Submitted by (edna.saturno@ufrpe.br) on 2016-08-15T15:51:58Z No. of bitstreams: 1 Durval Barauna Junior.pdf: 734474 bytes, checksum: 741df0e4a7b2278f3858f4d6f5cb23db (MD5) / Made available in DSpace on 2016-08-15T15:51:58Z (GMT). No. of bitstreams: 1 Durval Barauna Junior.pdf: 734474 bytes, checksum: 741df0e4a7b2278f3858f4d6f5cb23db (MD5) Previous issue date: 2006-02-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Cranial cruciate ligament rupture (CCLR) is a common disease in dogs that cause joint instability resulting in lameness and rapid development of degenerative joint disease (DJD). The aim of this work was evaluate the results of a new technique of restoration of joint femur-fabelo-tibial stability for the treatment of spontaneous CCLR in dogs, using for this purpose clinical and radiographic features. Sixteen joint of fifteen dogs were operated, six male and nine female, with weight between 2.3 to 53.0 kg (median 8.4 kg) and age between 1 year and 10 months to 11years (mean 6.1± 2.8 years), miscellaneous breed and that the interval between the suspect of lesion by the owners and the surgical procedures varied between 3 to 365 days (mean 123 ±131.5 days), were submitted to the surgical correction though the extracapsular femur-fabelo-tibial interconnection technique. The tibial compression radiographs and the distal displacement of the popliteal sesamóide were 100 per cent efficient and sensitive to the diagnostic of CCLR. In anyone of the sixteen operated joint were observed difficulty or intra-operative complication. In 3 dogs were observed discreet instability (until 2mm) in the cranial drawer test and the tibial compression test, until 180 days; however these dogs didn’t show any damage in the functional evaluation in this period. In another three operated joints a discreet degree of cranial drawer remains until the 30º day, disappearing completely at 90 days. After 30 days of the surgery all the animals showed a improvement (P≤0.05) in the evaluated parameters, with progressive improvement until the 90 days after the surgical. There was no more change statistically significant, although observed clinical improvement until 180 days, when all the animals showed complete functional recovery. The increase (90 and 180 days) in the thigh perimeter weren’t statistically significant. Among 20 joints evaluated (operated or non operated) radiographically between 0 and 180 day, the evolution of degenerative changes was seen in 90 per cent of joints. It was possible conclude that the extracapsular femur-fabelo-tibial interconnection technique evaluated in this experiment is efficient in the immediate stabilization of joint with CCLR, offering functional recovery for reduce the cranial displacement and internal rotation of the tibia, however it not arrest the osteoarthritis progression. Secondarily it can be conclude that: the nylon strands despite its elasticity and plastic deformation can produce a discreet clinical instability, it continue been a good option for joint stabilization because of its low cost, feasibility of sterilization, no production of fistulous tracts and disposability of different diameters with variable resistance adequate for the animal size. Thick strands of difficult management can be arrest through by crimp clamp system with relative facility. Another important conclusion is that like the radiographic tibial compression test, the orthopedic evaluation with tibial compression test and cranial drawer test is 100 per cent efficient in the diagnosis of CCLR, in dogs. / A ruptura do ligamento cruzado cranial (RLCC) é uma afecção comum em cães, geradora de instabilidade do joelho, resultando em claudicação e rápido desenvolvimento de doença articular degenerativa. O objetivo deste trabalho foi avaliar os resultados de uma nova técnica de reconstituição da estabilidade da articulação femoro-tíbio-patelar, como forma de tratamento da RLCC espontânea em cães, utilizando para isto avaliações clínicas e radiográficas. Foram operados 16 joelhos de 15 cães afetados, sendo seis machos e nove fêmeas, com peso variando entre 2.3 a 53.0 kg (mediana 8.4 kg), idades entre um ano e 10 meses a 11 anos (média 6.1 ± 2.8 anos), de raças variadas e onde o intervalo entre a suspeita da lesão por parte dos proprietários e os procedimentos cirúrgicos variaram entre três a 365 dias, (média 123 ± 131.5 dias), que foram submetidos à correção cirúrgica através da técnica de interligação extracapsular femoro-fabelo-tibial. O exame radiográfico sob teste de compressão tibial e a avaliação do deslocamento distal do sesamóide do poplíteo foram 100% eficientes e sensíveis, para o diagnóstico da RLCC. Em nenhum dos 16 joelhos operados foram observadas dificuldades ou complicações trans-operatórias. Em três cães foi observada instabilidade discreta (até 2mm) no movimento de gaveta cranial (MGC) e no teste de compressão tibial, até 180 dias; entretanto estes cães não apresentaram prejuízos na avaliação funcional neste mesmo