Canine cranial cruciate ligament deficient stifle biomechanics associated with extra‐articular stabilization predicted using a computer model

Brown, Nathan P.; Bertocci, Gina; Marcellin‐Little, Denis J.

doi:10.1111/vsu.12652

Cited by 3 publications

(3 citation statements)

References 44 publications

(92 reference statements)

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“…2,3 Numerous surgical treatment options have been proposed and have been grouped by extra-capsular, intra-articular or osteotomy techniques. 4 Lateral fabellotibial suture is an extra-capsular technique first described in 1970. 5 A heavy non-absorbable suture material is placed around the sesamoid of the lateral head of the gastrocnemius tendon and through bone tunnel(s) made in the tibial tuberosity mimicking craniocaudal restraint of the cranial cruciate ligament.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

Cox

Maddox²,

Pettitt

et al. 2020

Vet Comp Orthop Traumatol

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Objectives This study investigated variables associated with surgical site infection (SSI) in dogs with cranial cruciate ligament rupture managed with stifle joint examination and lateral fabellotibial suture stabilization. Study Design A retrospective study of dogs that had stifle arthroscopy, stifle arthrotomy, or a combination of both, followed by lateral fabellotibial suture stabilization for cranial cruciate ligament rupture. All cases had a minimum follow-up of 90 days. Lameness grades were recorded preoperatively, and at 6-week and final follow-up. Results One hundred fifty procedures in 130 dogs met the inclusion criteria. Overall, SSI rate was 17.3% and removal of the lateral fabellotibial suture was performed in 53% of SSI. Multivariable analysis showed significant association between SSI and bodyweight (p = 0.013), and induction using propofol (p = 0.029). Multilevel ordinal logistic regression analysis showed a greater proportion of dogs had a higher lameness grade at 6-week (p = 0.021) and final follow-up (p = 0.002) assessments in the infected compared with non-infected dogs. Conclusion Our study demonstrated a higher SSI incidence than previously reported in dogs undergoing a lateral fabellotibial suture for cranial cruciate ligament rupture. Bodyweight and induction with propofol were identified as significant risk factors for postoperative SSI. Owners could be advised of an increased SSI risk in larger dogs and consideration should be given to selection of induction agent. Dogs that develop an SSI have a worse lameness grade at 6-week and final follow-up.

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Section: Introductionmentioning

confidence: 99%

Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

Cox

Maddox²,

Pettitt

et al. 2020

Vet Comp Orthop Traumatol

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“…Outcome evaluations of surgical treatments for CCLD have been conducted by retrospective studies ( 26 ), in vivo limb function evaluation with force plates ( 20 ), arthroscopy ( 24 , 27 , 28 ), osteoarthritis scoring ( 27 , 28 ), computer model prediction ( 29 ), and ex vivo biomechanical studies ( 30 , 31 ). Among these methods, ex vivo biomechanical testing allows for direct experimental exploration of the effects of diseases or therapeutic factors on stifle kinematic responses.…”

Section: Introductionmentioning

confidence: 99%

Ex vivo biomechanical investigations of combined extra- and intracapsular stabilization in canines with cranial cruciate ligament deficiency

Sun,

Lin,

2024

Front. Vet. Sci.

