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1.
G. K. Sicard  DVM    K. Hayashi  DVM  PhD    P. A. Manley  DVM  MSc 《Veterinary surgery : VS》2002,31(1):78-84
OBJECTIVE: To evaluate the mechanical properties of 5 types of fishing material, 2 sterilization methods, and a commercially designed crimp-clamp system for the extra-articular repair of the canine stifle joint. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Animals were not used in this study. METHODS: Two brands of monofilament nylon fishing line and 3 brands of monofilament nylon leader line were used to determine the effect of steam and ethylene oxide sterilization on strength and elongation of the material. A strand of 36-kg test monofilament nylon fishing material was wrapped around 2 rods or knotted to form a loop around 2 rods on a materials-testing machine. Ten trials of each brand of unsterilized, steam-sterilized, and ethylene oxide-sterilized fishing material were tested. A strand of each material was elongated to failure at a constant displacement of 1,000 mm/min to determine strength. A strand of each material was cycled 10 times to a load of 50 N to determine percent elongation. The brand of fishing material with the greatest strength and least elongation was crimped to form a loop around 2 rods on a materials-testing machine and tested as described above. ANOVA was used to determine the effect of sterilization method, brand of material, knot, wrap, and crimp on strength and elongation of the material, and a post-hoc t test was used when significant differences were found. A Student t test was used to compare fixation techniques (wrap, knot, and crimp). RESULTS: Sterilization by steam or ethylene oxide had no significant effect on the strength of the nylon fishing material. Steam sterilization resulted in significant increases (2- to 4-fold) in elongation of most nylon fishing material when compared with unsterilized material. Ethylene oxide sterilization had minimal effect on elongation of the fishing material. Mason leader line showed no significant change in strength or elongation regardless of sterilization method. Significantly less strength and significantly less elongation were demonstrated in Mason leader line that was crimped as compared with Mason leader line that was knotted. CONCLUSION: Ethlylene oxide was the preferred method of sterilization to preserve strength and minimize elongation of the fishing material. Of the materials tested, Mason leader line had the least elongation and the greatest preservation of strength when ethylene oxide was used as the sterilization method. Mason leader line and Sufix fishing line were comparable choices when steam was used as the sterilization method. Significantly less elongation was demonstrated in crimped Mason leader line as compared with knotted Mason leader line. CLINICAL RELEVANCE: Of the materials tested, Mason leader line and Sufix fishing line had the best mechanical properties for extracapsular stabilization of the canine stifle joint. Crimping is an attractive alternative to knotting and results in a reduction in elongation of the nylon fishing material.  相似文献   

2.
Partial rupture of the cranial cruciate ligament was diagnosed in 25 dogs. In all dogs, the primary problem at the time of physical examination was hind limb lameness. The mean time from initial onset of lameness to diagnosis at exploratory surgery was 17 weeks. A cranial drawer sign was detected in 13 of the 25 dogs; in 9, the cranial drawer sign was evident only when the stifle was positioned in flexion. Of the 25 dogs, 12 had no detectable cranial drawer sign in response to manipulation of the involved stifle. In all dogs, lateral stifle arthrotomy was performed in routine manner, and the cranial cruciate ligament was found to be incompletely torn. Lesions identified during arthrotomy were rupture of the craniomedial band (n = 20 dogs), interstitial tear (n = 4 dogs), and rupture of the caudolateral band (n = 1 dog).  相似文献   

3.
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   

4.
The mechanical properties of the cranial cruciate ligament were determined, using unilateral bone-ligament-bone preparations from 65 dogs of various ages and body sizes. Tensile loading of the cranial cruciate ligament from 1 of each pair of stifle joints demonstrated a decrease in material properties (modulus, maximum stress, strain energy) with aging. The decreases in maximum stress and strain energy with age were significantly less (P less than 0.05 and P less than 0.05, respectively) in the cranial cruciate ligament from dogs weighing less than 15 kg, compared with those weighing 15 kg or more. The cranial cruciate ligament and remaining femorotibial ligaments were collected from the opposite stifle joints and examined microscopically. By 5 years of age, the cranial cruciate ligaments of dogs weighing greater than 15 kg consistently had microscopic evidence of degenerative disease (loss of ligamentocytes, metaplasia of surviving ligamentocytes to chondrocytes, and failure to maintain collagen fibers and primary collagen bundles) which progressed in severity with age. The caudal cruciate ligaments were similarly affected, although the degenerative changes were rarely as severe as in the cranial cruciate ligament. The collateral ligaments underwent minimal degeneration. Sex differences had no bearing on degeneration. The cranial cruciate ligaments in dogs weighing less than 15 kg generally had less severe alterations than those in heavier dogs, and the onset of the degenerative process was delayed by several years. Cranial cruciate ligaments removed from dogs after ligament failure not only had degenerative disease, but also had undergone unsuccessful attempts at repair. In contrast, fibrous repair was rarely present in intact ligaments of asymptomatic dogs with degenerative disease of the cranial cruciate ligament.  相似文献   

