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胫骨平台平整截骨术中旋转中心对股四头肌拉力的影响:犬尸体的体外研究

Effect of the Centre of Rotation in Tibial Plateau Levelling Osteotomy on Quadriceps Tensile Force: An Ex Vivo Study in Canine Cadavers.

作者信息

Kanno Nobuo, Ochi Yoshiyuki, Ichinohe Tom, Hakozaki Takaharu, Suzuki Shuji, Harada Yasuji, Yogo Takuya, Hara Yasushi

机构信息

Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Tokyo, Japan.

出版信息

Vet Comp Orthop Traumatol. 2019 Mar;32(2):117-125. doi: 10.1055/s-0039-1677868. Epub 2019 Mar 7.

Abstract

OBJECTIVE

The aim of this study was to determine the effect of the centre of rotation in tibial plateau levelling osteotomy (TPLO) on the tensile force of the quadriceps.

MATERIALS AND METHODS

Tibial plateau levelling osteotomy was performed on the left pelvic limbs from 20 normal adult Beagle cadavers. To replicate the tensile force of the quadriceps, gastrocnemius and stifle flexor muscles, these muscles were replaced with wires. The tensile force of each wire, cranial tibial displacement and internal tibial rotation were measured under the following conditions: intact cranial cruciate ligament, transected cranial cruciate ligament, ideally centred osteotomy TPLO (ICO group) and distally centred osteotomy TPLO (DCO group). The ratios of the tensile forces for the wires divided by the vertical force were used for analyses.

RESULTS

The mean intact and post-TPLO tibial plateau angles (TPA) in the ICO group were 30.3° ± 1.9° and 6.1° ± 1.6°, respectively, and those in the DCO group were 29.8° ± 2.4° and 6.8° ± 0.9°, respectively. The mean quadriceps tensile force after TPLO was significantly greater in the DCO group (3.9 ± 0.3) than the ICO group (3.3 ± 0.4) ( = 0.006). Both groups exhibited tibial caudal displacement after TPLO.

CLINICAL RELEVANCE

The tensile force of the quadriceps muscles changed in accordance with the centre of the osteotomy in TPLO. The DCO group had increased tensile force, which may cause patellar ligament thickening after TPLO. Setting the postoperative TPA at 6° may cause excessive rotation in patients with a normal tensile force of the stifle flexor muscles.

摘要

目的

本研究旨在确定胫骨平台水平截骨术(TPLO)中旋转中心对股四头肌张力的影响。

材料与方法

对20只正常成年比格犬尸体的左后肢进行胫骨平台水平截骨术。为模拟股四头肌、腓肠肌和膝关节屈肌的张力,用金属丝替代这些肌肉。在以下条件下测量每根金属丝的张力、胫骨近端位移和胫骨内旋:完整的前交叉韧带、切断的前交叉韧带、理想中心截骨的TPLO(ICO组)和远端中心截骨的TPLO(DCO组)。将金属丝的张力与垂直力的比值用于分析。

结果

ICO组TPLO前后胫骨平台角(TPA)的平均值分别为30.3°±1.9°和6.1°±1.6°,DCO组分别为29.8°±2.4°和6.8°±0.9°。TPLO后DCO组股四头肌平均张力(3.9±0.3)显著高于ICO组(3.3±0.4)(P = 0.006)。两组TPLO后均出现胫骨向尾侧移位。

临床意义

TPLO中股四头肌的张力随截骨中心的变化而改变。DCO组张力增加,可能导致TPLO后髌韧带增厚。对于膝关节屈肌张力正常的患者,将术后TPA设定为6°可能会导致过度旋转。

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