período. Em outros três joelhos operados um grau discreto de MGC permaneceu até o trigésimo dia desaparecendo completamente no retorno aos 90 dias. Aos 30 dias após a cirurgia todos os animais apresentavam uma melhora (P≤ 0.05) nos parâmetros avaliados, com progressão da melhora até os 90 dias após a cirurgia, a partir daí não houve mais modificação estatisticamente significante, embora tenha sido observada melhora clínica até os 180 dias, quando todos os animais apresentaram plena recuperação funcional. Os incrementos (90 e 180 dias) no perímetro da coxa não foram estatisticamente significantes. Dos 20 joelhos avaliados (operados e não operados) radiograficamente nos dias zero e 180, a evolução das alterações degenerativas foi observada em 90% destes. Foi possível concluir que a técnica de interligação extracapsular femoro-fabelo-tibial avaliada neste experimento é eficiente na estabilização imediata da articulação com RLCC, oferecendo recuperação funcional ao reduzir o deslocamento cranial e a rotação interna da tíbia, porém que não impede a progressão da osteoartrite. Secundariamente pode-se concluir que: o fio de náilon, apesar da sua elasticidade e deformação plástica poder produzir uma discreta instabilidade clinica, este continua sendo uma boa opção para estabilização articular em virtude do seu baixo custo, facilidade de esterilização, não produzir tratos fistulosos, possuir diferentes diâmetros com resistências variadas adequadas ao tamanho do animal. Fios grossos de difícil manuseio podem ser presos através de grampos tubulares com relativa facilidade. Outra conclusão importante é que assim como o exame radiográfico sob o teste de compressão tibial, o exame ortopédico com testes de compressão tibial e de movimento de gaveta cranial é 100% eficiente no diagnóstico da RLCC, em cães.

Submitted by (edna.saturno@ufrpe.br) on 2016-10-19T16:37:12Z No. of bitstreams: 1 Marcella Luiz de Figueiredo.pdf: 607417 bytes, checksum: b3643c44ea7390885e18f5ffa83a4480 (MD5) / Made available in DSpace on 2016-10-19T16:37:12Z (GMT). No. of bitstreams: 1 Marcella Luiz de Figueiredo.pdf: 607417 bytes, checksum: b3643c44ea7390885e18f5ffa83a4480 (MD5) Previous issue date: 2010-02-23 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The medial patellar luxation is an orthopedic disorder frequently seen in veterinary practice, affecting mainly small dogs. It is characterized by the medial displacement of the patella from its normal position in the trochlear groove, and surgical treatment is recommended from grade two dislocation. The objective of this study was to test if the creation of a complementary patellar ligament, manufactured from shredding of surplus retinaculum is a good technique to reinforce the patellar stabilization for the treatment of medial patellar luxation in dogs. We used 16 knees of 13 dogs, regardless of gender or age who had medial patellar luxation grades two, three and four, and among these, 8 were part of the B group in which we used the technique of synthetic patellar ligament for comparison. The animals were evaluated 30 and 90 days after surgery, for the parameters of pain, willingness to lift the contralateral limb, lameness and weight-bearing on the affected limb by the nonparametric Wilcoxon test for differences between ordered pairs. Since all animals showed functional recovery in 90 days, it is concluded that the proposed technique is also an appropriate surgical option for the strengthening of patellar stabilization in the treatment of medial patellar luxation in dogs. / A luxação patelar medial é um transtorno ortopédico frequentemente visto na clínica veterinária, acometendo especialmente cães de pequeno porte. Caracteriza-se pelo deslocamento medial da patela de sua posição normal no sulco troclear, sendo seu tratamento cirúrgico recomendado a partir do grau dois de luxação. Objetivou-se neste trabalho verificar se a criação de um ligamento patelar complementar confeccionado através do retalhamento do retináculo excedente constitui uma boa técnica de reforço da estabilização patelar para o tratamento da luxação medial de patela em cães. Foram utilizados 16 joelhos de 13 cães, sem distinção de sexo ou idade que apresentavam luxação de patela medial de graus dois, três e quatro, sendo que entre esses, 8 fizeram parte do grupo B onde se utilizou a técnica do ligamento patelar sintético para fazer a comparação. Os animais foram avaliados com 30 e 90 dias após a cirurgia, em relação aos parâmetros dor, disposição para levantar o membro contra-lateral, claudicação e suporte de peso no membro afetado. As diferenças entre os pares para esses parâmetros foram submetidas ao teste não paramétrico de Wilcoxon, evidenciando aos 30 dias melhor evolução estatística no grupo B, mas igual desempenho para ambos os grupo aos 90 dias. Conclui-se então, que a técnica proposta também constitui opção cirúrgica apropriada de reforço na estabilização patelar para o tratamento da luxação patelar medial em cães.

