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Rhode M, Harms O, Finck Y, Dautzenberg P, Schweizer J, Lüpke M, Freise F, Fehr M. Performing a Three-Dimensional Finite Element Analysis (FEA) to Simulate and Quantify the Contact Pressure in the Canine Elbow Joint: A Pilot Study. Vet Comp Orthop Traumatol 2022; 35:279-288. [PMID: 35785818 DOI: 10.1055/s-0042-1748876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to measure surface pressures and force distribution on radius and ulna in healthy and dysplastic elbow joints in different positions using the finite element analysis (FEA). STUDY DESIGN FEA was performed on computed tomographic data of healthy and fragmented coronoid process diseased elbow joints of Labrador Retrievers. It considered the articular cartilage, collateral ligaments, triceps and biceps muscle. The analysis of each joint was performed in four positions (standing position: 145 degrees and three positions of the stance phase of gait: beginning: 115 degrees, middle: 110 degrees, end: 145 degrees joint angle) in consideration of different ground reaction forces (standing: 88.3 N; stance phase of gait: 182.5 N). RESULTS Mean values of total force of 317.5 N (standing), 590.7 N (beginning), 330.9 N (middle) and 730.9 N (end) were measured. The percentual force distribution resulted in a total of 49.56 ± 26.58% on the ulna with a very inhomogeneous distribution. A significant difference was detected between the positions 'standing' and 'end' (p = 0.0497) regardless of the joint condition. In some FEA results, visual assessment of the surface pressures indicated an increase in pressure in the region of the medial compartment without a uniform pattern. An increase in pressure resulted in an area increase in the pressure marks on the joint surface and measurable pressure was increased at a larger joint angle. CLINICAL SIGNIFICANCE FEA can provide information about the transmission of force in the joint. Prior to the use of FEA in scientific clinical research for the simulation of force, further model improvements are necessary.
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Affiliation(s)
- Michaela Rhode
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Oliver Harms
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | | | - Philipp Dautzenberg
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Julia Schweizer
- Veterinary Practice for Small Animal Surgery, Neuenrade, Germany
| | - Matthias Lüpke
- Institute for General Radiology and Medical Physics, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Fritjof Freise
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Michael Fehr
- Clinic for Small Mammals, Reptiles and Birds, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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Rohwedder T. Biomechanics of the Canine Elbow Joint. Vet Med Sci 2021. [DOI: 10.5772/intechopen.99569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The canine elbow joint is a complex joint, whose musculoskeletal anatomy is well investigated. During the last 30 years kinematic analysis has gained importance in veterinary research and kinematics of the healthy and medial coronoid disease affected canine elbow joint are progressively investigated. Video-kinematographic analysis represents the most commonly used technique and multiple studies have investigated the range of motion, angular velocity, duration of swing and stance phase, stride length and other kinematic parameters, mostly in the sagittal plane only. However, this technique is more error-prone and data gained by video-kinematography represent the kinematics of the whole limb including the soft tissue envelope. A more precise evaluation of the in vivo bone and joint movement can only been achieved using fluoroscopic kinematography. Based on recent studies significant differences in the motion pattern between healthy joints and elbows with medial coronoid disease could be detected. Thereby not only adaptive changes, caused by pain and lameness, could be described, but primary changes in the micromotion of the joint forming bones could be found, which potentially represent new factors in the pathogenesis of medial coronoid disease. This chapter gives a review of current literature on elbow joint kinematics, with particular focus onto pathologic biomechanics in dysplastic canine elbows.
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Rohwedder T, Böttcher P. Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease. Vet Comp Orthop Traumatol 2021; 34:386-393. [PMID: 34344054 DOI: 10.1055/s-0041-1731811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking. STUDY DESIGN This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs). MATERIALS AND METHODS Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk. RESULTS Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772-1.8824). Mean dRUI in controls (-0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918-2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. -0.4 mm; p = 0.0138; CI: 0.1820-1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963). CONCLUSION In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to -0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.
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Vezzoni A, Benjamino K. Canine Elbow Dysplasia: Ununited Anconeal Process, Osteochondritis Dissecans, and Medial Coronoid Process Disease. Vet Clin North Am Small Anim Pract 2021; 51:439-474. [PMID: 33558015 DOI: 10.1016/j.cvsm.2020.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Elbow dysplasia is a major cause of front limb lameness in medium to large dog breeds. Underlying causes include ununited anconeal process, medial coronoid process disease, and osteochondritis dissecans. When a definitive diagnosis of elbow dysplasia is made, the surgeon can improve elbow function but cannot entirely prevent progression of osteoarthrosis. Conventional surgical treatment with joint debridement and removal of loose osteocartilaginous bodies is not rewarding if joint incongruity persists; the result is overloading and subchondral bone exposure with erosion of the cartilage of the medial humeral condyle and medial coronoid area of the ulna leading to medial compartment disease.
