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三种稳定犬颅十字韧带损伤 stifles 的手术技术的体外比较。

Ex vivo comparison of three surgical techniques to stabilize canine cranial cruciate ligament deficient stifles.

作者信息

Snow Lynne A, White Rick, Gustafson Scott, Xie Lin, Hosgood Giselle, Monroe W Todd, Casey John P, Lopez Mandi J

机构信息

Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.

出版信息

Vet Surg. 2010 Feb;39(2):195-207. doi: 10.1111/j.1532-950X.2009.00635.x.

Abstract

OBJECTIVE

To quantify and compare canine stifle stability after 3 stabilization techniques.

STUDY DESIGN

Randomized controlled study.

SAMPLE POPULATION

Adult canine cadaveric pelvic limbs.

METHODS

Total craniocaudal (CrCa) tibial translation quantified in stifles with the cranial cruciate ligament (CrCL) intact, transected, and stabilized with 1 of 3 techniques: (1) hamstring graft (HG); (2) modified retinacular imbrication (MRIT); (3) anatometric fascia lata translocation (AFLT). Tibial translation was quantified from radiographs generated during application of cranial and caudal forces to the tibia. After removal of all soft tissues except periarticular ligaments and fixation, CrCa tibial translation, as before, and medial-lateral rotation, via torsional loading, was quantified with an active motion analysis system. Total tibial translation was evaluated for effect of technique and cruciate status using mixed effect linear model with significance considered at P-value <.05.

RESULTS

CrCa translation was not significantly different across stabilization techniques with CrCLs intact, transected, or after stabilization. Poststabilization translation was significantly less than posttransection for all techniques. Compared with the intact CrCL, CrCa translation poststabilization after HG was significantly greater whereas poststabilization after MRIT and AFLT was not significantly different. Tibial rotation exceeded instrumentation limits in 62.5% HG limbs, 20% MRIT limbs, and 60% AFLT limbs.

CONCLUSIONS

All 3 stifle stabilization techniques confer comparable CrCa translational stability after CrCL disruption with that provided by the MRIT and AFLT techniques comparable to the intact CrCL.

CLINICAL RELEVANCE

The extra- and intracapsular techniques evaluated in this study reduced CrCa tibial translation in CrCL deficient stifles to varying amounts.

摘要

目的

量化并比较三种稳定技术后的犬膝关节稳定性。

研究设计

随机对照研究。

样本群体

成年犬尸体骨盆肢体。

方法

在完整、横断及采用三种技术之一进行稳定处理的膝关节中,对胫骨干骺端前后向(CrCa)平移进行量化:(1)绳肌移植(HG);(2)改良支持带重叠缝合(MRIT);(3)解剖学阔筋膜张肌移位(AFLT)。通过在胫骨施加前后向力时产生的X线片对胫骨平移进行量化。在去除除关节周围韧带和固定装置外的所有软组织后,如前所述对胫骨干骺端前后向平移以及通过扭转负荷进行的内外侧旋转,使用主动运动分析系统进行量化。使用混合效应线性模型评估技术和交叉韧带状态对总胫骨平移的影响,P值<.05时认为具有显著性。

结果

在完整、横断或稳定处理后的交叉韧带中,不同稳定技术之间的胫骨干骺端前后向平移无显著差异。所有技术在稳定处理后的平移均显著小于横断后。与完整交叉韧带相比,HG稳定处理后的胫骨干骺端前后向平移显著更大,而MRIT和AFLT稳定处理后的平移无显著差异。在62.5%的HG肢体、20%的MRIT肢体和60%的AFLT肢体中,胫骨旋转超过了器械限制。

结论

所有三种膝关节稳定技术在交叉韧带断裂后提供的胫骨干骺端前后向平移稳定性相当,MRIT和AFLT技术与完整交叉韧带相当。

临床意义

本研究评估的关节内外技术在不同程度上减少了交叉韧带缺失膝关节中的胫骨干骺端前后向平移。

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