Twelve pairs of cadaveric pelvic limbs were harvested from skeletally mature dogs. Tibias were randomly assigned pairwise to two study groups: locking buttress screw fixation (LBS) and bone-screw-fastener fixation (BSF). A tibial plateau leveling osteotomy (TPLO) was performed. Each specimen was positioned in a servohydraulic testing machine to simulate physiological orientation and loading at the mid-point of the stance phase at the walk. Cyclic loading was performed for 30,000 cycles at 4Hz with a peak-load of 1000N. The cyclic test was then continued by stepwise increasing the peak-load at a rate of 75N per 500 cycles until failure of the construct. The findings of this current study suggest that stabilization of the TPLO with BSF in the proximal part of a locking TPLO plate provided similar biomechanical stability under cyclic axial loading conditions as the LBS. BSF may be an acceptable alternative to LBS for TPLO.

No description available.

No description available.

Este trabalho objetivou avaliar através do exame clínico, radiográfico e ultra-sonográfico a articulação fêmuro-tíbio-patelar pós desmotomia patelar medial. Foram utilizados oito equinos, machos e fêmeas, de peso, raça e idade variáveis. Todos animais foram submetidos a desmotomia patelar medial no membro pélvico direito. Os exames clínico e ultra-sonográfico foram realizados no 7º, 14º, 21º, 28º, 43º, 58º, 88º e 118º dia do pós-operatório. Os exames radiográficos e do líquido sinovial foram realizados no 15º, 30º, 60º, 90º e 120º dia do pós-operatório. No pós-operatório foi observado durante exame radiográfico do joelho direito, aumento do ângulo entre a superfície articular proximal da patela e a superfície cranial distal do fêmur, formação óssea na crista tibial, entesofitos na patela, deslocamento da patela e irregularidade óssea na superfície patelar lateral. No exame ultra-sonográfico foi observado aumento da espessura (p<0,05) no segmento proximal e médio do ligamento patelar intermédio do membro pélvico direito, desmite do patelar intermédio, enteseofitos na patela, distensão do recesso articular medial do fêmur, efusão articular e irregularidade da cartilagem do sulco troclear femoral. Conclui-se que a desmotomia patelar medial causa alterações no joelho devido a instbilidade articular e deve ser indicada apenas nos casos que não responderam a outras forma de tratamento. / This study aimed the evaluation of the femurotibiopatellar joint trough clinical, radiographic and ultrasonographic examinations after experimental medial patellar desmotomy. Medial patellar desmotomy was performed on the right hindlimb in eight mixed-breed horses. The clinical and ultrasonographic evaluation was performed on day 7, 14, 21, 28, 43, 58, 88 e 118 after surgery. The radiographic and synovial fluid evaluation was performed on day 15, 30, 60, 90 e 120 after surgery. It was observed during radiographic evaluation of the right stifle, an increase of the angle between the patellar proximal articular surface and the cranial distal femur surface. During ultrasonographic evaluation it was observed thickening (p<0,05) on the proximal and midlle segment of the midlle patellar ligament on the right hindlimb, entesophyte at the patella, femoral medial joint recess distending, joint effusion and cartilage irregularity of the femoral troclear groove. The medial patellar desmotomy causes stifle changes and must be performed only in animals non responsive to other treatment.

