Surgical Treatments for Canine Anterior Cruciate Ligament Rupture: Assessing Functional Recovery Through Multibody Comparative Analysis

Abstract

Anterior cruciate ligament (ACL) deficiency can result in serious degenerative stifle injuries. Although tibial plateau leveling osteotomy (TPLO) is a common method for the surgical treatment of ACL deficiency, alternative osteotomies, such as a leveling osteotomy based on the center of rotation of angulation (CBLO) are described in the literature. However, whether a CBLO could represent a viable alternative to a TPLO remains to be established. The aim of this study is to compare TPLO and CBLO effectiveness in treating ACL rupture. First, a computational multibody model of a physiological stifle was created using three-dimensional surfaces of a medium-sized canine femur, tibia, fibula and patella. Articular contacts were modeled by means of a formulation describing the contact force as function of the interpenetration between surfaces. Moreover, ligaments were represented by vector forces connecting origin and insertion points. The lengths of the ligaments at rest were optimized simulating the drawer test. The ACL-deficient model was obtained by deactivating the ACL related forces in the optimized physiological one. Then, TPLO and CBLO treatments were virtually performed on the pathological stifle. Finally, the drawer test and a weight-bearing squat movement were performed to compare the treatments effectiveness in terms of tibial anteroposterior translation, patellar ligament force, intra-articular compressive force and quadriceps force. Results from drawer test simulations showed that ACL-deficiency causes an increase of the anterior tibial translation by up to 5.2 mm, while no remarkable differences between CBLO and TPLO were recorded. Overall, squat simulations have demonstrated that both treatments lead to an increase of all considered forces compared to the physiological model. Specifically, CBLO and TPLO produce an increase in compressive forces of 54% and 37%, respectively, at 90° flexion. However, TPLO produces higher compressive forces (up to 16%) with respect to CBLO for wider flexion angles ranging from 135° to 117°. Conversely, TPLO generates lower forces in patellar ligament and quadriceps muscle, compared to CBLO. In light of the higher intra-articular compressive force over the physiological walking range of flexion, which was observed to result from TPLO in the current study, the use of this technique should be carefully considered.

Determining the Online Measurable Input Variables in Human Joint Moment Intelligent Prediction Based on the Hill Muscle Model

“…In this method, musculoskeletal geometry [35,36] comprised of Hill muscle models [37,38] are utilized for representing the muscle mechanical response. Furthermore, the input variables to predict joint moment based on the Hill muscle model includes four time-varying variables: the muscle activation, muscle-tendon moment arm, velocity and length are found [39], that generally cannot be measured online in vivo.…”

Finite Element Modeling Application in Forensic Practice: A Periprosthetic Femoral Fracture Case Study

“…The structural analysis of skeletal body elements and of biomechanical systems consisting of a bone element coupled to a prosthesis, an implant or a fracture synthesis device, can be performed both numerically and experimentally. There are indeed many examples of clinical problems which have moved from a qualitative assessment to a quantitative evaluation thanks to computational modeling (Vitale et al, 2008;Zanetti and Bignardi, 2013;Zanetti et al, 2017Zanetti et al, , 2018aAldieri et al, 2018b;Calì et al, 2018;Putzer et al, 2018;Terzini et al, 2018Terzini et al, , 2019Putame et al, 2019), to the application of classical experimental methods of structural analysis in the evaluation of the efficacy of procedures or surgical techniques (Bresciano et al, 2005;Menicucci et al, 2006;Zanetti and Audenino, 2010;Zanetti et al, 2012aZanetti et al, , 2018bBoero Baroncelli et al, 2013;Manzella et al, 2013Manzella et al, , 2016Bignardi et al, 2018), or to the evaluation of the mechanical characteristics of the materials used at different scales of investigation (Peluccio et al, 2007;Bignardi et al, 2010;Zanetti et al, 2012b;Terzini et al, 2016a,b;Aldieri et al, 2018a). Computational modeling, more than experimental one, finds natural application in forensic practice, as samples are often unavailable for experimental investigations.…”

Arthroscopically Guided Proximal Tibial Epiphysiodesis Screw Placement as Treatment of a Bilateral Partial Cranial Cruciate Ligament Injury in a Juvenile Dog

“…In addition, avulsion of the liga-ment with an osteochondral fragment from the femoral origin or tibial insertion of the CrCL is commonly observed. 1,[3][4][5] Several surgical procedures have been proposed for CrCL rupture treatment in dogs. Among them, tibial plateau levelling techniques, such as tibial plateau levelling osteotomy, allow the neutralization of the cranial tibial thrust by changing the slope of the tibial plateau.…”

“…2,6,7 Although this is a commonly accepted technique for adult dogs, its use for immature dogs is a controversial topic due to the higher risk of complications as well as iatrogenic trauma to the open proximal tibial growth plate. 4 Proximal tibial epiphysiodesis (PTE), which consists of fusing the craniocentral portion of the proximal tibial epiphysis while allowing the continued growth of the caudal aspect of the plateau, was developed in an attempt to progressively level the tibial slope in immature dogs. 3,5,8 This procedure should be performed prior to proximal tibial epiphyseal closure to allow for significant tibial plateau angle (TPA) changes, and dogs younger than 7 months old have been reported to be the best candidates.…”