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Canine Rehabilitation and Biomechanics

Joint Kinematics During Aquatic and Land Treadmill Activity in Dogs with Surgically Repaired Cranial Cruciate Ligament Injury

Kyle with dogThe cranial cruciate ligament (CCL) is a primary stabilizing ligament of the knee in a dog.  Rupture of the CCL (CCLR) is the most commonly diagnosed knee injury and the second most common joint disease in dogs.  It results in knee instability, joint inflammation, and lameness.  If left untreated the animal will develop progressive osteoarthritis (OA) causing pain and decreased function of the limb.  In the United States, owners spent an estimated 1.3 billion dollars in 2003 for treatment of CCLR.  This injury has had major impact on canine health with large costs to guardians.

Much attention has been given to surgical technique for the repair of CCLR and the role it plays in recovery, with relatively little attention to postoperative therapy.  In humans, numerous studies have shown significant improvements in return to function following orthopedic surgery. Rehabilitation is now standard for humans following major orthopedic surgery.  Recent studies in dogs have also shown that rehabilitation can significantly improve function following surgery.  Although rehabilitation is not standard care in dogs at this point, it has become increasingly more popular in recent years.  Rehabilitation facilities for dogs often use aCanine_MaxTRAQn aquatic treadmill to allow exercise with partial weight bearing on the affected joint.  However, little is known regarding the biomechanics associated with dogs walking on an aquatic treadmill.  Objective documentation of biomechanical measures during aquatic treadmill therapy is needed and may aid in quantifying its benefits.

The purpose of this study is to characterize and compare the joint kinematics in dogs that have undergone CCL surgery while walking on a land treadmill and an aquatic treadmill at three different water levels.  Joint range of motion and angular velocity will be calculated from joint motion data that will be collected using two digital video camcorders and MaxTRAQ (Innovision Systems, Inc., Lapeer, Michigan), computer software with a manual and automatic digitizing tool that can be used to extract kinematic properties from standard AVI files.  In addition, passive range of motion measurements of injured dogs will be assessed and compared to the measured active range of motion. 

We hypothesize that dogs that have undergone surgical treatment of a ruptured CCL will have greater hip, stifle, and tarsus joint ROM and angular velocity while walking on the aquatic treadmill than walking on the land treadmill.  We also hypothesize that the highest water level (water level with greater trochanter) will produce the greatest ROM and angular velocity.  This study may be beneficial in providing information that can be used to better understand and optimize rehabilitation prescriptions.

The study is in collaboration with the Rehabilitation & Conditioning Services department in the Central Texas Veterinary Specialty Hospital (CTVSH) in Austin, Texas.  CTVSH provides referral service in Surgery, Internal Medicine, Dermatology, Emergency & Critical Care, and Rehabilitation & Conditioning Services for companion animals.  For more information about CTVSH please visit their website at http://ctvsh.com.

Click below to see a video of a dog walking on the aquatic treadmill:

Water Treadmill Video

 CTVSH Logo

 







Development of a Canine Stifle Computer Model to Investigate Cranial Cruciate Ligament Deficiency

 

AKCCHF_Logo    funded by American Kennel Club - Canine Health Foundation Canine_Pelvic_Limb_Model_Development

Cranial cruciate ligament (CCL) rupture in the canine stifle is a leading cause of orthopedic lameness in the dog. Several corrective surgical procedures have been developed to return the dog to pre-injury function following CCL rupture, but no one technique has proven to be fully superior or fully accepted by orthopedic surgeons. A complete understanding of the biomechanics of the canine stifle prior to and following CCL rupture is needed to gain an improved understanding of stifle biomechanics and the factors that predispose dogs to CCL rupture. A three dimensional solid body computer model of the canine hind limb was developed to simulate both a CCL intact stifle and a CCL deficient stifle. Furthermore, key biomechanical parameters thought to be associated with CCL deficiency likelihood (such as ligament stiffness and tibial plateau angle) were investigated by conducting a parametric sensitivity analysis. This computer model is also being used to implement and simulate corrective surgical procedures to gain an understanding of the altered stifle joint biomechanics following surgical intervention. This analysis will seek to provide biomechanical evidence in support of or against current CCL surgical repair techniques.

