Graph showing the TPI% in the affected limb of each individual patient over time

The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency

Brittany Jean Carr, Sherman O Canapp, Stephanie Meilleur, Scott A Christopher, Jeffery Collins, Catherine Cox

Published:  22/01/2016    in:  Articles
Views
1814
HTML:
5126
PDF:
655



Graph showing the TPI% in the affected limb of each individual patient over time
Abstract

Objective: To assess weight bearing of dogs treated for unilateral cranial cruciate ligament insufficiency with a custom stifle orthotic.

Background: Cranial cruciate ligament (CCL) insufficiency is the most common cause of hind limb lameness in dogs. While there are numerous options for surgical management, surgery is not always an option. Recently, the use of canine stifle orthotics has also emerged as a means to non-surgically manage patients with cranial cruciate ligament insufficiency. 

Evidentiary value:  This is a retrospective study of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic.

Methods: Medical records (January 2005- December 2012) of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic were reviewed.  Temporospatial gait analysis was performed using a pressure sensing walkway at baseline and 90 days or greater post orthotic placement to identify weight bearing with total pressure index % (TPI%).

Results: TPI% improved significantly by 5.1% in the affected limb when compared to baseline (p = 0.0020). At final gait analysis, TPI% significantly improved by 3% in the affected limb with the orthotic off when compared to the unaffected limb (p = 0.0020).

Conclusion: Custom canine stifle orthotics allow for improved weight bearing in the affected limb.

Application: Custom canine stifle orthotics should be considered for cases with concurrent medical conditions or financial constraints that do not allow for surgical intervention.


Open AccessPeer Reviewed

Full Text:

HTML PDF


Click to see References Click to hide References
References

  1. Witsberger,T. H. et al (2008) Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs. Journal of the American Veterinary Medical Association. 232(12) pp 1818-1824 http://dx.doi.org/10.2460/javma.232.12.1818
  2. Kim, S.E. , Lewis, D.D. and Pozzi, A. (2012) Effect of Tibial Plateau Leveling Osteotomy on Femorotibial Subluxation: In Vivo Analysis during Standing. Veterinary Surgery, 41(4) pp 465–470 http://dx.doi.org/10.1111/j.1532-950X.2012.00973.x
  3. Nelson, S.A. et al (2012) Long-Term Functional Outcome of Tibial Plateau Leveling Osteotomy Versus Extracapsular Repair in a Heterogeneous Population of Dogs. Veterinary Surgery. 42(1) pp38–50 http://dx.doi.org/10.1111/j.1532-950X.2012.01052.x
  4. Christopher, S.A. , Beetem, J., and  Cook, J.L (21012).  Comparison of Long-Term Outcomes Associated With Three Surgical Techniques for Treatment of Cranial Cruciate Ligament Disease in Dogs. Veterinary Surgery. 42(3) pp 329–334
    http://dx.doi.org/10.1111/j.1532-950X.2013.12001.x
  5. Biskup, J.J etc al (2014) Ability of the Tightrope and Percutaneous Lateral Fabellar Suture Techniques to Control Cranial Tibial Translation. Veterinary Surgery 43(8) pp 959-985
    http://dx.doi.org/10.1111/j.1532-950X.2014.12111.x
  6. Wucherer, K.L et al (2013) Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. Journal of the American Veterinary Medical Association. 242(10) pp 1364-1372  http://dx.doi.org/10.2460/javma.242.10.1364
  7. Molsa,S.H. et al (2014) Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs. BMC Veterinary Research. 10:266 http://dx.doi.org/10.1186/s12917-014-0266-8
  8. Nelson, S.A. et al (2013) Long term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs. Veterinary Surgery 42(1) pp:38-50 http://dx.doi.org/10.1111/j.1532-950X.2012.01052.x
  9. Cook, J.L, et al, (2010) Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs, Veterinary Surgery 39(3) pp 315-323  http://dx.doi.org/10.1111/j.1532-950X.2010.00658.x
  10. Headrick, J.F.,  Zhang, S and  Millard, R.P. (2014)  Use of an inverse dynamics method to compare the three-dimensional motion of the pelvic limb among clinically normal dogs and dogs with cranial cruciate ligament–deficient stifle joints following tibial plateau leveling osteotomy or lateral fabellar–tibial suture stabilization. American Journal of Veterinary Research. 75(6) pp:554–564 http://dx.doi.org/10.2460/ajvr.75.6.554
  11. Au, K.K. , Gordon-Evans, W.J. and Dunning, D (2010) Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization. Veterinary Surgery 39(2) pp:173–180
    http://dx.doi.org/10.1111/j.1532-950X.2009.00628.x
  12. Oxley, B. et al,(2013)  Comparison of complication rates and clinical outcome between tibial plateau leveling osteotomy and a modified cranial closing wedge osteotomy for treatment of cranial cruciate ligament disease in dogs. Veterinary Surgery. 42(6): pp 739–750  http://dx.doi.org/10.1111/j.1532-950X.2013.12033.x
  13. Baltaci, G., Aktas, G., and Camci, E. (2011) The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power. Knee Surgery Sports Traumatology Arthroscopy. 19(10) pp1722–1728  http://dx.doi.org/10.1007/s00167-011-1491-3
  14. Bodendorfer, B.M. et al, (2013) Anterior Cruciate Ligament Bracing: Evidence in Providing Stability and Preventing Injury or Graft Re-Rupture. The Physician and Sports Medicine. 41(3) pp 92–102 http://dx.doi.org/10.3810/psm.2013.09.2020
  15. Segal, N.A. (2012) Bracing and Orthoses: A Review of Efficacy and Mechanical Effects for Tibiofemoral Osteoarthritis. PM&R. 4(5) Supplement pp:S89–S96  http://dx.doi.org/10.1016/j.pmrj.2012.01.018
  16. Smith, S.D. et al. (2013) Functional bracing of ACL injuries: current state and future directions. Knee Surgery Sports Traumatology Arthroscopy. 22(5) pp 1131–1141  http://dx.doi.org/10.1007/s00167-013-2514-z
  17. Chew, K.T.L et al, (2007) Current Evidence and Clinical Applications of Therapeutic Knee Braces. American Journal of Physical Medicine & Rehabilitation. 86(8) pp:678–686 http://dx.doi.org/10.1097/PHM.0b013e318114e416
  18. Birmingham, T.B. et al, (2001)  Knee bracing for medial compartment osteoarthritis: effects on proprioception and postural control. Rheumatology. 40(3) pp 285-289 http://dx.doi.org/10.1093/rheumatology/40.3.285
  19. Birmingham, T.B. et al, (2001) Knee bracing after ACL reconstruction: effects on postural control and proprioception. Medicine & Science in Sports & Exercise. 33(8) pp 1253-1258 http://dx.doi.org/
  20. Giotis, G et al (2013). Effects of Knee Bracing on Tibial Rotation During High Loading Activities in Anterior Cruciate Ligament–Reconstructed Knees. Arthroscopy. 29(10) pp 1644–1652  http://dx.doi.org/10.1016/j.arthro.2013.07.258
  21. Giotis, G et al (2011), Knee braces can decrease tibial rotation during pivoting that occurs in high demanding activities. Knee Surgery Sports Traumatology Arthroscopy. 1998) pp 1347–1354  http://dx.doi.org/10.1007/s00167-011-1454-8
  22. Palm, H.G. et al. (2012) Effects of knee bracing on postural control after anterior cruciate ligament rupture. The Knee. 19(5) pp 664–671 http://dx.doi.org/10.1016/j.knee.2011.07.011
  23. Canapp, S.O., Campana, D.M and Fair, L.M. (2012) Orthopedic coaptation devices and small-animal prosthetics, In Tobias KM, Johnston SA: Veterinary Surgery Small Animal. St. Louis, Missouri, Elsevier, pp  628-646


Refbacks
  • There are currently no refbacks.


Copyright (c) 2016 Brittany Jean Carr, Sherman O Canapp, Stephanie Meilleur, Scott A Christopher, Jeffery Collins, Catherine Cox

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Made possible through a project grant from the RCVS Council.

RCVS