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Affiliation(s)
- Aldo Vezzoni
- Clinica Veterinaria Vezzoni srl, via delle Vigne 190, Cremona 26100, Italy.
| | - Kevin Benjamino
- MedVet Medical and Cancer Centers for Pets, Columbus, 8155 Markhaven Drive, Columbus, OH 43235, USA
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Coghill FJ, Ho-Eckart LK, Baltzer WI. Mid- to Long-Term Outcome after Arthroscopy and Proximal Abducting Ulnar Osteotomy Versus Arthroscopy Alone in Dogs with Medial Compartment Disease: Thirty Cases. Vet Comp Orthop Traumatol 2020; 34:85-90. [PMID: 33003225 DOI: 10.1055/s-0040-1716843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine owner-assessed mid- to long-term outcome for dogs with medial compartment disease treated arthroscopically with fragment removal with or without proximal abducting ulnar osteotomy (PAUL). STUDY DESIGN This was a retrospective clinical study. MATERIALS AND METHODS Records from 30 dogs with medial compartment disease treated with arthroscopy with or without PAUL were retrospectively reviewed over a 5-year period. Proximal abducting ulnar osteotomy cases were matched to arthroscopy-alone controls based on bodyweight and modified Outerbridge score. Outcome was assessed via owner questionnaire using the Canine Brief Pain Inventory (CBPI), frequency of non-steroidal anti-inflammatory drug (NSAID) administration and owner-assessed overall improvement. RESULTS Canine Brief Pain Inventory score for dogs in the PAUL group was not significantly different from the control group (p = 0.54). Non-steroidal anti-inflammatory drug administration was similar between groups (p = 0.61) and there was no significant difference between modified Outerbridge score and outcome (p = 0.57) over a median of 43 months post-surgically (range: 7-66 months). Canine Brief Pain Inventory and NSAID use were affected by the age of the dog with dogs greater than 3 years of age at the time of surgery having a higher CBPI score and increased NSAID use regardless of the surgery that was performed. Overall, owner-assessed improvement was not different between groups (p = 0.72). CLINICAL SIGNIFICANCE Proximal abducting ulnar osteotomy showed no owner-assessed benefit over arthroscopic medial coronoid fragment removal for dogs with medial compartment disease and modified Outerbridge score of 3 or greater. A prospective, blinded, controlled clinical trial is warranted to determine the appropriate clinical application of the PAUL procedure.
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Affiliation(s)
| | | | - Wendy I Baltzer
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Amadio A, Corriveau KM, Norby B, Stephenson TR, Saunders WB. Effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment: An ex vivo canine study. Vet Surg 2020; 49:1437-1448. [PMID: 32463515 DOI: 10.1111/vsu.13425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/10/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment in standing and recumbent positions. STUDY DESIGN Ex vivo cadaveric study. SAMPLE POPULATION Canine thoracic limbs (n = 15 limb pairs). METHODS Limbs were acquired from healthy Labrador retrievers that had been euthanized for reasons unrelated to this study. A limb press was used to obtain standing and recumbent caudocranial radiographs before and after PAUL. Foot lateralization and rotation were directly measured in standing position. Mechanical joint angles were determined using full limb radiographic montages and the center of rotation of angulation (CORA) method for pre-PAUL (Pre), 2-mm PAUL (PAUL2), and 3-mm PAUL (PAUL3). Data are reported as mean ± SD and 95% CI. Mixed linear modeling was used to identify differences in limb alignment values and foot position, with significance established at P ≤ .004. RESULTS There were differences in five of 12 limb alignment values pre-PAUL and post-PAUL in standing and recumbent positions. In the standing position, there was an increase in mechanical medial proximal radioulnar angle (Pre, 80.6° ± 2.5°; PAUL2, 82.6° ± 2.4°; PAUL3, 84° ± 2.4°) and a decrease in elbow compression angle (Pre, 1.4° ± 1.3°; PAUL2, 1° ± 0.9°; PAUL3, 0.8° ± 1°). There was a movement of mechanical humeral radioulnar angle (Pre, -8.9° ± 2.8°; PAUL2, -6.1° ± 2.7°; PAUL3, -5.2 ± 2.7°), mechanical thoracic humeral angle (Pre, 3.9° ± 1.7°; PAUL2, 2.4° ± 1.4°; PAUL3, 2.6° ± 1.5°), and elbow mechanical axis deviation (Pre, 1.9% ± 1.1%; PAUL2, 0.9% ± 1.1%; PAUL3, 0.4% ± 1.4%) toward a value of "0" representing coaxial alignment of the limb. The foot underwent lateralization (Pre, 1.4 ± 0.6 cm; PAUL2, 1.8 ± 0.7 cm; PAUL3, 2.3 ± 0.7 cm) and external rotation (Pre, 10.5° ± 4.7°; PAUL2, 13.7° ± 5.1°; PAUL3, 16° ± 6.6°). CONCLUSION In the ex vivo setting, PAUL resulted in translation of the mechanical axis of the thoracic limb from a medial to lateral direction through alterations in limb alignment values associated with the elbow, humerus, and proximal radius/ulna. CLINICAL SIGNIFICANCE Additional studies are required to determine whether PAUL alters thoracic limb alignment in client-owned dogs.
