Canine Stifle Joint Research Articles

EVALUATION OF THE WARP‐TURBO SPIN ECHO SEQUENCE FOR 3 TESLA MAGNETIC RESONANCE IMAGING OF STIFLE JOINTS IN DOGS WITH STAINLESS STEEL TIBIAL PLATEAU LEVELING OSTEOTOMY IMPLANTS

Susceptibility artifacts caused by ferromagnetic implants compromise magnetic resonance imaging (MRI) of the canine stifle after tibial plateau leveling osteotomy (TPLO) procedures. The WARP-turbo spin echo sequence is being developed to mitigate artifacts and utilizes slice encoding for metal artifact reduction. The aim of the current study was to evaluate the WARP-turbo spin echo sequence for imaging post TPLO canine stifle joints. Proton density weighted images of 19 canine cadaver limbs were made post TPLO using a 3 Tesla MRI scanner. Susceptibility artifact sizes were recorded and compared for WARP vs. conventional turbo spin echo sequences. Three evaluators graded depiction quality for the tibial tuberosity, medial and lateral menisci, tibial osteotomy, and caudal cruciate ligament as sufficient or insufficient to make a diagnosis. Artifacts were subjectively smaller and local structures were better depicted in WARP-turbo spin echo images. Signal void area was also reduced by 75% (sagittal) and 49% (dorsal) in WARP vs. conventional turbo spin echo images. Evaluators were significantly more likely to grade local anatomy depiction as adequate for making a diagnosis in WARP-turbo spin echo images in the sagittal but not dorsal plane. The proportion of image sets with anatomic structure depiction graded adequate to make a diagnosis ranged from 28 to 68% in sagittal WARP-turbo spin echo images compared to 0-19% in turbo spin echo images. Findings indicated that the WARP-turbo spin echo sequence reduces the severity of susceptibility artifacts in canine stifle joints post TPLO. However, variable depiction of local anatomy warrants further refinement of the technique.

Intra-articular transplantation of porcine adipose-derived stem cells for the treatment of canine osteoarthritis: A pilot study.

To test whether intra-articular injection of porcine adipose-derived stem cells (ADSCs) can treat canine osteoarthritis (OA). To enroll in this study dogs must have stifle joint OA that had lasted ≥ 3 mo and been treated with OA medication without significant improvement. Three dogs fulfilled these criteria and were thus subjects for ADSCs treatment. ADSCs were isolated from abdominal adipose tissue of a 2-mo-old female Yorkshire pig. Their stem cell marker expression was examined by immunofluorescence staining. For treatment, 5 million ADSCs were injected into the diseased joint of each dog. In the next 48 h, the patient was observed for signs of inflammatory and allergic reactions. The patient was then discharged to the owner and, at 2, 6, and 12 wk, followed up with orthopedic assessment, owner questionnaire, X-ray imaging, and force-plate gait analysis. Porcine ADSCs expressed mesenchymal stem cell markers CD90 and CD105. Injection of porcine ADSCs into canine stifle joints did not cause any inflammatory or allergic reactions. Orthopedic evaluation found improvements in two dogs, particularly at the longest time point. Owners' evaluation found increased capacity and decreased pain in all three dogs' activities such as walking and running. Radiographic evaluation did not find statistically significant differences before and after treatment. Force-plate analysis found significant improvements in all three dogs after treatment. Xenotransplantation of ADSCs for the treatment of OA is feasible. Further studies are needed to validate this novel treatment modality, which can then be implemented for the routine treatment of OA in veterinary medicine.

Evaluation of varying morphological parameters on the biomechanics of a cranial cruciate ligament–deficient or intact canine stifle joint with a computer simulation model