5.
O bjective : To estimate specificity, sensitivity, positive predictive value and negative predictive value of tests and signs used for the diagnosis of cranial cruciate ligament failure in dogs.
M ethods : One stifle in each of 42 dogs was examined: 25 "affected" and 17 "control" dogs. All dogs were subjected to the following tests when conscious: cranial drawer, tibial compression, patellar tendon palpation and palpation of the medial aspect of the joint. Under general anaesthesia, cranial drawer and tibial compression tests were repeated and a lateral stifle radiograph was taken to evaluate changes of the infrapatellar fat pad. The results were analysed using a 2×2 table method. Sensitivity, specificity, positive predictive value and negative predictive value were estimated.
R esults : The sensitivity of the cranial drawer and tibial compression tests was surprisingly low when performed on conscious patients but significantly better when performed under anaesthesia. Similarly, palpation of the medial aspect of the stifle joint cannot be considered a reliable indicator of cranial cruciate ligament injury. Patellar palpation and radiographic assessment showed excellent sensitivity, specificity, positive predictive value and negative predictive value.
C linical S ignificance : In the diagnosis of cranial cruciate ligament, it is essential that the clinician is aware of each test's features and limitations to reduce the risk of misdiagnosis.  相似文献   

6.
This study aimed to evaluate the stifle joint of marsh deer using imaging studies and in comparison with gross anatomy. Ten hindlimbs from 5 marsh deer (Blastocerus dichotomus) were used. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed in each stifle joint. Two hindlimbs were dissected to describe stifle gross anatomy. The other limbs were sectioned in sagittal, dorsal or transverse planes. In the craniocaudal radiographic view, the lateral femoral condyle was broader than the medial femoral condyle. The femoral trochlea was asymmetrical. Subsequent multiplanar reconstruction revealed in the cranial view that the external surface of the patella was roughened, the medial trochlea ridge was larger than the lateral one, and the extensor fossa at the lateral condyle was next to the lateral ridge. The popliteal fossa was better visualized via the lateral view. Sagittal MRI images identified lateral and medial menisci, caudolateral and craniomedial bundles of cranial cruciate ligament, caudal cruciate ligament, patellar ligament and common extensor tendon. In conclusion, the marsh deer stifle presents some anatomical characteristics of the ovine stifle joint.  相似文献   

7.
Twenty-three cases of partial rupture of the cranial cruciate ligament (CCL) were reviewed. All of these patients were evaluated for clinical and radiographic signs of instability. Nine cases showed a negative drawer sign on manual assessment. A positive radiographic tibial compression test was obtained for all stifle joints with a partially ruptured cruciate. In 13 cases, the site of injury and the appearance of the torn ends were evaluated. The final diagnosis of partial CCL rupture was made by direct visualisation and probing of the CCL during arthrotomy (22 cases) or arthroscopy (one case).  相似文献   

