Rey J, Fischer M S, Böttcher P
Prof. Dr. Peter Böttcher, Klinik für Kleintiere, der Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany, Email:
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2014;42(3):151-6.
This in vivo study qualitatively describes the sagittal motion pattern of the cranial cruciate ligament (CrCL) insufficient canine stifle in operated and unoperated joints with cranio-caudal laxity on palpation.
Sagittal stifle kinematics were recorded in vivo in dogs (> 15 kg BW) with unilateral (n = 7) or bilateral (n = 6) complete CrCL rupture and positive cranial drawer test as well as two sound control dogs using uniplanar fluoroscopic kinematography with the dogs walking on a treadmill. Stifle stability and sagittal motion pattern of the femur and the tibia were determined by visual inspection of the fluoroscopic video sequences.
Control dogs showed no cranio-caudal instability, identical to the contralateral stifles of the dogs with unilateral rupture. All unoperated stifles with CrCL rupture (n = 6) showed caudal slippage of the femur at the beginning of the stance phase. Of the 13 operated stifles (TightRope: n = 1, tibial tuberosity advancement, TTA: n = 6, tibial plateau leveling osteotomy, TPLO: n = 5, cranial closing wedge osteotomy, CCWO: n = 1) nine were unstable, showing the same motion pattern as the unoperated stifles.
In the CrCL insufficient stifle with in vivo cranio-caudal instability caudal slippage of the distal femur at tow touch is the predominant motion pattern.
The discrepancy between in vivo motion pattern and in vitro simulation of CrCL insufficiency in which cranial tibial subluxation is the predominant sagittal motion pattern warrants further studies.
本体内研究定性描述了颅交叉韧带(CrCL)功能不全的犬膝关节在触诊时手术侧和未手术侧关节颅尾侧松弛情况下的矢状面运动模式。
采用单平面荧光透视运动学方法,在跑步机上行走的犬(体重>15 kg)中记录矢状面膝关节运动学情况,这些犬单侧(n = 7)或双侧(n = 6)存在完全性CrCL断裂且颅侧抽屉试验阳性,以及两只健康对照犬。通过荧光透视视频序列的视觉检查确定股骨和胫骨的膝关节稳定性及矢状面运动模式。
对照犬未表现出颅尾侧不稳定,与单侧断裂犬的对侧膝关节相同。所有CrCL断裂的未手术膝关节(n = 6)在站立期开始时均出现股骨尾侧移位。在13个手术膝关节中(TightRope:n = 1,胫骨结节前移术,TTA:n = 6,胫骨平台平整截骨术,TPLO:n = 5,颅侧闭合楔形截骨术,CCWO:n = 1),9个不稳定,表现出与未手术膝关节相同的运动模式。
在体内存在颅尾侧不稳定的CrCL功能不全的膝关节中,双触诊时股骨远端尾侧移位是主要的运动模式。
体内运动模式与体外模拟CrCL功能不全时以胫骨颅侧半脱位为主要矢状面运动模式之间的差异值得进一步研究。