To investigate the influence of varying morphological parameters on canine stifle joint biomechanics by use of a 3-D rigid-body canine pelvic limb computer model that simulated an intact and cranial cruciate ligament (CrCL)-deficient stifle joint across the stance phase of gait at a walk. Data from computer simulations. Computer model morphological parameters, including patellar ligament insertion location, tibial plateau angle (TPA), and femoral condyle diameter (FCD), were incrementally altered to determine their influence on outcome measures (ligament loads, relative tibial translation, and relative tibial rotation) during simulation of the stance phase of gait at a walk. Outcome measures were assessed for each scenario and compared between an intact and CrCL-deficient stifle joint with the sensitivity index (the percentage change in outcome measure divided by the percentage change in input parameter). In a CrCL-intact stifle joint, ligament loads were most sensitive to TPA. In a CrCL-deficient stifle joint, outcome measures were most sensitive to TPA with the exception of caudal cruciate ligament and lateral collateral ligament loads, which were sensitive to FCD and TPA. Relative tibial translation was sensitive to TPA and patellar ligament insertion location, whereas relative tibial rotation was most sensitive to TPA. The computer model sensitivity analyses predicted that individual parameters, particularly TPA and FCD, influence stifle joint biomechanics. Therefore, tibial and femoral morphological parameters may affect the likelihood, prevention, and management of CrCL deficiency.

Validation of stress magnetic resonance imaging of the canine stifle joint with and without an intact cranial cruciate ligament

To validate use of stress MRI for evaluation of stifle joints of dogs with an intact or deficient cranial cruciate ligament (CrCL). 10 cadaveric stifle joints from 10 dogs. A custom-made limb-holding device and a pulley system linked to a paw plate were used to apply axial compression across the stifle joint and induce cranial tibial translation with the joint in various degrees of flexion. By use of sagittal proton density-weighted MRI, CrCL-intact and deficient stifle joints were evaluated under conditions of loading stress simulating the tibial compression test or the cranial drawer test. Medial and lateral femorotibial subluxation following CrCL transection measured under a simulated tibial compression test and a cranial drawer test were compared. By use of tibial compression test MRI, the mean ± SD cranial tibial translations in the medial and lateral compartments were 9.6 ± 3.7 mm and 10 ± 4.1 mm, respectively. By use of cranial drawer test MRI, the mean ± SD cranial tibial translations in the medial and lateral compartments were 8.3 ± 3.3 mm and 9.5 ± 3.5 mm, respectively. No significant difference in femorotibial subluxation was found between stress MRI techniques. Femorotibial subluxation elicited by use of the cranial drawer test was greater in the lateral than in the medial compartment. Both stress techniques induced stifle joint subluxation following CrCL transection that was measurable by use of MRI, suggesting that both methods may be further evaluated for clinical use.

Ganglion Cysts Arising from a Canine Stifle Joint

ABSTRACTA 10-year-old, neutered male Labrador retriever presented with progressive left hind lameness. Ultrasonography revealed large, subcutaneous, ovoid cysts around the stifle joint. Radiographic and computed tomographic images revealed periosteal reaction of the distal femur. Magnetic resonance (MR) imaging showed a large cyst that was hypointense in T1-weighted images, hyperintense in T2-weighted images and had a thin lining that was enhanced by intravenous gadonium injection. The cyst communicated with the joint cavity and other small cysts around the joint. Histopathology of an excisional biopsy specimen led to diagnosis of ganglion cyst. This report provides MR images of a ganglion cyst in a canine stifle.

PREVALENCE, ASSOCIATION WITH STIFLE CONDITIONS, AND HISTOPATHOLOGIC CHARACTERISTICS OF TIBIAL TUBEROSITY RADIOLUCENCIES IN DOGS

A tibial tuberosity radiolucency is sometimes identified on lateral radiographs of canine stifle joints, however little is known about the cause or significance. The purpose of this study was to describe the prevalence, association with other stifle conditions, and histopathologic characteristics of tibial tuberosity radiolucencies in a group of dogs. Radiographs of all canine stifle joints over 5 years were evaluated. Presence or absence of a tibial tuberosity radiolucency was recorded by an observer who was unaware of clinical status. Patient signalment and presence of other stifle joint conditions were recorded from medical records. A tibial tuberosity radiolucency was found in 145/675 dogs (prevalence = 21.5%). Statistically significant associations were identified between tibial tuberosity radiolucency and stifle condition (P < 0.0001), breed size (P = 0.011), and younger age of presentation (P = 0.001), but not with gender (P = 0.513). Dogs with a tibial tuberosity radiolucency had higher odds of having a medial patellar luxation than dogs without (OR = 9.854, P < 0.0001, 95% CI 6.422-15.120). Dogs with a tibial tuberosity radiolucency had lower odds of having a cranial cruciate ligament rupture than dogs without (OR = 0.418, P < 0.0001, 95% CI 0.287-0.609). Four canine cadavers, two with normal stifles and two with tibial tuberosity radiolucencies, underwent radiographic, computed tomographic, and histologic examination of the stifles. Computed tomography revealed a hypoattenuating cortical defect in the lateral aspect of the proximal tibial tuberosity that corresponded histopathologically to a hyaline cartilage core. Findings indicated that the tibial tuberosity radiolucency may be due to a retained cartilage core and associated with medial patellar luxation in dogs.