8.
OBJECTIVE: To evaluate the effect of knotting method on the mechanical properties of large diameter nonabsorbable monofilament suture materials. STUDY DESIGN: In vitro mechanical evaluation. METHODS: A conventional square knot was compared with the surgeon's knot, sliding half-hitch, and clamped square knot. Knotted suture loops were created in a uniform manner and acutely tensioned to failure (20 mm/min loading rate; n = 20 per knot type for each material). Stiffness, yield, and failure characteristics of USP #2 nylon, #2 polybutester, #2 polypropylene, 27 kg test monofilament nylon fishing line, and 27 kg nylon leader material were evaluated. RESULTS: Compared with a conventional square knot, a surgeon's knot decreased stiffness for #2 polypropylene, 27 kg fishing line, and 27 kg leader (P < .05). A sliding half-hitch weakened all materials except 27 kg leader (P < .05). Clamping the first throw of a square knot increased the stiffness of 27 kg leader loops (P < .05). CONCLUSIONS: Based on clinically relevant parameters (stiffness and yield), knotting method had no effect on #2 nylon and #2 polybutester. The surgeon's knot is not recommended for #2 polypropylene and 27 kg fishing line and leader material. A sliding half-hitch decreased the yield of leader material. Clamping the first throw of a square knot had no adverse effects on acute properties of tested materials; it increased the stiffness for leader material. CLINICAL RELEVANCE: Knotting method does influence the structural properties of suture materials and should be considered when tying knots under tension.  相似文献   

9.
A prosthetic replacement for the cranial cruciate ligament was successfully implanted under arthroscopic guidance in four canine cadavers and seven normal dogs. Several strands of size 2 braided polyester were implanted in the cadavers and one normal dog, and a copolymer coated tow of 10,000 carbon fibers was implanted in six normal dogs. The average time required to surgically implant the carbon fiber prosthetic ligaments was 60 minutes. All of the dogs had slight to no drawer sign postoperatively. Five of the dogs were bearing more weight 3 weeks postoperatively than after transection of the cranial cruciate ligament. The surgical technique for implantation was successful for elimination of the cranial drawer sign, but carbon fibers were broken prematurely and instability reoccurred.  相似文献   

10.
Cranial tibial thrust: a primary force in the canine stifle   总被引：5，自引：0，他引：5  
A cranially directed force identified within the canine stifle joint was termed cranial tibial thrust. It was generated during weight bearing by tibial compression, of which the tarsal tendon of the biceps femoris is a major contributor, and by the slope of the tibial plateau, found to have a mean cranially directed inclination of 22.6 degrees. This force may be an important factor in cranial cruciate ligament rupture and in generation of cranial drawer sign.  相似文献   

11.
A 6-year-old, 43-kg, spayed female rottweiler was presented for a 1-month history of progressive, left hind-limb lameness. Upon physical examination, a cranial drawer sign and joint distention were present in the left stifle. Radiographically, the stifle had evidence of effusion, remodeling of the patella, and an enlarged popliteal lymph node. Marked synovial thickening and an intact cranial cruciate ligament were noted during surgery. Despite finding a nonspecific, mixed inflammatory response on joint fluid cytopathology, histopathology demonstrated T-cell lymphoma of the synovium. Lameness may be the sole presenting clinical sign in canine lymphoma.  相似文献   

12.
An in vitro study of rottweiler and racing greyhound cranial cruciate ligaments revealed that the rottweiler ligaments had a significantly greater cross-sectional area at their distal attachments. Mechanical testing showed that the ultimate load related to body mass was significantly higher in the extended racing greyhound stifle during cranial tibial loading to failure, as were linear stiffness, tensile strength and tangent modulus. During ligament axis loading to failure, the only significant difference in structural and mechanical properties recorded between the two breeds was a greater ultimate strain for the greyhound ligament with the stifle joint flexed. Energy absorbed by the ligament complex at failure during cranial tibial loading was twice that for ligament axis loading for both breeds. The clinical significance is that the rottweiler cranial cruciate ligament is more vulnerable to damage as it requires half the load per unit body mass that the greyhound requires to cause a rupture.  相似文献   