Zielstellung: Gegenwärtig wird nach Ruptur des vorderen Kreuzbandes (VKB) beim Hund häufig eine laterale Fadenzügelungen (LFZ) vorgenommen. In der vorliegenden Arbeit wurden folgende Ziele verfolgt: (1) Bestimmung der kranio-kaudalen Kniegelenkstabilität nach LFZ und passiver Kniegelenksbewegung. (2) Bestimmung der Schlaufenspannung nach Knotung mit der Hand. (3) Einfluss von vier häufig verwendeten Verankerungsformen auf die LFZ und von drei Kniegelenkwinkeln zum Zeitpunkt der Knotung des Fadenzügels auf den Spannungsverlauf innerhalb des Fadens. Material und Methode: Die kranio-kaudale Kniegelenkstabilität (KKStab) wurde anhand von latero-medialen Röntgenaufnahmen an 10 rechten Kniegelenken orthopädisch gesunder Hunde (>20 kg KM) ex-vivo bestimmt. Die Messung der KKStab erfolgte am intakten Gelenk, nach Durchtrennung des VKB und nach lateraler Ethibondfadenzügelung. Anschließend wurden die Gelenke 350 mal passiv gebeugt und gestreckt und die KKStab nach 50, 100, 250 und 350 Bewegungszyklen erneut bestimmt. Des Weiteren wurde die Spannung in 7 Ethibondfadenschlaufen an einer Materialprüfmaschine bestimmt. Die Spannung in der Schlaufe wurde nach dem ersten (FMax) und nach dem letzten Knoten (FEnd) gemessen. Mit Hilfe eines speziell konstruierten Kraftaufnehmers wurde die Spannung in der lateralen Fadenzügelung über den passiven Bewegungsradius des Kniegelenks in weiteren 9 Kniegelenken in-vitro gemessen. Dabei wurde nach Durchtrennung des VKB jedes Kniegelenk mit 4 Formen der LFZ bei 3 unterschiedlichen Kniegelenkswinkeln zur Zeit der Fixierung der Fadenschlaufe stabilisiert. Ergebnisse: KKStab nach Stabilisierung des Gelenkes betrug im Mittel 3,7 mm und war im Mittel um 2,7 mm größer als bei intaktem Kreuzband. Bereits 250 passive Bewegungszyklen bewirkten eine signifikante Destabilisierung um weitere 1,5 mm. FMax beim Knüpfen von sieben Fadenschlaufen betrug im Mittel 133 N und fiel auf 6 N (FEnd) im Mittel nach dem fünften Knoten ab. Alle 4 untersuchten LFZ-Formen zeigten eine Zunahme der Fadenspannung bei Beugung des Kniegelenkes. Die LFZ, bei der die Zügelung um die laterale Fabella geführt und in 2 parallelen Bohrungen in der proximalen Tibia fixiert wurde, zeigte die geringsten Spannungsänderungen über einen kompletten Bewegungsradius des Kniegelenks. Die Fixation der LFZ in einen Gelenkwinkel von 70° ergab einen signifikanten Abfall der Fadenspannung in Extension des Gelenkes. Schlussfolgerungen: Eine LFZ aus Ethibondfäden mit fünffacher Knotung erlaubt es nicht, die physiologische Gelenkstabilität nach Durchtrennung des VKB herzustellen. Bereits wenige passive Bewegungszyklen bewirken eine signifikante weitere Destabilisierung. Die in diesem Teil der Studie angewendete Knotentechnik erlaubte es nicht, die manuell in der Fadenzügelung aufgebaute Spannung dauerhaft zu konservieren und sollte deshalb keine Klinische Verwendung haben. Keine der getesteten LFZ-Formen zeigte einen gleichmäßigen Spannungsverlauf bei Bewegung des Kniegelenks. Aus diesem Grund sollten die aktuellen Empfehlungen hinsichtlich „isometrischer“ Verankerungspunkte kritisch betrachtet werden. Die Fixierung der LFZ bei gebeugtem Kniegelenk ist nicht zu empfehlen, da es in Extension zur Destabilisierung kommt.