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Intracapsular reconstruction (ICR) has long been recommended as a treatment for cranial cruciate ligament deficiency (CCLD) in dogs, but it has fallen out of favor due to its inferior long-term functional outcomes. These outcomes may be attributed to the poor stiffness and strength of the graft in the early period before ligamentization is completed. Additional placement of extracapsular sutures to mechanically protect the graft during the ligamentization process may be a viable method to address this problem. However, the biomechanical effect of this combined surgical approach remains unknown. This study aimed to evaluate the 3D kinematics of the CCLD stifle in dogs in response to ICR and combined extra- and intracapsular reconstruction (CEICR). Twelve hindlimbs were collected from nine cadavers of mature dogs. The limbs were tested using a custom-made testing apparatus that reproduces their sagittal plane kinematics during the stance phase. Four statuses of stifle joints were tested, namely, (a) cranial cruciate ligament (CCL) intact; (b) CCLD; (c) CCLD stifle stabilized by CEICR; and (d) CCLD stifle stabilized by ICR only. Three-dimensional stifle kinematics at the 5 instances of the stance phase were measured with an optoelectronic system. The results showed that ICR marginally corrects the increased adduction, internal rotation, and caudodistal stifle joint center displacement that occur as a result of CCLD. CEICR led to better restoration of the stifle kinematics, especially with respect to the internal rotation and cranial translation stabilities. Furthermore, CEICR only resulted in minor excessive restraints on other motion components. The findings indicated that the additional lateral fabellotibial suture offers immediate stability to the stifle, consequently lowering the risk of graft over-elongation in the short term postoperatively. Considering the propensity for the extracapsular suture to degrade over time, further in vivo studies are warranted to explore the long-term effects of the CEICR procedure.

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“…[8][9][10][11][12][13] The biomechanical properties of these 2 techniques used for stifle joint stabilization, with both osteotomies and extracapsular fixation, have been widely evaluated in dogs. [14][15][16][17][18][19][20][21] Nevertheless, there are limited reports available that assess the biomechanical behavior of extracapsular techniques for stifle stabilization in cats. 7,[22][23][24] A biomechanical study 7 on cat cadaveric stifle joints demonstrated that a lateral femoro-tibial suture with the screw placed at the quasi-isometric point provides better stabilization to the joint in the proximal-distal plane compared to a standard lateral suture.…”

mentioning

confidence: 99%

Ex vivo biomechanical evaluation and comparison of lateral femoro-fabella ligament suture and lateral suture with bone anchor for cranial cruciate ligament repair in cats

Tassani,

de Witt,

Fosgate

et al. 2024

ajvr

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OBJECTIVE To compare the biomechanical properties of lateral femoro-fabella ligament suture (FFLS) and lateral suture with a bone anchor suture (BAS) for management of feline cranial cruciate ligament disease. ANIMALS 12 femurs from 6 mature cat cadavers. METHODS The samples were collected from April to June 2023. The specimens had an FFLS and, subsequently, BAS placed and were positioned into a biomechanical testing machine, preloaded from 5 N to 15 N for 100 cycles, and subsequently, a load to suture failure was applied. The displacement at 5 N and 15 N, the total precycle displacement (millimeters), the force at 3 mm displacement and at failure (newtons), the displacement at failure (millimeters), and the stiffness to failure (Newton:millimiter) were recorded. Nonparametric Wilcoxon signed-rank tests were used to compare data between the 2 groups. RESULTS The displacement at 5 N and 15 N and the total precycle displacement were significantly higher in the FFLS group compared to the BAS group. Additionally, the FFLS group results showed less consistent displacement and marked variability. The force (newtons) at 3 mm displacement was higher in the BAS group. There was no significant difference in force and no significant difference in displacement at failure between the 2 groups. However, the stiffness to failure (N/mm) was significantly higher in the BAS group. CONCLUSION BAS represented a more stable and reliable femur attachment for extracapsular suture in cats. CLINICAL RELEVANCE To demonstrate the stability and reliability between BAS and FFLS and influence implant selection in the treatment of cranial cruciate ligament rupture in cats with evaluation of biomechanical properties.

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Canine cranial cruciate ligament deficient stifle biomechanics associated with extra‐articular stabilization predicted using a computer model

Cited by 3 publications

References 44 publications

Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

Ex vivo biomechanical investigations of combined extra- and intracapsular stabilization in canines with cranial cruciate ligament deficiency

Ex vivo biomechanical evaluation and comparison of lateral femoro-fabella ligament suture and lateral suture with bone anchor for cranial cruciate ligament repair in cats

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