13.
OBJECTIVE: To determine the in vitro structural and material properties of braided, multifilament, nonabsorbable polyester tapes, used for intra-articular stabilization of cranial cruciate ligament- (CCL-) deficient stifle joints in dogs, and compare those with properties of multifilament polyamide tapes. SAMPLE POPULATION: 30 polyester tapes (width, 4 mm), 10 polyester tapes (width, 7 mm), and 30 polyamide tapes (width, 4 mm) were tested to failure. Cyclic loading experiments were also performed, using 3 polyester tapes of each width. PROCEDURE: Tapes were mounted in a tensile tester as single loops, simulating intra-operative conditions, and elongated to failure at 1,000 mm/min. Additionally, the behavior of polyester tapes was tested at different elongation rates. In a second series of experiments, biomechanical variables of the polyester tapes were measured after 25 sets of 2,000 cycles between physiologic force limits. RESULTS: Mean (+/- SD) ultimate loads of the 4-mm wide polyamide tapes, 4-mm wide polyester tapes, and 7-mm wide polyester tapes were 266.48 +/- 13.19 301.78 +/- 16.92, and 726.40 +/- 37.74 N, respectively. Corresponding stiffnesses were 15.57 +/- 0.49, 21.63 +/- 2.19, and 34.85 +/- 2.66 N/mm, respectively. Failure properties of polyester tapes were affected by previous cyclic loading. CONCLUSIONS AND CLINICAL RELEVANCE: Polyester tapes of 4- or 7-mm widths should be able to resist forces resulting from weight bearing in dogs, suggesting that these tapes will be effective for stabilization of the stifle joint in dogs with a ruptured CCL.  相似文献   

14.
A four year-old intact male Dalmatian was referred to the veterinary teaching hospital at Louisiana State University for acute, non-weight-bearing left hindlimb lameness of three weeks duration. Information supplied by the referring veterinarian indicated the lameness was first diagnosed and treated seven months previously, but recurred three weeks ago. External rotation of the left stifle, mild discomfort upon stifle flexion, mild to moderate muscle atrophy and palpable joint effusion were noted during physical examination. Slight cranial drawer movement with a soft end-point was discovered during manipulation of the left stifle. A triangular bone fragment and thickened, confluent intracapsular soft tissues were observed on radiographs of the stifle. Radiographically, moderate degenerative changes suggested chronicity. This report describes the clinical and radiographic findings of a rarely reported partial avulsion of the origin of the cranial cruciate ligament in a skeletally mature dog.  相似文献   

15.
OBJECTIVE: To determine craniocaudal laxity of the stifle joint of dogs when joints were positioned in tibial compression or neutral position. SAMPLE POPULATION: 19 normal stifle joints in 10 clinically normal dogs, 29 stifle joints with varying injury to the cranial cruciate ligament (10 complete ruptures alone, 10 complete ruptures with concomitant damage to the medial meniscus, 6 partial ruptures alone, and 3 partial ruptures with concomitant meniscal tearing), and 19 unaffected contralateral stifle joints in those 29 dogs. PROCEDURE: Relative displacement of bony landmarks was measured on paired lateral radiographs (neutral and tibial compression positions). Two measuring techniques were customized for use in dogs. RESULTS: The first technique failed to distinguish results in normal stifle joints from those in stifle joints with partial deficiency of cranial cruciate ligaments. Significant differences were found for joints with complete rupture, compared with stifle joints in clinically normal dogs. The second technique detected differences between normal stifle joints and injured joints with partial or complete rupture of the cranial cruciate ligament. Significant differences were not detected between joints with partial versus complete rupture. Adjusting data to account for size of dog did not improve results. CONCLUSIONS AND CLINICAL RELEVANCE: A wide range in measurements of laxity was found for stifle joints with intact cranial cruciate ligaments. Differences in degree of damage to the ligament and medial meniscus cannot be deduced from the amount of relative displacement measured on radiographs. Pathologic changes to the cranial cruciate ligament will not necessarily induce detectable changes in laxity of stifle joints in dogs.  相似文献   

16.
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   

17.
This prospective clinical study investigated the activity of matrix metalloproteinases (MMPs) in stifle synovial fluid (SF) of 13 dogs with acute cranial cruciate ligament (CCL) rupture, and the effect of a postoperative doxycycline treatment. MMP-2, 3, 9 and 13 activities were compared with respect to the time of sampling (preoperatively or 1 month after surgical stabilisation) and the type of postoperative adjuvant treatment (doxycycline or not). No significant activity was detected for both MMP-3 and MMP-13. MMP-2 and MMP-9 activities were found to be significantly highly increased in SF of CCL ruptured stifles compared to control stifles of unaffected dogs. No significant effect from surgical stabilisation and postoperative doxycycline treatment on MMP-2 and MMP-9 activities was found, indicating that doxycycline may not be an appropriate postoperative medical treatment after CCL rupture.  相似文献   