Este trabalho objetivou avaliar através do exame clínico, radiográfico e ultra-sonográfico a articulação fêmuro-tíbio-patelar pós desmotomia patelar medial. Foram utilizados oito equinos, machos e fêmeas, de peso, raça e idade variáveis. Todos animais foram submetidos a desmotomia patelar medial no membro pélvico direito. Os exames clínico e ultra-sonográfico foram realizados no 7º, 14º, 21º, 28º, 43º, 58º, 88º e 118º dia do pós-operatório. Os exames radiográficos e do líquido sinovial foram realizados no 15º, 30º, 60º, 90º e 120º dia do pós-operatório. No pós-operatório foi observado durante exame radiográfico do joelho direito, aumento do ângulo entre a superfície articular proximal da patela e a superfície cranial distal do fêmur, formação óssea na crista tibial, entesofitos na patela, deslocamento da patela e irregularidade óssea na superfície patelar lateral. No exame ultra-sonográfico foi observado aumento da espessura (p<0,05) no segmento proximal e médio do ligamento patelar intermédio do membro pélvico direito, desmite do patelar intermédio, enteseofitos na patela, distensão do recesso articular medial do fêmur, efusão articular e irregularidade da cartilagem do sulco troclear femoral. Conclui-se que a desmotomia patelar medial causa alterações no joelho devido a instbilidade articular e deve ser indicada apenas nos casos que não responderam a outras forma de tratamento. / This study aimed the evaluation of the femurotibiopatellar joint trough clinical, radiographic and ultrasonographic examinations after experimental medial patellar desmotomy. Medial patellar desmotomy was performed on the right hindlimb in eight mixed-breed horses. The clinical and ultrasonographic evaluation was performed on day 7, 14, 21, 28, 43, 58, 88 e 118 after surgery. The radiographic and synovial fluid evaluation was performed on day 15, 30, 60, 90 e 120 after surgery. It was observed during radiographic evaluation of the right stifle, an increase of the angle between the patellar proximal articular surface and the cranial distal femur surface. During ultrasonographic evaluation it was observed thickening (p<0,05) on the proximal and midlle segment of the midlle patellar ligament on the right hindlimb, entesophyte at the patella, femoral medial joint recess distending, joint effusion and cartilage irregularity of the femoral troclear groove. The medial patellar desmotomy causes stifle changes and must be performed only in animals non responsive to other treatment.

Zielstellung: Die Ruptur des vorderen Kreuzbandes (VkB) ist die häufigste Ursache einer Lahmheit beim Hund. Im Gegensatz zu der Humanmedizin, wo die anatomische intraartikuläre Rekonstruktion des vorderen Kreuzbandes als Therapie der Wahl gilt, wird die intraartikuläre Rekonstruktion beim Hund nur selten durchgeführt und hat bis jetzt nicht dauerhaften Erfolg. Die anatomische Platzierung der Bohrkanäle ist bei Menschen für den Erfolg der Operation bei Menschen entscheidend. Erstes Ziel der Studie war die Bestimmung der radiologischen Lage des Zentrums des femoralen vorderen Kreuzbandursprungs beim Hund. Zweites Ziel war die Entwicklung und Erprobung eines Zielgerätes für die arthroskopisch-assistierte, anatomische vordere Kreuzbandrekonstruktion beim Hund. Material und Methode: A. Radiologische Studie: Die kraniale Begrenzung des femoralen Ursprungs des vorderen Kreuzbandes (VK) wurde mit einem röntgendichten Draht bei 49 Femora orthopädisch gesunder Hunde (KM > 20 kg) markiert. Anschließend wurde eine Computertomographie und 3D- Rekonstruktion jedes Femurs angerfertigt, anhand derer der Ursprung manuell segmentiert und das Zentrum berechnet wurde. Schließlich wurden, basierend auf den 3D-Modellen, virtuelle Röntgenbilder in zwei Ebenen berechnet. An diesen wurde die Position des berechneten Zentrums mit drei unterschiedlichen Methoden bestimmt (4x4-Gitterbox-Methode und prozentuale Position für die medio-laterale Projektion; Ziffernblattmethode für die disto-proximale Projektion). B. Zielgerät: Hintergliedmaßen (n = 12) von 6 Hundekadavern (KM ≥20 kg) wurden verwendet. Eine Gliedmaße jedes Kadavers wurde zufällig ausgewählt und die kaudo-kraniale Lage des Zentrums des vorderen Kreuzbandansatzes (vKBA) in medio-lateralen Röntgenbildern berechnet und anschließend auf ein justierbares Zielgerät übertragen. Unter arthroskopischer Kontrolle wurde das Zielgerät hinter der lateralen Kondyle eingehakt und ein Steinmann Pin von extra nach intraartikulär platziert. Die Position der resultierenden Bohrkanäle wurde sowohl röntgenologisch bestimmt als auch dreidimensional mit dem anatomischen Zentrum des vKBA der kontralateralen Hintergliedmaßen verglichen. Ergebnisse: A. Radiologische Studie: In der medio-lateralen Projektion befand sich das Zentrum des femoralen Kreuzbandursprungs im zweiten Rechteck von proximal in der kaudalen Spalte. Die mittlere