Modified stabilization method for the tibial tuberosity advancement technique: a biomechanical study
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Data
2009-04-01
Autores
Lins, Bruno Testoni [UNESP]
Rahal, Sheila Canevese [UNESP]
Louzada, Mário Jefferson [UNESP]
Dalmas, José Carlos
Selmi, André Luis
Título da Revista
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Editor
Universidade Federal de Santa Maria (UFSM)
Resumo
O presente estudo teve como objetivo determinar as alterações biomecânicas decorrentes da modificação da técnica de avanço da tuberosidade tibial (TTA), originalmente descrita para estabilização da ruptura do ligamento cruzado cranial. Foram avaliados 10 cães, sem raça definida e com peso entre 25 e 30kg, submetidos à eutanásia por razões independentes do presente estudo. Os membros pélvicos foram distribuídos em dois grupos: G1 operado (n=10) e G2 controle (n=10), representado pelo membro contralateral. Os membros operados foram submetidos à avaliação ortopédica, goniométrica e radiográfica nos momentos 1 (articulação intacta), 2 (após desmotomia do cruzado cranial), 3 (após estabilização articular pela TTA modificada) e 4 (após a desmotomia do cruzado caudal). A tuberosidade tibial foi estabilizada por um parafuso cortical em posicionamento craniocaudal e um espaçador de titânio inserido no local de osteotomia. A posição do tendão patelar perpendicular em relação ao platô tibial promoveu a neutralização da força de cisalhamento tibial cranial, apesar da permanência do movimento de gaveta cranial em todos os joelhos. Os testes biomecânicos confirmam a viabilidade do método empregado para estabilização da tuberosidade tibial e sustentam a realização de estudos clínicos futuros para validação da técnica.
The present study aimed to determine biomechanical alterations resultant from a modification in the fixation method of the tibial tuberosity advancement technique (TTA), originally described for stabilization of the cranial cruciate-deficient stifle. Ten adult mongrel dogs weighing 25-30kg were used. After euthanasia, performed for reasons unrelated to this study, the hind limbs were distributed into two groups: G1 operated (n=10) and G2 control (n=10), represented by the contralateral limb. The operated hind limbs were orthopedically, goniometrically and radiographically evaluated, sequentially at four moments: moment 1, in intact joints; moment 2, after cranial cruciate desmotomy; moment 3, after surgical stabilization of the stifle joint using modified TTA; and moment 4, after caudal cruciate ligament desmotomy. The tibial tuberosity was stabilized by one shaft screw craniocaudally and a titanium cage inserted at the osteotomy site. The position of the patellar tendon at 90° in relation to the tibial plateau allowed cranial tibial thrust force neutralization, despite cranial drawer motion maintenance in all dogs. The biomechanical tests confirm the viability of the tibial tuberosity fixation method and support future clinical trials to validate the technique.
The present study aimed to determine biomechanical alterations resultant from a modification in the fixation method of the tibial tuberosity advancement technique (TTA), originally described for stabilization of the cranial cruciate-deficient stifle. Ten adult mongrel dogs weighing 25-30kg were used. After euthanasia, performed for reasons unrelated to this study, the hind limbs were distributed into two groups: G1 operated (n=10) and G2 control (n=10), represented by the contralateral limb. The operated hind limbs were orthopedically, goniometrically and radiographically evaluated, sequentially at four moments: moment 1, in intact joints; moment 2, after cranial cruciate desmotomy; moment 3, after surgical stabilization of the stifle joint using modified TTA; and moment 4, after caudal cruciate ligament desmotomy. The tibial tuberosity was stabilized by one shaft screw craniocaudally and a titanium cage inserted at the osteotomy site. The position of the patellar tendon at 90° in relation to the tibial plateau allowed cranial tibial thrust force neutralization, despite cranial drawer motion maintenance in all dogs. The biomechanical tests confirm the viability of the tibial tuberosity fixation method and support future clinical trials to validate the technique.
Descrição
Palavras-chave
avanço da tuberosidade tibial, ruptura do ligamento cruzado cranial, biomecânica, tibial tuberosity advancement, cranial cruciate rupture, biomechanics
Como citar
Ciência Rural. Universidade Federal de Santa Maria (UFSM), v. 39, n. 2, p. 473-478, 2009.