18.
Unilateral cranial cruciate ligament excision and fibular head transposition (FHT) were performed on 30 adult dogs. Vertical ground reaction forces were determined using force plate data before and after surgery. Cranial drawer motion, tibial rotation, and varus-valgus motion were measured at monthly intervals. Radiographic, gross, and histological examinations of the stifle joints that had been operated on were performed 3 weeks, 4 months, and 10 months after surgery. A scoring system was used to evaluate lameness, osteophyte formation, and meniscal damage. Rank correlation coefficients were calculated between variables tested in pairs. Cranial drawer motion and abnormal tibial rotation were present in all of the joints that had been operated on. Peak vertical force and associated impulse were not restored during the study time period. Meniscal damage was noted in 25% of the dogs at month 4 and in 50% of the dogs at month 10. Progressive gross and histological deterioration of the articular cartilage was observed in all joints. Positive correlations were noted between the degree of stifle joint instability and meniscal injury or radiographic changes. FHT did not control cranial drawer motion and rotational instability, was not successful in restoring limb function, and did not prevent joint degeneration, especially meniscal damage.  相似文献   

19.
Cranial cruciate ligament (CCL) disease in the dog is a multifactorial complex problem that requires a thorough understanding of the biomechanics of the stifle joint to be understood. Successful treatment of rupture of the CCL should be based on managing underlying anatomical and conformational abnormalities rather than attempting to eliminate the tibial cranial drawer sign. The cranial and caudal cruciate ligaments, the patella ligament and quadriceps mechanism, the medial and lateral collateral ligaments, the medial and lateral menisci and the joint capsule provide stability of the joint and load-sharing. The function of the stifle is also significantly influenced by the musculature of the pelvic limb. An active model of biomechanics of the stifle has been described that incorporates not only the ligamentous structures of the stifle but also the forces created by weight-bearing and the musculature of the pelvic limb. This model recognises a force called cranial tibial thrust, which occurs during weight-bearing, and causes compression of the femoral condyles against the tibial plateau. In middle-aged, large-breed dogs, forces acting on the CCL together with conformation-related mild hyperextension of the stifle and slightly increased tibial plateau slopes are suspected to cause progressive degeneration of the ligament. Palpation of craniolateral stifle laxity has become pathognomonic for CCL rupture; however, chronic periarticular fibrosis, a partial CCL rupture, and a tense patient, may make evaluation of instability of the stifle difficult. Surgical treatment is broadly separated into three groups: intracapsular, extracapsular, and tibial osteotomy techniques. Tibial osteotomy techniques do not serve to provide stability of the stifle but rather alter the geometry of the joint to eliminate cranial tibial thrust such that functional joint stability is achieved during weight-bearing. Visualisation of both menisci is a critical aspect of CCL surgery, irrespective of the technique being performed. Regardless of the surgical technique employed, approximately 85% of dogs show clinical improvement. However, many of these dogs will demonstrate intermittent pain or lameness. Post-operative management is an integral part of the treatment of CCL rupture, and significant benefits in limb function occur when formalised post-operative physiotherapy is performed.  相似文献   

20.
In the human and veterinary orthopaedic literature it has been implied that intercondylar notch stenosis is a mechanical factor in cranial cruciate ligament rupture and intraarticular graft failure. The patients in this study were classified as normal (32), unilateral cruciate rupture (23), or bilateral cruciate rupture (17). The dogs were placed under general anaesthesia and both stifles were scanned via computed tomography (CT) as previously described. Three CT slices at predetermined levels were evaluated within the notch. Measurements included opening notch angle, notch width and height, condyle width, and notch width index (notch width/condyle width) at two different heights within the notch. Intercondylar notch measurements at the most cranial extent were significantly more narrow in unilateral and bilaterally affected stifles when compared to the normal population. Significant differences were noted in the opening notch angle (ONA), notch width index (NWI), NWI at two thirds notch height (NWI2/3), and tibial slope index (TSI). No significant differences were noted between unilateral and bilateral affected stifles. Increased mechanical contact of the cranial cruciate ligament with a stenotic intercondylar notch may predispose the ligament to mechanical wear and structural weakening. Intercondylar notch measurements have been used as a tool to predict the risk of anterior cruciate ligament injury in young human athletes, and to assess the risk factors for intra-articular graft replacements. Our findings may be useful in developing similar predictive models using stifle CT scans.  相似文献   

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