The Effectiveness of 3D Animations to Enhance Understanding of Cranial Cruciate Ligament Rupture

Cranial cruciate ligament (CCL) rupture is one of the most important orthopedic diseases taught to veterinary undergraduates. The complexity of the anatomy of the canine stifle joint combined with the plethora of different surgical interventions available for the treatment of the disease means that undergraduate veterinary students often have a poor understanding of the pathophysiology and treatment of CCL rupture. We designed, developed, and tested a three dimensional (3D) animation to illustrate the pertinent clinical anatomy of the stifle joint, the effects of CCL rupture, and the mechanisms by which different surgical techniques can stabilize the joint with CCL rupture. When compared with a non-animated 3D presentation, students' short-term retention of functional anatomy improved although they could not impart a better explanation of how different surgical techniques worked. More students found the animation useful than those who viewed a comparable non-animated 3D presentation. Multiple peer-review testing is required to maximize the usefulness of 3D animations during development. Free and open access to such tools should improve student learning and client understanding through wide-spread uptake and use.

The Use and Interpretation of Tibial Plateau Leveling Osteotomy (TPLO) in Dogs in Cranial Cruciate Ligament Lesions

In this study, 7 dogs of various breed, age and sex, which were referred to the Clinics of Orthopaedics and Traumatology in Ankara University, Faculty of Veterinary Medicine, were used as study materials. Clinical radiological and arthroscopical examinations revealed 7 dogs were having unilateral CCL lesions. Tibial plato levelling Osteotomy operation was performed to stabilize the stifle joints. Operation results were evaluated clinically and radiological. According to the postoperative clinical and radiological examination. The TPLO technique with TPLO plate include locking screw mechanism was preferable for the treatment of cranial cruciate ligament ruptures of large breed dogs. Introduction The canine stifle joint is a hinge joint with two interdependent compartments; the femoropatellar joint and the femoro-tibial joint. The major motion of this joint is flexion and extention in a para-sagittal plane. However, internal rotation of the tibia and a small degree of cranial tibial translation also occurs normally. These later two motions are closely constrained by the two ligaments. In dogs rupture of the CLL seems to occur in most cases due to prior degeneration of the

Mechanical testing of orthopaedic suture material and a crimp clamp system for the extracapsular stabilisation of canine cruciate-deficient stifles

The cranial cruciate ligament (CCL) provides cranio-caudal stability, prevents hyperextension and constrains medial rotation of the tibia in the canine stifle joint and CCL rupture is the leading cause of hind leg lameness in dogs. Treatment of CCL rupture aims to resolve lameness caused by joint instability and provide good long-term function of the affected hind limb. The extracapsular technique is one of the most popular methods to restore joint stability. The technique involves a suture loop that is placed around the lateral fabella and through the tibial tuberosity. The ideal suture material should be strong, aseptic, easily handled, inexpensive, and provide excellent knot security and knot compactness. A critical property of the loop is the application of either a knot or crimp to maintain the tension on the loop. There is a variety of orthopaedic suture materials used for the extracapsular technique. Our aim was to compare the mechanical properties of four commercially available materials in pure tension. The materials tested were monofilament nylon leader (MNL) 100 lb, MNL 80 lb, Supramid and Silon. Our second objective was to compare the interoperator variability of applying either a knot or a crimp to secure the suture loop. Ultimate tensile strength was greatest with MNL 100 lb (373 N) followed by MNL 80 lb (285 N), Supramid (160 N) and Silon (103 N). Based on our results, we conclude that MNL 100 lb and MNL 80&amp;nbsp;lb are mechanically superior to Silon and Supramid. Our study also shows significant effects for the operator and method of loop fixation (P &amp;lt; 0.0001). Intraoperator differences were also found to be significant, for operator 1 (P &amp;lt; 0.0001), for operator 2 (P &amp;lt; 0.001) and operator 3 (P &amp;lt; 0.01). Our findings indicate that MNL is most suitable orthopaedic material and that loop fixation should remain the method of choice for surgeons treating CCL.