prozentuale kaudo-kraniale und proximo-distale Position war 20,2 % (± 2,2), beziehungsweise 33,8% (± 3,7). Im disto-proximalen Röntgenbild lag in 97,6 % der Femora das Zentrum des femoralen Kreuzbandursprungs zwischen 14:00 und 15:00 Uhr. B. Zielgerät: In allen postoperativen Röntgenaufnahmen lagen die sechs Bohrkanäle im bzw. nahe dem Zentrum des vKBA. Die 3D- Messungen ergaben eine mediane Abweichung der Bohrkanalposition im Vergleich zum anatomischen Zentrum der kontralateralen Seite von 0,6 mm (Bereich:0,2– 0,9 mm). Schlussfolgerung: Die erarbeiteten Referenzwerte können für die Planung sowie die intra- und postoperative Kontrolle der femoralen Bohrung verwendet werden. Die Verwendung eines justierbaren Zielgerätes ermöglicht die präzise anatomische Platzierung des femoralen Bohrkanals für die intraartikuläre Rekonstruktion des vorderen Kreuzbandes. Die beschriebene Methode wird helfen, eine Fehlplatzierung des femoralen Bohrkanals im Zuge der intraartikulären vorderen Kreuzbandplastik zu reduzieren. In Kombination mit dem bereits beschriebenen tibialen Zielgerät sind nun die technischen Voraussetzungen für die arthroskopisch-assistierte anatomische vordere Kreuzbandplastik in der Tiermedizin gegeben. / Objective: Cranial cruciate ligament (CrCL) pathology is the most frequent cause of lameness in dogs. In contrast to human medicine, where anatomic reconstruction of the ACL is considered the treatment of choice, intra-articular repair in dogs is not commonly performed and until now has not met with enduring success. Accurate tunnel placement has been shown to be crucial in obtaining a successful outcome after anterior cruciate ligament reconstruction in humans. The first aim of our study was to define the radiographic location of the center of the femoral attachment of the CrCL in dogs, for the pre- operative planning as well as post-operative control of anatomical placement of the femoral tunnel. Second aim of the study was to develop and validate an aiming device for arthroscopic femoral tunnel placement. Materials and Methods: A. Radiographic study: Using femora from 49 adult, orthopedically sound dogs (BW ≥ 20 kg), a radiopaque marker was placed on the cranial border of the femoral footprint of the CrCL. Computed tomography and 3D reconstruction of each femur was performed subsequently, followed by manual segmentation of the footprint on the 3D models and calculation of its center. Finally, virtual digital radiographs in two planes were produced and the location of the calculated center of the CrCL was expressed using three different methods (4x4 box grid method and percentage position for the medio-lateral projection; o’clock position for the disto-proximal projection). B. Aiming device: Hindlimbs (n=12) of 6 cadaveric dogs weighing ≥20 kg were used. One hindlimb from each cadaver was randomly chosen and the caudo- cranial position of the CrCL center was calculated, on standard medio-lateral stifle radiographs, and transferred onto to an adjustable aiming device. During stifle arthroscopy the aiming device was inserted and guide pin placed from extra-to-intra-articular. The position of the resulting bone tunnel was evaluated on stifle radiographs and also compared with the anatomic center of each contralateral hindlimb, in the three dimensional (3D) space. Results: A. Radiographic study: In the medio-lateral radiographs the center of the femoral footprint was consistently located in the second rectangle from the top of the most caudal column of the 4x4 grid. The mean percentage caudo- cranial and proximo-distal location was 20.2% (± 2.2) and 33.8% (± 3.7), respectively. In the disto-proximal radiograph, the o’clock position of the CrCL center was between 2 and 3 o’clock in 97.6% of the femora. B. Aiming device: According to the postoperative radiographs, the location of all 6 intra-articular tunnel openings was consistent with the results of the radiographic study. In 3D space, arthroscopic femoral drilling resulted in a median deviation of the drill tunnels of 0.6 mm around the CrCL center. All tunnel openings were located within the CrCL insertion. Conclusions: The reported data can be used to plan and verify the placement of the femoral tunnel opening during intra-articular anatomic CrCL repair. The use of the aiming device suggests that arthroscopic femoral tunnel placement can be achieved with high precision. The measurement for the device can be derived from a standard medio-lateral radiograph of the stifle, which is part of the diagnostic work up of every dog with lameness localized in the stifle. The proposed technique may reduce femoral tunnel misplacement when performing intra-articular CrCL repair in dogs. In combination with the described technique for arthroscopic tibial tunnel drilling, arthroscopic assisted anatomic reconstruction of the CrCL in dogs can be achieved.

