Department for Companion Animals and Horses, University Clinic for Small Animals, Small Animal Surgery, University of Veterinary Medicine, Vienna, Austria.
VetCORE - Facility for Research, University of Veterinary Medicine, Vienna, Austria.
J Feline Med Surg. 2020 Oct;22(10):1016-1024. doi: 10.1177/1098612X20913353. Epub 2020 Jun 1.
The aim of our study was to compare the standard fabellotibial suture with Mini TightRope fixation for the treatment of a cranial cruciate ligament (CCL) rupture using a feline custom-made limb press.
Cadaveric hindlimbs of 10 cats were inserted in the limb press at predefined joint angles and loads of 10% and 30% body weight (BW) were applied. Mediolateral radiographs were taken and three-dimensional coordinates were recorded using a microscribe digitiser, with intact and transected CCLs and after either fabellotibial suture or Mini TightRope fixation were performed. Different distances and angles from radiographs or microscribe coordinates were analysed.
Radiographic distances from the femoral condyle to the cranial edge of the tibia (X1-X2) were higher in CCL-deficient stifles than in intact stifles at 10% and 30% BW loads. All fabellotibial sutures and Mini TightRope fixations neutralised excessive cranial tibial thrust. A significant difference in the distance between the patella and tibial tuberosity (D2) was observed between CCL-deficient limbs and Mini TightRope-fixed limbs at 10% BW load ( <0.04). A significant difference in the distance between the tibial tuberosity and lateral collateral ligament of the femur (D3) was observed between the intact and transected CCLs on the left legs at 10% BW load ( <0.003) and on both legs at 30% BW load ( <0.002). Furthermore, we observed significant differences between CCL-deficient left legs and Mini TightRope-treated legs at 10% BW load ( <0.003). With regard to fabellotibial suture-treated legs, we observed significant differences between transected limbs and fixed limbs at 30% BW load ( <0.004). W1 (craniocaudal angle) and W2 (mediolateral angle) showed significant differences between intact and transected CCLs and between transected and fixed limbs at 30% BW load ( <0.004).
Fixation of CCL-deficient stifles with lateral fabellotibial suture, as well as Mini TightRope tightened with a 20 N load, produces good biomechanical stability, as detected via radiographic assessment.
本研究旨在比较使用定制的猫肢压迫器，对前十字韧带（CCL）断裂进行标准的腓肠豆-胫侧副韧带缝合与 Mini TightRope 固定的治疗效果。
10 只猫的后肢标本在肢压器中以预定的关节角度插入，并施加 10%和 30%体重（BW）的负荷。在存在和不存在 CCL 以及进行腓肠豆-胫侧副韧带缝合或 Mini TightRope 固定后，拍摄侧位 X 线片，并使用 Microscribe 数字化仪记录三维坐标。分析 X 线片或 Microscribe 坐标的不同距离和角度。
在 10%和 30% BW 负荷下，与正常膝关节相比，CCL 缺失的膝关节的股骨髁至胫骨嵴（X1-X2）的放射学距离更高。所有腓肠豆-胫侧副韧带缝合和 Mini TightRope 固定均能消除过度的胫骨前推力。在 10% BW 负荷下，与 CCL 缺失的肢体相比，Mini TightRope 固定的肢体的髌腱和胫骨粗隆（D2）之间的距离存在显著差异（<0.04）。在 10% BW 负荷下，左侧正常 CCL 和切断 CCL 的膝关节之间的胫骨粗隆和外侧副韧带（D3）之间的距离存在显著差异（<0.003），在 30% BW 负荷下，双侧膝关节之间的距离存在显著差异（<0.002）。此外，在 10% BW 负荷下，与 CCL 缺失的左侧肢体相比，我们观察到 Mini TightRope 治疗的肢体之间存在显著差异（<0.003）。对于腓肠豆-胫侧副韧带缝合治疗的肢体，在 30% BW 负荷下，与切断的肢体相比，固定的肢体之间存在显著差异（<0.004）。在 30% BW 负荷下，W1（颅尾角）和 W2（内外侧角）在正常和切断的 CCL 之间以及切断和固定的肢体之间存在显著差异（<0.004）。
使用外侧腓肠豆-胫侧副韧带缝合和 Mini TightRope 固定（在 20N 负荷下收紧）固定 CCL 缺失的膝关节，通过放射学评估可以产生良好的生物力学稳定性。