Effects of sterilization with hydrogen peroxide gas plasma, ethylene oxide, and steam on bioadhesive properties of nylon and polyethylene lines used for stabilization of canine stifle joints

To compare effects of sterilization with hydrogen peroxide gas plasma (HPGP), ethylene oxide, and steam on bioadhesive properties of nylon and polyethylene lines used for stabilization of canine stifle joints. Samples of a 36.3-kg test nylon leader line, 57.8-kg test nylon fishing line, and 2-mm ultrahigh-molecular weight polyethylene (UHMWPE) were used. In this in vitro study, samples of nylon leader line, fishing line, and UHMWPE sterilized by use of HPGP, ethylene oxide, and steam or unsterilized samples were used. Bacterial adherence on unsterilized and sterilized samples was tested with Staphylococcus epidermidis and Escherichia coli. Five samples were examined for each line type and sterilization condition, and final colony counts were obtained. Bacterial adherence was significantly affected by method of sterilization for all 3 line types. For most of the samples, bacterial adherence was similar or lower when HPGP sterilization was used, compared with results for sterilization via ethylene oxide and steam, respectively. Bacterial adherence was significantly higher for UHMWPE, compared with adherence for the nylon line, regardless of the sterilization method used. Bacterial adherence was higher for nylon fishing line than for nylon leader line for S epidermidis after ethylene oxide sterilization and for E coli after HPGP and ethylene oxide sterilization. Effects of HPGP sterilization on bioadhesive properties of nylon and polyethylene lines compared favorably with those for ethylene oxide and steam sterilization. Also, nylon line may be a more suitable material than UHMWPE for suture prostheses on the basis of bacterial adherence properties.

Development and validation of a multi-body model of the canine stifle joint

Multi-body musculoskeletal models that can be used concurrently to predict joint contact pressures and muscle forces would be extremely valuable in studying the mechanics of joint injury. The purpose of this study was to develop an anatomically correct canine stifle joint model and validate it against experimental data. A cadaver pelvic limb from one adult dog was used in this study. The femoral head was subjected to axial motion in a mechanical tester. Kinematic and force data were used to validate the computational model. The maximum RMS error between the predicted and measured kinematics during the complete testing cycle was 11.9 mm translational motion between the tibia and the femur and 4.3° rotation between patella and femur. This model is the first step in the development of a musculoskeletal model of the hind limb with anatomically correct joints to study cartilage loading under dynamic conditions.

In vitro evaluation of the relationship between the semitendinosus muscle and cranial cruciate ligament in canine cadavers

To evaluate the role of the semitendinosus muscle in stabilization of the canine stifle joint. Left stifle joints collected from cadavers of 8 healthy Beagles. Left hind limbs, including the pelvis, were collected. To mimic the tensile force of the quadriceps, gastrocnemius, and semitendinosus muscles, wires were placed under strain between the ends of each muscle. A sensor was used to measure the tensile force in each wire. Specimens were tested in the following sequence: cranial cruciate ligament (CrCL) intact, CrCL transected, released (tensile force of semitendinosus muscle was released in the CrCL-transected stifle joint), and readjusted (tensile force of semitendinosus muscle was reapplied in the CrCL-transected stifle joint). Specimens were loaded at 65.3% of body weight, and tensile force in the wires as well as the cranial tibial displacement were measured. Tensile force for the CrCL-transected condition increased significantly, compared with that for the CrCL-intact condition. Mean ± SD cranial tibial displacement for the CrCL-transected condition was 2.1 ± 1.3 mm, which increased to 7.2 ± 2.3 mm after release of the tensile force in the semitendinosus muscle. Results supported the contention that the semitendinosus muscle is an agonist of the CrCL in the stifle joint of dogs. Moreover, the quadriceps and gastrocnemius muscles may be antagonists of the CrCL. These findings suggested that the risk of CrCL rupture may be increased by diseases (such as cauda equina syndrome) associated with a decrease in activity of the semitendinosus muscle.

