Lee Tsai-Yu, Wu Ching-Ho, Lin Cheng-Chung
Department of Surgery, National Taiwan University Veterinary Hospital, Taipei City, Taiwan.
Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei City, Taiwan.
BMC Vet Res. 2025 Aug 2;21(1):501. doi: 10.1186/s12917-025-04932-4.
BACKGROUND: Accurate femoral tunnel placement is essential for successful anatomical intra-articular reconstruction of the cranial cruciate ligament (CrCL), a standard treatment for anterior cruciate ligament disease in humans. Surgical outcomes are influenced by multiple factors related to tunnel placement, including ligament footprint restoration, tunnel length, and graft bending angle (GBA), among others. However, no consensus has been reached regarding the optimal placement of the femoral tunnel for CrCL reconstruction in dogs. This study aimed to investigate the effects of various femoral tunnel entry (FTE) points on these key parameters to determine favourable tunnel locations for canine CrCL reconstruction. METHODS: The influences of various FTE points were evaluated based on six parameters: footprint coverage, footprint overhang, footprint similarity, tunnel length, tunnel-face angle, and GBA. Three-dimensional femoral models reconstructed from CT scans of 25 canine cadaveric hindlimbs were used to simulate tunnel placement. In addition, tibiofemoral kinematic data from 13 client-owned dogs during treadmill gait were analysed to quantify the GBA associated with each simulated tunnel. RESULTS: A more proximal extracapsular tunnel aperture relative to Blumensaat's line provided greater footprint coverage, improved similarity, and longer tunnel length. However, along the cranial-caudal axis, a trade-off emerged between these factors and GBA, suggesting that a mid-range position may offer the most balanced compromise. CONCLUSION: Placing the FTE point proximally is preferable, while a mid-range cranial-caudal position may best balance key factors affecting postoperative outcomes in dogs.
背景:准确放置股骨隧道对于成功进行颅交叉韧带(CrCL)的解剖学关节内重建至关重要,这是人类前交叉韧带疾病的标准治疗方法。手术结果受与隧道放置相关的多种因素影响,包括韧带附着点恢复、隧道长度和移植物弯曲角度(GBA)等。然而,对于犬类CrCL重建中股骨隧道的最佳放置位置尚未达成共识。本研究旨在调查不同股骨隧道入口(FTE)点对这些关键参数的影响,以确定犬类CrCL重建的有利隧道位置。 方法:基于六个参数评估不同FTE点的影响:附着点覆盖范围、附着点悬垂、附着点相似性、隧道长度、隧道面角度和GBA。使用从25只犬类尸体后肢的CT扫描重建的三维股骨模型来模拟隧道放置。此外,分析了13只客户拥有的犬在跑步机步态期间的胫股运动学数据,以量化与每个模拟隧道相关的GBA。 结果:相对于布卢姆萨尔特线,更靠近近端的关节外隧道开口提供了更大的附着点覆盖范围、更高的相似性和更长的隧道长度。然而,在颅尾轴线上,这些因素与GBA之间出现了权衡,表明中间位置可能提供最平衡的折衷方案。 结论:将FTE点放置在近端是可取的,而颅尾中间位置可能最能平衡影响犬术后结果的关键因素。
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