with cranial cruciate ligament (CCL) rupture undergoing 213 TPLO surgeries.
Methods— Medical records and radiographs of 2 groups of dogs that had TPLO surgery (2000–2001, 2004–2005) were evaluated to determine the effect of operative technique and surgeon experience on TT fracture.
Results— TT fracture was diagnosed in 8 dogs (9 TPLO, 4.2% of surgical procedures). Four fractures occurred after unilateral TPLO in 167 dogs (2.4%), 4 fractures occurred after simultaneous bilateral TPLO in 5 dogs (40%), and 1 fracture occurred after staged bilateral TPLO in 36 dogs (2.8%). Simultaneous bilateral TPLO resulted in a 12.4 times higher odds of TT fracture versus unilateral TPLO ( P =.046). The mean absolute thickness of the TT after TPLO was less in dogs sustaining TT fractures (7.2 ± 2.2 mm) than those that did not (10.8 ± 2.7 mm, P <.0001). The odds of fracture decreased by 37% when the absolute TT width postosteotomy increased by 1 mm ( P <.0001). An increase in tibial plateau angle at follow-up versus immediately postoperative was associated with TT fracture ( P =.025). Surgeon experience was not associated with TT fracture.
Conclusion— A combination of surgical decision-making and surgical technique play a role in the occurrence of TT fracture after TPLO. Simultaneous bilateral TPLO was associated with a high percentage of TT fracture.
Clinical Relevance— Careful planning of osteotomy positioning is advised while performing TPLO surgery. 相似文献
Study Design— Retrospective study.
Animals— Dogs (n=182) with cranial cruciate ligament (CCL) rupture undergoing 213 TPLO surgeries.
Methods— Medical records and radiographs of 2 groups of dogs that had TPLO surgery (2000–2001, 2004–2005) were evaluated to determine the effect of operative technique and surgeon experience on TT fracture.
Results— TT fracture was diagnosed in 8 dogs (9 TPLO, 4.2% of surgical procedures). Four fractures occurred after unilateral TPLO in 167 dogs (2.4%), 4 fractures occurred after simultaneous bilateral TPLO in 5 dogs (40%), and 1 fracture occurred after staged bilateral TPLO in 36 dogs (2.8%). Simultaneous bilateral TPLO resulted in a 12.4 times higher odds of TT fracture versus unilateral TPLO ( P =.046). The mean absolute thickness of the TT after TPLO was less in dogs sustaining TT fractures (7.2 ± 2.2 mm) than those that did not (10.8 ± 2.7 mm, P <.0001). The odds of fracture decreased by 37% when the absolute TT width postosteotomy increased by 1 mm ( P <.0001). An increase in tibial plateau angle at follow-up versus immediately postoperative was associated with TT fracture ( P =.025). Surgeon experience was not associated with TT fracture.
Conclusion— A combination of surgical decision-making and surgical technique play a role in the occurrence of TT fracture after TPLO. Simultaneous bilateral TPLO was associated with a high percentage of TT fracture.
Clinical Relevance— Careful planning of osteotomy positioning is advised while performing TPLO surgery. 相似文献
18.
OBJECTIVE: To compare the mechanical properties and interoperator variabilities of 2 crimp clamp systems for extracapsular, fabello-tibial, nylon loop stabilization of the cranial cruciate ligament-deficient stifle in dogs. STUDY DESIGN: In vitro mechanical testing. METHODS: Three operators with different grip strengths each secured 20 standardized nylon loops using stainless-steel crimp clamps: 10 using a Veterinary Instrumentation system (45 kg [100 lb] test nylon leader line, 12 mm crimp clamps) and 10 using a Securos system (36 kg [80 lb] test nylon leader line, 36 kg [80 lb] crimp clamps). Loops were tensile loaded to failure in a materials testing machine. RESULTS: Mean ultimate load and mean stiffness were significantly higher for the Securos (336.9 N, 60.6 N/mm) than for the Veterinary Instrumentation system (113.8 N, 37.0 N/mm). For both systems, ultimate load was subject to interoperator variability. CONCLUSIONS: The Securos loops were significantly stronger and stiffer than the Veterinary Instrumentation loops for all operators, but significant differences between operators for ultimate load existed for both systems. CLINICAL RELEVANCE: Securos fabello-tibial sutures will withstand greater loads than Veterinary Instrumentation sutures and this is particularly true for sutures created by surgeons with reduced grip strength. It may be necessary to use more than 1 Veterinary Instrumentation suture to match the ultimate load and stiffness of a Securos suture. 相似文献
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GARY A. SOD DVM PhD Laura M. RIGGS DVM PhD Diplomate ACVS COLIN F. MITCHELL BVMS MS Diplomate ACVS JEREMY D. HUBERT BVSc MS Diplomate ACVS GEORGE S. MARTIN DVM MS MBA Diplomate ACVS 《Veterinary surgery : VS》2010,39(1):83-90
Objectives— To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP‐TLS) with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (3‐TLS) for the equine proximal interphalangeal (PIP) joint arthrodesis. Study Design— Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Sample Population— Cadaveric adult equine forelimbs (n=15 pairs). Methods— For each forelimb pair, 1 PIP joint was stabilized with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion. Five matching pairs of constructs were tested in single cycle to failure under axial compression, 5 construct pairs were tested for cyclic fatigue under axial compression, and 5 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results— Mean yield load, yield stiffness, and failure load under axial compression and torsion, single cycle to failure, of the DCP‐TLS fixation were significantly greater than those of the 3‐TLS fixation. Mean cycles to failure in axial compression of the DCP‐TLS fixation was significantly greater than that of the 3‐TLS fixation. Conclusion— The DCP‐TLS was superior to the 3‐TLS in resisting the static overload forces and in resisting cyclic fatigue. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a treatment modality for arthrodesis of the equine PIP joint. 相似文献
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Objectives: To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow locking compression plate (ELCP) using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (ELCP–TLS) with an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP–TLS) for equine proximal interphalangeal (PIP) joint arthrodesis. Design: Experimental. Animal Population: Cadaveric adult equine forelimbs (n=18 pairs). Methods: For each forelimb pair, 1 PIP joint was stabilized with an axial ELCP using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 PIP joint with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion. Six matching pairs of constructs were tested in single cycle to failure under axial compression, 6 construct pairs were tested for cyclic fatigue under axial compression, and 6 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results: Mean yield load, yield stiffness, and failure load under axial compression, single cycle to failure, of the DCP–TLS fixation were significantly greater than those of the LCP–TLS fixation. There was no significant difference between the mean number of cycles to failure in axial compression of the LCP–TLS and the DCP–TLS fixations. Mean yield load, yield stiffness, and failure load under torsion, single cycle to failure, of the LCP–TLS fixation were significantly greater than those of the DCP–TLS fixation. Conclusion: The DCP–TLS construct provided significantly greater stability under axial compression in single cycle to failure than the ELCP–TLS construct, the ELCP–TLS construct provided significantly greater stability under torsional loading in single cycle to failure than the DCP–TLS construct, and there was no significant difference in stability between the 2 constructs for cyclic loading under axial compression. 相似文献