Clinical changes in sodium monoiodoacetate–induced stifle osteoarthritis model in dogs

In six dogs, experimental model of osteoarthritis (OA) was reproduced by intraarticular injection of sodium monoiodoacetate (MIA) in left stifle joints. Contralateral joints served as control. The clinical status and some goniometric parameters were monitored before MIA introduction and at post injection days 30, 60 and 105. The results showed convincingly that the used experimental chemical OA model reproduced successfully the disease in canine stifle joints. The studied clinical indices correlated with the severity of disease. ey words: dogs, stifle joint, sodium monoiodoacetate, osteoarthritis

Radiographic landmarks for measurement of cranial tibial subluxation in the canine cruciate ligament deficient stifle

The primary objective was to develop a repeatable radiographic technique for assessment of cranial tibial subluxation (CTS) and test the intra-observer and inter-observer repeatability of the chosen landmarks. A secondary objective was to determine the effects of digital radiographic magnification on CTS measurement repeatability. Twenty-three normal canine pelvic limbs were used to determine the magnitude of CTS before and after transection of the cranial cruciate ligament. Mediolateral radiographs were taken with and without fiduciary markers in place. Three investigators measured the CTS using radiographically visible anatomic landmarks at two different magnifications. The total observed variabilities were assessed by inter-observer and intra-observer differences. Paired t-tests were used to determine the effect of magnification and marker presence on CTS measures. Measurement of the CTS from the caudal margin of the intercondylar fossa on the femur to the intercondylar eminence was the most repeatable. Poor correlation between the anatomic landmarks and the fiduciary bone markers was observed. We found no effect of magnification or presence or absence of bone markers on measurement of CTS. Cranial tibial subluxation can be detected with the most repeatability by measuring between the caudal margin of the intercondylar fossa and the intercondylar eminence. Magnification of the digitized radiographic image had minimal effect on repeatability. This technique can be used for in vivo analysis of the canine cruciate ligament deficient stifle joint.

Early kinematic outcome after treatment of cranial cruciate ligament rupture by tibial plateau levelling osteotomy in the dog

To establish the effect of tibial plateau levelling osteotomy (TPLO) on two selected pelvic limb kinematic variables in dogs treated for clinical cranial cruciate ligament rupture (CCLR). Thirteen dogs that had incurred CCLR and were treated by TPLO walked on a treadmill whilst kinematic data on pelvic limb paw motion were acquired using motion capture equipment. Data were subject to secondary processing using matrix analysis software and statistical analysis. Pelvic limb stance duration significantly increased during the 12 week study period, recovering to near-normal values. Range of pelvic limb paw velocity also significantly increased but did not reach normal values by 12 weeks postoperatively. The improvement in stance duration to near normality may aid in explaining the widely-held subjective impression that TPLO frequently provides an excellent outcome in the early stages after repair of the cruciate deficient canine stifle joint. Both stance length and range of paw velocity provide useful objective measures to compare outcome following surgery for CCLR.

Anatomic Study of the Canine Stifle Using Low‐Field Magnetic Resonance Imaging (MRI) and MRI Arthrography

To investigate the use of low-field magnetic resonance imaging (MRI) and MR arthrography in normal canine stifles and to compare MRI images to gross dissection. Descriptive study. Adult canine pelvic limbs (n=17). Stifle joints from 12 dogs were examined by orthopedic and radiographic examination, synovial fluid analysis, and MRI performed using a 0.2 T system. Limbs 1 to 7 were used to develop the MR and MR arthrography imaging protocol. Limbs 8-17 were studied with the developed MR and MR arthrography protocol and by gross dissection. Three sequences were obtained: T1-weighted spin echo (SE) in sagittal, dorsal, and transverse plane; T2-weighted SE in sagittal plane and T1-gradient echo in sagittal plane. Specific bony and soft tissue structures were easily identifiable with the exception of articular cartilage. The cranial and caudal cruciate ligaments were identified. Medial and lateral menisci were seen as wedge-shaped hypointense areas. MR arthrography permitted further delineation of specific structures. MR images corresponded with gross dissection morphology. With the exception of poor delineation of articular cartilage, a low-field MRI and MR arthrography protocol provides images of adequate quality to assess the normal canine stifle joint.