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Affiliation(s)
- Alexandra Amadio
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy.,Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kayla M Corriveau
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Bo Norby
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Timothy R Stephenson
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - W Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Erosion of the medial compartment of the canine elbow: occurrence, diagnosis and currently available treatment options. Vet Comp Orthop Traumatol 2017; 28:9-18. [DOI: 10.3415/vcot-13-12-0147] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 10/23/2014] [Indexed: 11/17/2022]
Abstract
SummaryErosion of the medial compartment of the elbow joint refers to full thickness cartilage loss with exposure of the subchondral bone (modified Outerbridge grades 4–5) of the medial part of the humeral condyle (MHC) and the corresponding ulnar contact area. This finding may appear in the absence of an osteochondral fragment or a cartilage flap, or in combination with fragmentation of the medial coronoid process (MCP) or osteochondritis dissecans (OCD) of the MHC. With regard to the prognosis, it is important to diagnose these severe erosions. Imaging of cartilage lesions by means of radiography, ultrasonography, computed tomography or magnetic resonance imaging is challenging in dogs. In contrast, direct arthroscopic inspection provides detailed information about the cartilage.The treatment of these severe erosions is difficult because of the limited regenerative capacity of cartilage and presumed mechanical or physical triggering factors. Several conservative and surgical treatment methods have been proposed to treat elbows with severe cartilage defects. However, due to irreversible loss of cartilage, the prognosis in these cases remains guarded.
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Rohwedder T, Fischer M, Böttcher P. In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Vet J 2017; 7:221-228. [PMID: 28795018 PMCID: PMC5538087 DOI: 10.4314/ovj.v7i3.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022] Open
Abstract
Aim of the study was to investigate dynamic radio-ulnar incongruence (dRUI) in the
canine elbow joint comparing orthopedic healthy and dysplastic dogs in a prospective
in vivo study design. In 6 orthopedic sound elbow joints (5 dogs, median age 17
months & mean body weight 27.9 kg) and 7 elbow joints with medial coronoid
disease (6 dogs, median age 17.5 months & mean body weight 27.6 kg) 0.8 mm
Ø tantalum beads were surgically implanted into radius, ulna and humerus for
dynamic radiosteriometric analysis (RSA) using high-speed biplanar fluoroscopy with
the dogs walking on a treadmill. dRUI, in the form of proximo-distal translation of
the radius relative to the ulna, was measured for the first third of stance phase and
compared between groups using unpaired t-testing. Healthy elbow joints exhibited a
relative radio-ulnar translation of 0.7 mm (SD 0.31 mm), while dysplastic joints
showed a translation of 0.5 mm (SD 0.30 mm). No significant difference between groups
was detected (p = 0.2092, confidence interval -0.6 – 0.2). Based on these
findings dRUI is present in every canine elbow joint, as part of the physiological
kinematic pattern. However, dysplastic elbow joints do not show an increased
radio-ulnar translation, and therfore dRUI cannot be considered causative for medial
coronoid disease.
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Affiliation(s)
- Thomas Rohwedder
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
| | - Martin Fischer
- Institute of Systematic Zoology and Evolutionary Biology with Phyletic Museum, Friedrich-Schiller-University, Jena, Germany
| | - Peter Böttcher
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
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Breiteneicher AH, Norby B, Schulz KS, Kerwin SC, Hulse DA, Fox DB, Saunders WB. The Effect of Sliding Humeral Osteotomy (SHO) on Frontal Plane Thoracic Limb Alignment: An Ex Vivo Canine Cadaveric Study. Vet Surg 2016; 45:1095-1107. [DOI: 10.1111/vsu.12574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Adam H. Breiteneicher
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Bo Norby
- Department of Large Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | | | - Sharon C. Kerwin
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Don A. Hulse
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Derek B. Fox
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia Missouri
| | - W. Brian Saunders
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
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McConkey MJ, Valenzano DM, Wei A, Li T, Thompson MS, Mohammed HO, van der Meulen MCH, Krotscheck U. Effect of the Proximal Abducting Ulnar Osteotomy on Intra-Articular Pressure Distribution and Contact Mechanics of Congruent and Incongruent Canine Elbows Ex Vivo. Vet Surg 2016; 45:347-55. [DOI: 10.1111/vsu.12456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 06/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Alexander Wei
- Sibley School of Mechanical and Aerospace Engineering; Cornell University; Ithaca New York
| | - Ting Li
- Sibley School of Mechanical and Aerospace Engineering; Cornell University; Ithaca New York
| | | | | | | | - Ursula Krotscheck
- Department of Clinical Sciences; Cornell University; Ithaca New York
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