Zusammenfassung Markus Zeißler Gelenkknorpeldicke und Spaltlinienverlauf im Hinblick auf eine autologe osteochondrale Transplantation vom Knie ins Ellbogengelenk beim Hund Klinik für Kleintiere der Veterinärmedizinischen Fakultät der Universität Leipzig ( 87 Seiten, 19 Abbildungen, 221 Literaturangaben) Eingereicht im August 2012 Schlüsselwörter: autologe osteochondrale Transplantation – Ellbogengelenk-Kniegelenk – Hund – Knorpeldicke – Spaltlinien – Mosaikplastik Zielstellung: Ziel der Arbeit war es eine autologe osteochondrale Transplantation zur Therapie einer Osteochondrosis dissecans (OCD) beim Hund unter Berücksichtigung der morphologischen Grundlagen an potentiellen Empfängerstellen des Ellbogengelenkes und Spenderstellen des Kniegelenkes, durchzuführen. Dazu wurden die Knorpeldicke bestimmt und die Spaltlinien des Knorpels dargestellt und die potentiellen Empfänger- und Spenderstellen miteinander verglichen. Material und Methode: Es wurde eine postmortale Studie an Gelenken von 20 über 20 kg schweren knorpelgesunden Hunden durchgeführt. An 15 Vorder- und den entsprechenden 15 Hintergliedmaßenpaaren wurden mit einem 2,7 mm Hohlmeißel osteochondrale Zylinder an jeweils vier Empfängerstellen an der Trochlea humeri und 14 potentiellen Spenderstellen im Kniegelenk entnommen und mittels eines hochauflösenden digitalen Röntgensystems die Knorpeldicke bestimmt. Nachträglich wurde an fünf zusätzlichen Hintergliedmaßen, die die selben Kriterien wie die anderen 15 Gliedmaßen erfüllten, kurz vor Abschluss der Studie ein bis dahin nicht bekanntes Spenderareal (CO) mit jeweils drei Spenderstellen nachbeprobt und ebenfalls die Knorpeldicke vermessen. Weiterhin wurden an den ipsilateralen 15 Gliedmaßen die Spaltlinien der Trochlea humeri und des gesamten distalen Femurs präpariert, um die Hauptausrichtung der Kollagenfasern darzustellen, die ein Ausdruck der Dehnungsausrichtung und damit der Belastung des hyalinen Knorpels sind. Dazu wurde eine in königsblauer Tinte benetzte Präpariernadel alle drei Millimeter senkrecht in den Gelenkknorpel eingestochen und damit entstandene Spaltlinien dargestellt. Dies gelang erfolgreich an zehn Vorder- und Hintergliedmaßen. Ergebnisse: Es konnte ein primär transversal verlaufendes Spaltlinienmuster im Kniegelenk für die innerhalb der Trochlea gelegenen Spenderstellen nachgewiesen werden. Die Spenderareale außerhalb des Femoropatellargelenkes wiesen keine Spaltlinien auf. Die Trochlea humeri wies ein konstantes zentripetales Spaltlinienmuster auf. An der typischen Prädilektionsstelle der Osteochondrosis dissecans in der Trochlea humeri wurde eine Knorpeldicke im Median von 0,55 mm (95%KI: 0,48-0,6) bestimmt. Innerhalb der Trochlea ossis femoris wurde eine mediane Knorpeldicke an den inneren lateralen Spenderstellen von 0,45 mm (95% KI: 0,42-0,48), an den inneren medialen Spenderstellen von 0,49 mm (95% KI: 0,49-0,63) und an den lateral und medialen Spenderstellen der distalen Trochlea von 0,56 mm (95%KI: 0,49-0,63) gemessen. Die niedrigsten Knorpeldicken wiesen die äußeren Spenderstellen der Trochlea ossis femoris auf mit Median 0,2 mm (95% KI: 0,16-0,23) an den lateralen und 0,24 mm (95% KI: 0,17-0,31) an den medialen äußeren Spenderstellen. Schlussfolgerungen: Spenderstellen außerhalb des Femoropatellargelenkes weisen deutlich zu niedrige Knorpeldicken und ein fehlendes Spaltlinienmuster auf und sollten deshalb unter Berücksichtigung der morphologischen Situation zur OAT beim Hund am Ellbogen vermieden werden. Die Spenderstellen an der distalen Trochlea ossis femoris eigenen sich am besten zur Transplantation in die Trochlea humeri. Mit diesen Daten wird es erstmals möglich sein die osteochondrale Transplantation vom Kniegelenk ins Ellbogengelenk beim Hund zur Therapie einer OCD unter Berücksichtigung der morphologischen Grundlagen Knorpeldicke und Spaltlinienmuster durchzuführen. Inwieweit eine Verbesserung