Mapping Subchondral Bone Density of Selected Donor and Recipient Sites for Autologous Osteochondral Transplantation in the Canine Stifle Joint Using Computed Tomographic Osteoabsorptiometry

To characterize donor and recipient sites for autologous osteochondral transplantation (AOT) in the canine stifle joint with respect to maximal subchondral bone density (mSBD). Descriptive laboratory study. Femora (n=15) of dogs (>20 kg). mSBD at selected donor sites within and outside the femoropatellar joint and at potential recipient sites for both femoral condyles was assessed using nonvolumetric computed tomographic osteoabsorptiometry and normalized to values obtained at the central weight-bearing aspect of the lateral femoral condyle. Only transplants harvested at the axial aspects of the lateral and medial trochlear ridge had a normalized mSBD comparable with the lateral and medial femoral condyle. Grafts from outside the femoropatellar joint, at the most proximal aspect of the medial femoral condyle and at the most distal aspect of the trochlea (the notch area) had mSBD values 13.8-24.4% less than at the femoral condyles. Choosing between donor sites within or outside the femoropatellar joint may significantly affect subchondral bone quality of harvested transplants. Donor sites abaxial to the femoropatellar joint and at the most proximal aspect of the medial femoral condyle may provide transplants of suboptimal bone morphology, challenging their use as primary donor sites for AOT in dogs. However, this statement is based on nonvolumetric assessment of bone density, necessitating verification using volumetric density analysis to finally infer the biomechanical value of different grafts.

The Canine Stifle Joint

The Canine Stifle Joint

Computer Simulation of the Distal Aspect of the Femur for Assessment of Donor Core Size and Surface Curvature for Autologous Osteochondral Transplantation in the Canine Stifle Joint

To report topographic matching of selected donor sites and donor core sizes for congruous reconstruction of the weight-bearing aspect of the femoral condyles in dogs for autologous osteochondral transplantation (AOT) using computer simulation. Computer simulation. Computed tomographic scans of the distal aspect of 1 femur from each of 6 mature dogs (>20 kg). Three-dimensional surface models of the distal femora were constructed for virtual AOT. Different donor sites (n=15) within and outside the femoropatellar joint and 5 transplant sizes (diameters 3.5, 4.5, 6.0, 8.0, and 10.0 mm) were analyzed with respect to their topographic match with the articular surface of both femoral condyles. Transplants from the proximal abaxial aspect of the medial condyle and from the abaxial aspects of the medial and lateral trochlear ridges were the best topographic match. Mismatch increased linearly with increasing core diameter. Small core diameters (3.5 mm, 4.5 mm) from within the femoropatellar joint allowed restoration of surface contour at both femoral condyles similar to large core diameters (6 mm, 8 mm) from outside the femoropatellar joint. Based on this computer simulation, large core diameters should only be harvested from convex donor sites outside the femoropatellar joint, whereas transplants from the concave, axial aspects of the trochlear ridges may result in similar topographic match provided they are of small diameter. The abaxial aspect of the medial trochlear ridge and the proximal aspect of the medial femoral condyle appear to be the preferred AOT donor sites.

Diagnostic Imaging of the Canine Stifle: A Review

The stifle joint, a common location for lameness in dogs, is a complex arrangement of osseous, articular, fibrocartilaginous, and ligamentous structures. The small size of its component structures, restricted joint space, and its intricate composition make successful diagnostic imaging a challenge. Different tissue types and their superimposition limit successful diagnostic imaging with a single modality. Most modalities exploit the complexity of tissue types found in the canine stifle joint. Improved understanding of the principles of each imaging modality and the properties of the tissues being examined will enhance successful diagnostic imaging.