Cranial Cruciate Ligament Transection Research Articles

The effect of intercondylar notchplasty on the normal canine stifle.

This study evaluated the effect of notchplasty (enlargement of the intercondylar fossa) in stable and unstable canine stifles. Bilateral notchplasty and unilateral cranial cruciate ligament (CrCL) transection were performed in 6 dogs. Exercise, consisting of walking 1.5 miles three times a week, began 1 month after surgery and continued until euthanasia 6 months after surgery. Evaluation methods included orthopedic examination, serial radiographs, thin section radiography, histopathology, and gross pathology. Notchplasty in the stable stifle did not cause lameness beyond 3 weeks, joint instability, or degenerative joint disease. In the stable stifle, smooth resurfacing of the notchplasty site with fibrous and osseous tissue occurred. Stifles with notchplasty and CrCL transection exhibited persistent lameness, instability, and degenerative joint disease. In CrCL deficient stifles osteophytes formed within the notchplasty site, resulting in a rough surface. Our observations indicated significant refilling in notchplasties of both stable and unstable stifles (P < .05). However, the intercondylar fossa (ICF) width 6 months after notchplasty was significantly smaller in unstable stifles compared with stable stifles (P < .05) indicating that greater refilling of the notchplasties occurred in the unstable stifles. In clinical cases, notchplasty should be larger than the desired final result to accomodate the partial refilling that occurs even in stable stifles.

Comparison of Stifle Biomechanics after Two Different Techniques of Cranial Cruciate Ligament Repair

SummaryStifle joint biomechanics were evaluated by analysis of instant centre of motion, after cranial cruciate ligament transection and after stifle joint stabilization, using either the fibular head transposition or the under-and-over fascial strip technique. The instant centres of motion and resulting velocity vectors were determined by radiographic evaluation of the stifle of twelve fresh cadavers before and after cranial cruciate ligament transection, and after stabilization of the stifle joint by either the fibular head transposition or the under-and-over fascial strip technique. All 12 stifles had normal instant centres of motion before transection of the cranial cruciate ligament, and 10 of 12 were normal after transection. All six stifles repaired by fibular head transposition retained normal instant centre of motion. Abnormal instant centres of motion were present in three of six stifles repaired by the under-and-over technique. These differences were not statistically significant.Stifle joint biomechanics were evaluated by analysis of instant centre of motion after cranial cruciate ligament transection and after stifle joint stabilization using either the fibular head transposition or the underand-over fascial strip technique. Neither surgical technique consistently resulted in abnormal instant centres of motion.

An in vitro Comparison of Two Replacement Techniques Utilizing Fascia Lata after Cranial Cruciate Ligament Transection in the Dog

SummaryThe immediate postoperative biomechanical properties of an “underand-over” cranial cruciate ligament (CCL) replacement technique consisting of fascia lata and the lateral onethird of the patellar ligament, were compared with that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The right CCL in twelve adult dogs was dissected out and replaced with an autograft. The contralateral, intact CCL served as the control. In group A, the graft was secured to the lateral femoral condyle with a spiked washer and screw. In group B the intracapsular graft was secured to the lateral femoro-fabellar ligament, and the remainder to the patellar tendon. Both CCL replacement techniques exhibited a 2.0 ± 0.5 mm anterior drawer immediately after the operation. After skeletonization of the stifles, the length and cross-sectional area of the intact CCL and CCL substitutes were determined. Each bone-ligament unit was tested in linear tension to failure at a fixed distraction rate of 15 mm/s with the stifle in 120° flexion. Data was processed to obtain the corresponding material parameters (modulus, stress and strain in the linear loading region, and energy absorption to maximum load).The immediate postoperative structural and material properties of the “under-and-over” cranial cruciate ligament replacement technique with autogenous fascia lata, were compared to that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The combined UOT T technique was slightly stronger (6%), but allowed 2.8 ± 0.9 mm more cranial tibial displacement at maximum linear force.

Effect of Suture Type on Stifle Joint Biomechanics After Extra-Articular Repair of Cranial Cruciate Ligament Transection in the Dog

SummaryThe effect of two suture types, monofilament polybutester and braided polyester, on stifle joint biomechanics after extra-articular repair of cranial cruciate ligament rupture was evaluated by analysis of the instant centre of motion. The instant centres of motion and resulting velocity vectors were determined radiographically on both stifles of eight fresh canine cadavers before and after cranial cruciate ligament transection. After ligament transection, all 16 stifles were repaired with an extra-articular technique utilizing a double strand of suture placed between the lateral fabella and the tibial tuberosity. One stifle on each cadaver was repaired with each suture type. The instant centres of motion and resulting velocity vectors were re-evaluated post repair. All stifles had normal instant centres of motion prior to transection of the cranial cruciate ligament. Neither ligament transection nor extra-articular repair with either suture type resulted in an abnormal change in the instant centre of motion.