vor allem der Langzeitprognose beim Hund unter Berücksichtigung dieser Aspekte erreicht wird, muss in weiteren klinischen Studien untersucht werden. Allerdings müssen weitere wichtige Kriterien wie Oberflächengeometrie und Spenderstellenmorbidität zusätzlich beachtet werden. / Summary Markus Zeißler Cartilage thickness and split-line as a basic principal for an autologous osteochondral transplantion from stifle to the elbow joint in dogs Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig Submitted in August 2012 (87 pages, 19 figures, 221 references) Keywords: autologous osteochondral transplantation – elbow joint – stifle joint – dog– cartilage thickness – split- line pattern – mosaicplasty Aim of the study: was to conduct an osteochondral transplantation as a treatment for Osteochondritis dissecans in dogs under consideration of the morphological basics to provide potential recipient sites on the elbow and donor sites in the stifle joint. In order to compare the potential donor and recipient sites the cartilage thickness was measured and the splitt line patterns were depicted. Material and methods: A postmortal study was conducted on joints with healthy cartilage of 20 dogs with a bodyweight over 20 kg. From 15 forelimb- and hindlimb pairs, osteochondral plugs were collected with a 2.7mm hollow chisel .These were taken from 4 donor sites on the trochlea humeri and 14 recipient sites from the stifle,respectively, and the cartilage thickness was measured with a high-solving digital xray system. Shortly before the end of this study a donor area (CO), until then unknown, was sampled from 5 additional hindlimbs with the same criteria as before. On each donor region, 3 osteochondral grafts were taken and the cartilage thickness measured.Furthermore, split line patterns from the trochlea humeri and the stifle were depicted on 15 ipsilateral limbs. The split line patterns represent the main orientation of the collagen fibers and this is an expression of the strain orientation and thus show us the load of the cartilage. A needle dipped in India ink was pierced perpendicular to the cartilage surface in a 3mm interval to produce split line patterns.This succeeded in 10 fore- and hindlimbs. Results: The donor sites in the trochlea of the stifle have a primary transversal splitline orientation.The donor sites outside the trochlea of the stifle show no split line patterns. The trochlea humeri display a constant zentripetal split line orientation. In the Trochlea humeri the mean cartilage thickness was 0.55mm (95% CI: 0.42-0.61). The mean cartilage thickness within the femoral trochlea on the inner lateral donor sites measured 0.45mm (95%CI:0.42-0.48), on the inner medial donor sites was 0.49mm( 95%CI:0.49-0.63),and on the medial and lateral donor sites of the distal femoral trochlea were 0.56mm(95%CI:0.49-0.63), respectively. The thinnest cartilage reported in the donor sites outside the femoral trochlea measured laterally 0.2mm (95% CI: 0.16-0.23) and medially 0.24mm (95% CI: 0.17-0.31). Conclusions: Donor sites outside the femoropatellar joint have too thin cartilage thickness and no split line orientation. Due to these morphological conditions they should be avoided for osteochondral autograft transplantation as donor sites for the trochlea humeri in dogs. The distal femoral trochlea is the best location for autologous grafting of the trochlea humeri. It is now possible to carry out an autologous osteochondral transplantation from stifle to the elbow joint for the treatment of Osteochondritis dissecans in dogs in consideration of morphological basic principals of cartilage thickness and split- line patterns. Further clinical evaluation is needed in order to assess the value of these findings for the long term prognosis. However, additional other important criteria, such surface curvature and donor site morbidity, must be considered.