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使用定制的肢体按压模型评估治疗猫颅交叉韧带断裂的关节内和关节外技术。

Use of a custom-made limb-press model to assess intra- and extracapsular techniques for treating cranial cruciate ligament rupture in cats.

作者信息

Kneifel Wolfgang, Borak Danilo, Bockstahler Barbara, Schnabl-Feichter Eva

机构信息

Department for Companion Animals and Horses, University Clinic for Small Animals, Small Animal Surgery, University of Veterinary Medicine, Vienna, Austria.

出版信息

J Feline Med Surg. 2018 Apr;20(4):271-279. doi: 10.1177/1098612X17704562. Epub 2017 Apr 24.

Abstract

Objectives This study aimed to compare the under-and-over technique, a type of intracapsular treatment, and the standard fabella-tibial suture, a method for extracapsular treatment, in achieving immediate, postoperative stifle stability after cranial cruciate ligament (CrCL) rupture by using a feline, custom-made limb-press model. Methods Cadaveric feline hindlimb specimens (n = 14) were positioned in the limb press at predefined joint angles (stifle joint: 120°; hock joint: 120°), and vertical loads of 5%, 10%, 20% and 30% body weight were applied statically. Mediolateral radiographic views were obtained of the stifles under each load before and after CrCL transection, as well as after treatment with either of the two surgical techniques, and differences in distance between two predefined radiographic points for each radiograph were analysed. Results The general linear model showed a significant effect of load ( P <0.01) and technique ( P = 0.004) and a significant interaction between load and technique ( P = 0.006) regarding craniocaudal stifle stability. Distances between predefined tibial and femoral reference points were consistently higher in transected CrCLs than in intact stifles. All standard fabella-tibial suture-treated stifles (n = 7) were stable at all loads tested. Of the seven under-and-over technique-treated stifles, one was unstable at 20% body weight load and three at 30% body weight load. Conclusions and relevance Our model, which appropriately reproduced certain aspects of domestic shorthair cat stifle mechanics, indicated that a 40 lb monofilament nylon prosthesis, tightened at 20 N, produces more favourable biomechanical stabilisation of craniocaudal cruciate-related stifle instability than a 0.5 cm wide strip of fascia lata applied intracapsularly.

摘要

目的 本研究旨在通过使用猫定制肢体按压模型,比较囊内治疗类型的上下技术和囊外治疗方法的标准腓肠豆 - 胫骨缝线,在颅交叉韧带(CrCL)断裂后实现即时术后 stifle 稳定性的效果。方法 将尸体猫后肢标本(n = 14)置于肢体按压装置中,使其处于预定关节角度( stifle 关节:120°;跗关节:120°),并静态施加5%、10%、20%和30%体重的垂直负荷。在 CrCL 横断前后以及两种手术技术之一治疗后,获取每个负荷下 stifle 的内外侧 X 光片,并分析每张 X 光片上两个预定 X 光片点之间距离的差异。结果 一般线性模型显示,关于 stifle 颅尾稳定性,负荷(P <0.01)和技术(P = 0.004)有显著影响,且负荷与技术之间存在显著交互作用(P = 0.006)。横断 CrCL 后的预定胫骨和股骨参考点之间的距离始终高于完整 stifle。所有标准腓肠豆 - 胫骨缝线治疗的 stifle(n = 7)在所有测试负荷下均稳定。在七例上下技术治疗的 stifle 中,一例在20%体重负荷下不稳定,三例在30%体重负荷下不稳定。结论与相关性 我们的模型适当再现了家猫 stifle 力学的某些方面,表明在20 N 下收紧的40磅单丝尼龙假体比囊内应用的0.5厘米宽的阔筋膜条在生物力学上更有利于稳定与颅尾交叉相关的 stifle 不稳定。

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