Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, No. 153, Sec. 3, Keelung Rd., Da'an Dist, Taipei City, 106328, Taiwan (R.O.C.).
Department of Electrical Engineering, Fu Jen Catholic University, New Taipei City, Taiwan (R.O.C.).
BMC Vet Res. 2023 Jul 24;19(1):93. doi: 10.1186/s12917-023-03656-7.
BACKGROUND: Cranial cruciate ligament (CCL) disease is one of the most common causes of lameness in dogs. The extracapsular stabilization (ECS) utilizing bone anchors and monofilament nylon leader was an alternative treatment for CCL-deficient (CCLD) dogs. However, the biomechanical response of the canine stifle to such a surgical repair strategy in conjunction with the use of recently reported quasi-isometric anchoring points remains unclear. The objectives of the study were to evaluate the mobility and stability of CCL-intact, CCLD, and CCLD stifles repaired with ECS at two different pairs of quasi-isometric points (quasi-IPs). METHODS: Twelve stifle specimens from 7 dogs underwent mobility and stability tests under 4 different conditions, namely, CCL-intact, CCLD, and ECS-repaired at 2 different pairs of quasi-IPs (referred to as ECS-IP1 and ECS-IP2). The mobility tests evaluated 6 degrees-of-freedom stifle kinematics during flexion and extension. The stability tests involved cranial drawer and tibial internal rotation (IR) tests at various stifle opening angles and quantifying the cranial tibial translation (CTT) and tibial IR angles under constantly applied loadings. RESULTS: The ECS repaired at quasi-IPs was shown to restore cranial instability of the stifles with averaged CTT magnitudes < 1.4 mm. During the tibial IR test, the ECS treatments resulted in significantly less tibial IR compared to those in intact CCL stifles. The mobility tests showed similar results. CONCLUSION: The 2 chosen pairs of quasi-IPs were shown to effectively correct the excessive CTT caused by CCLD stifles, whereas the excessive tibial external rotation in comparison to those of intact stifles should be considered for its subsequent influence on joint alignment and the contact pressure applied to the stifle joint.
背景：颅十字韧带（CCL）疾病是犬跛行的最常见原因之一。利用骨锚和单丝尼龙引导线的囊外稳定（ECS）是治疗 CCL 缺失（CCLD）犬的一种替代方法。然而，这种外科修复策略与最近报道的准等距锚固点结合使用时，犬膝关节的生物力学反应尚不清楚。本研究的目的是评估 CCL 完整、CCLD 和 CCLD 膝关节在两个不同的准等距点（准 IP）下使用 ECS 修复后的活动性和稳定性。 方法：来自 7 只狗的 12 个膝关节标本在 4 种不同条件下进行了活动性和稳定性测试，即 CCL 完整、CCLD 和使用 2 种不同准 IP（称为 ECS-IP1 和 ECS-IP2）修复的 ECS。活动性测试评估了膝关节在屈伸过程中的 6 自由度运动学。稳定性测试包括在不同膝关节开口角度下进行的颅抽屉和胫骨内旋转（IR）测试，并在恒定施加的载荷下量化颅胫骨平移（CTT）和胫骨 IR 角度。 结果：准 IP 下的 ECS 修复显示出能够恢复膝关节的颅侧不稳定性，平均 CTT 幅度<1.4mm。在胫骨 IR 测试中，与完整 CCL 膝关节相比，ECS 治疗导致胫骨 IR 明显减少。活动性测试也得到了类似的结果。 结论：选择的 2 对准 IP 被证明可以有效地纠正 CCLD 膝关节引起的过度 CTT，而与完整膝关节相比，过度的胫骨外旋应考虑其对关节对线和施加在膝关节上的接触压力的后续影响。
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