J Am Vet Med Assoc. 2021 Mar 1;258(5):493-501. doi: 10.2460/javma.258.5.493.
To quantify 3-D femorotibial joint kinematics during ambulation in dogs with cranial cruciate ligament (CCL) rupture treated with lateral fabellotibial suture stabilization (LFTS).
9 adult dogs (body weight, 15 to 35 kg [33 to 77 lb]) with unilateral complete CCL rupture.
Digital 3-D bone models of the femur and fabellae and tibia and fibula were created from CT scans. Lateral fluoroscopic images of stifle joints were collected during treadmill walking before surgery and 6 months after LFTS. The LFTS was performed with nylon leader material secured with knots. Gait cycles were analyzed with a 3-D to 2-D image registration process. Femorotibial joint kinematics (craniocaudal translation, internal-external rotation, and flexion and extension angles) were compared among CCL-deficient stifle joints before LFTS, CCL-deficient stifle joints 6 months after LFTS, and unaffected contralateral (control) stifle joints. Owners and veterinarians subjectively assessed lameness by use of a visual analog scale and gait examination, respectively, at each time point.
At midstance phase, medial cranial tibial translation decreased from 9.3 mm before LFTS to 7.6 mm after LFTS but remained increased when compared with control stifle joint values. Following LFTS, axial rotation and stifle joint flexion and extension angles were not significantly different from control stifle joints. On the owner survey, the median walking lameness score improved from 9.3 of 10 before surgery to 0.3 after surgery. On gait examination, median walking lameness score improved from 2 of 4 before surgery to 0 after surgery.
Stifle joint instability was only slightly mitigated at 6 months following LFTS performed with knotted nylon leader material in medium to large dogs with CCL rupture, despite improvement in lameness.
定量分析外侧髌腓骨缝合稳定术(LFTS)治疗前十字韧带(CCL)断裂犬的股胫关节 3-D 运动学。
9 只成年犬(体重 15 至 35 千克[33 至 77 磅]),单侧完全 CCL 断裂。
使用 CT 扫描创建股骨、髌腓骨和胫骨、腓骨的数字 3-D 骨骼模型。在 LFTS 前和 LFTS 后 6 个月,在跑步机上行走时采集膝关节外侧荧光透视图像。使用尼龙导丝材料进行 LFTS,并用结固定。使用 3-D 到 2-D 图像配准过程分析步态周期。在 LFTS 前、LFTS 后 6 个月的 CCL 缺失膝关节和未受影响的对侧(对照)膝关节之间比较股胫关节运动学(头侧尾侧平移、内外旋转以及屈伸角度)。在每个时间点,主人和兽医分别通过视觉模拟量表和步态检查主观评估跛行。
在中足阶段,与 LFTS 前相比,内侧胫骨头侧平移从 9.3 毫米减少到 LFTS 后 7.6 毫米,但与对照膝关节相比仍增加。LFTS 后,轴向旋转和膝关节屈伸角度与对照膝关节无显著差异。在主人调查中,行走跛行评分中位数从手术前的 10 分中的 9.3 分改善至手术后的 0.3 分。在步态检查中,行走跛行评分中位数从手术前的 4 分中的 2 分改善至手术后的 0 分。
尽管跛行有所改善,但在中等至大型犬 CCL 断裂的 LFTS 后 6 个月,使用打结尼龙导丝材料仅略微减轻了膝关节不稳定。