 

Evaluation of Canine Stifle Cranial Cruciate Ligament Deficiency Surgical Stabilization Procedures Using a Computer Model Stifle_TPLO

Stifle_TTA

AKCCHF_Logo    funded by American Kennel Club - Canine Health Foundation 

Cranial cruciate ligament (CrCL) deficiency affects the canine stifle (knee) and is one of the most common orthopedic problems in dogs, having an economic impact of more than $1 billion in the US. In one study, 31,698 of 1,243,681 dogs were diagnosed with CrCL deficiency; a prevalence of 2.55% across all breeds. CrCL deficiency is common in some breeds while unlikely in others; Newfoundlands (8.9%), Rottweilers (8.3%), and Labrador Retrievers (5.8%) have the greatest prevalence. Despite such high prevalence, CrCL deficiency is still poorly understood and is thought to be due to degradation and not the sole result of trauma. Surgical intervention is often employed to stabilize the CrCL-deficient stifle, but no single surgical procedure is supported conclusively by data to suggest long-term success, osteoarthritis prevention or superiority. We propose to investigate commonly employed surgical procedures (tibial plateau leveling osteotomy, tibial tuberosity advancement and extra-capsular stabilization) using our previously developed canine pelvic limb 3D computer model to gain an improved understanding of stifle biomechanics following CrCL-deficient stifle stabilization. We will investigate parametersspecific to each surgical procedure using our computer model to further our understanding of their influence on stifle stabilization. Furthermore, we will investigate anatomical characteristics (e.g. tibial plateau angle) togain an improved understanding of their role in surgical intervention efficacy. Our computer model will be used to compare ligament and stifle structure stresses in the intact stifle vs. surgically stabilized stifles. Our outcome will be a biomechanical, evidence-based assessment of currently used stifle stabilization surgical procedures.

 

 


Biomechanical Evaluation of a Canine Stifle-Stabilizing Orthosis for Cranial Cruciate Ligament Deficiency Using Computer Model Simulated Gait

   AKCCHF_Logo   funded by American Kennel Club - Canine Health Foundation Stifle_Orthosis

Cranial cruciate ligament (CrCL) deficiency affects the canine stifle (knee) and is one of the most common orthopedic disorders in dogs, costing more than $1 billion annually in the US. CrCL deficiency has a prevalence of 2.55% across all breeds and is most prevalent in Newfoundlands (8.9%), Rottweilers (8.3%), and Labrador Retrievers (5.8%). Surgical intervention is often employed to stabilize the CrCL-deficient stifle, but no single surgical procedure is supported conclusively by data to suggest long-term success, osteoarthritis prevention or superiority. Stifle orthoses (braces) offer an alternative to surgical intervention, especially in patients that are poor anesthesia candidates, suffer significant co-morbidities, and are of advanced age or whose owners lack the financial means for more costly surgery. However, orthoses can also provide stifle stability in combination with surgery pre- and post-operatively. We propose to describe canine stifle orthoses user characteristics through development of an orthoses patient database, and to investigate stifle biomechanics complimented with a customized stifle orthosis using a previously developed canine pelvic limb 3D computer simulation model of gait. Our analysis will compare stifle biomechanics with and without an orthosis in a CrCL-deficient stifle to an intact stifle during gait. We will investigate stifle orthosis design and fit parameters (e.g. hinge type, strap tension), along with patient-specific parameters, using our computer model of simulated gait to understand their role in orthosis effectiveness. Our goal is to biomechanically assess the effectiveness of a customized orthosis in stabilizing the CrCL-deficient stifle. This study is being conducted through collaboration with a leading veterinary orthoses developer and manufacturer, OrthoPets (www.orthopets.com).

 

Canine Wheelchair Project

Canine_Wheelchair

Neurological deficits, injury and disease can lead to hind limb paresis or paraplegia in dogs. Dogs with these conditions, as well as those recovering from hind limb surgeries may benefit from wheelchair usage. Studies have shown that canine wheelchair usage can improve overall health and quality of life of dogs, as well as assist guardians with care giving. Currently most wheelchairs are customized to an individual dog, leading to high costs and the inability of the wheelchairs to adapt to a growing dog or to be reused for another dog. Unfortunately for some guardians, the cost of a wheelchair is prohibitive, and may influence euthanasia decisions. Hence, the goal of this study was to design and develop a low cost, highly adjustable canine wheelchair prototype that is suitable for a medium sized dog. A video can be viewed by following the link below.

Canine Wheelchair Video

To find out more and to download wheelchair building instructions, please contact Gina Bertocci at g.bertocci@louisville.edu

 

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