Estimation of footprints of the canine stifle ligaments using deformable shape templates of bones

Knowledge regarding the ligament footprints in the canine stifle is essential for biomechanical modeling of the joint and patient-specific surgical planning for anatomical ligament reconstruction. The present study aimed to establish and evaluate deformable shape templates (DSTs) of the femur and tibia with footprints of the cruciate and collateral ligaments embedded for the noninvasive estimation of ligament footprint positions. To this end, a data set of computed tomography (CT)-derived surface models of the femur and tibia were established and used to build statistical shape models (SSMs). The contours of the stifle ligaments were obtained from CT scans of 27 hindlimb specimens with radio-opaque markings on the ligament footprints. The DST, constructed by embedding averaged footprint contours into the SSM, was used to estimate subject-specific ligament footprints in a leave-one-out cross-validation framework. The DST predictions were compared with those derived from radio-opaque-marked footprints. The results showed that the averaged Euclidean distances between the estimated and reference footprint centroids were less than 1.2 mm for the cruciate ligaments and 2.0 mm for the collateral ligaments. The DST appeared to provide a feasible alternative approach for noninvasively estimating the footprints of the stifle ligaments in vivo.

Development of a three-dimensional computer model of the canine pelvic limb including cruciate ligaments to simulate movement

Gait analysis as subjective visual assessment forms the foundation of the veterinarian's lameness examination. Pelvic limb lameness is frequently seen in dogs and the stifle joint with its cruciate ligaments, is a main cause of lameness due to cruciate ligament deficiency. In this study, we developed an open-source three-dimensional musculoskeletal pelvic limb model of a 30 kg Labrador Retriever including cruciate ligaments, simulating the gait cycle of the walking movement with the open-source programs NMSBuilder (Institutio Ortopedico Rizzoli, Bologna, Italy) and OpenSim (National Center for Simulation in Rehabilitation Research (NCSRR), Stanford, CA, USA). The computer model generated muscle activations based on motion data. The computed activations were similar to experimental electromyogram data. Highest joint torque was in extension/flexion in the stifle joint at 54 Nm at 14% of the gait cycle with cruciate ligaments. Highest stifle joint reaction force was 408 N at 16% of the gait cycle and was reduced after adding cruciate ligaments. Especially the cranial cruciate ligament loads up to 102 N (34% body weight). Cranial cruciate ligament forces increase with stifle extension and decrease with stifle flexion. On the contrary, the caudal cruciate ligament loads up to 27 N (9% body weight) during the swing phase with a flexed stifle joint. The model was validated with electromyogram data. The model's predictions are plausible because joint torques and forces match the applied ground reaction forces in curve progression and in timing. This model forms a basis for further investigations into stifle surgery after cruciate ligament deficiency.

Development of a Canine Rigid Body Musculoskeletal Computer Model to Evaluate Gait

Background

Kinematic and kinetic analysis have been used to gain an understanding of canine movement and joint loading during gait. By non-invasively predicting muscle activation patterns and forces during gait, musculoskeletal models can further our understanding of normal variability and muscle activation patterns and force profiles characteristic of gait.

Methods

Pelvic limb kinematics and kinetics were measured for a 2 year old healthy female Dachshund (5.4 kg) during gait using 3-D motion capture and force platforms. A computed tomography scan was conducted to acquire pelvis and pelvic limb morphology. Using the OpenSim modeling platform, a bilateral pelvic limb subject-specific rigid body musculoskeletal computer model was developed. This model predicted muscle activation patterns, muscle forces, and angular kinematics and joint moments during walking.

Results

Gait kinematics determined from motion capture matched those predicted by the model, verifying model accuracy. Primary muscles involved in generating joint moments during stance and swing were predicted by the model: at mid-stance the adductor magnus et brevis (peak activation 53.2%, peak force 64.7 N) extended the hip, and stifle flexor muscles (biceps femoris tibial and calcaneal portions) flexed the stifle. Countering vertical ground reaction forces, the iliopsoas (peak activation 37.9%, peak force 68.7 N) stabilized the hip in mid-stance, while the biceps femoris patellar portion stabilized the stifle in mid-stance and the plantar flexors (gastrocnemius and flexor digitorum muscles) stabilized the tarsal joint during early stance. Transitioning to swing, the iliopsoas, rectus femoris and tensor fascia lata flexed the hip, while in late swing the adductor magnus et brevis impeded further flexion as biceps femoris tibial and calcaneal portions stabilized the stifle for ground contact.

Conclusion

The musculoskeletal computer model accurately replicated experimental canine angular kinematics associated with gait and was used to predict muscle activation patterns and forces. Thus, musculoskeletal modeling allows for quantification of measures such as muscle forces that are difficult or impossible to measure in vivo.

Surgical Treatments for Canine Anterior Cruciate Ligament Rupture: Assessing Functional Recovery Through Multibody Comparative Analysis

Anterior cruciate ligament (ACL) deficiency can result in serious degenerative stifle injuries. Although tibial plateau leveling osteotomy (TPLO) is a common method for the surgical treatment of ACL deficiency, alternative osteotomies, such as a leveling osteotomy based on the center of rotation of angulation (CBLO) are described in the literature. However, whether a CBLO could represent a viable alternative to a TPLO remains to be established. The aim of this study is to compare TPLO and CBLO effectiveness in treating ACL rupture. First, a computational multibody model of a physiological stifle was created using three-dimensional surfaces of a medium-sized canine femur, tibia, fibula and patella. Articular contacts were modeled by means of a formulation describing the contact force as function of the interpenetration between surfaces. Moreover, ligaments were represented by vector forces connecting origin and insertion points. The lengths of the ligaments at rest were optimized simulating the drawer test. The ACL-deficient model was obtained by deactivating the ACL related forces in the optimized physiological one. Then, TPLO and CBLO treatments were virtually performed on the pathological stifle. Finally, the drawer test and a weight-bearing squat movement were performed to compare the treatments effectiveness in terms of tibial anteroposterior translation, patellar ligament force, intra-articular compressive force and quadriceps force. Results from drawer test simulations showed that ACL-deficiency causes an increase of the anterior tibial translation by up to 5.2 mm, while no remarkable differences between CBLO and TPLO were recorded. Overall, squat simulations have demonstrated that both treatments lead to an increase of all considered forces compared to the physiological model. Specifically, CBLO and TPLO produce an increase in compressive forces of 54% and 37%, respectively, at 90° flexion. However, TPLO produces higher compressive forces (up to 16%) with respect to CBLO for wider flexion angles ranging from 135° to 117°. Conversely, TPLO generates lower forces in patellar ligament and quadriceps muscle, compared to CBLO. In light of the higher intra-articular compressive force over the physiological walking range of flexion, which was observed to result from TPLO in the current study, the use of this technique should be carefully considered.

A three dimensional multiplane kinematic model for bilateral hind limb gait analysis in cats

Background

Kinematic gait analysis is an important noninvasive technique used for quantitative evaluation and description of locomotion and other movements in healthy and injured populations. Three dimensional (3D) kinematic analysis offers additional outcome measures including internal-external rotation not characterized using sagittal plane (2D) analysis techniques.

Methods

The objectives of this study were to 1) develop and evaluate a 3D hind limb multiplane kinematic model for gait analysis in cats using joint coordinate systems, 2) implement and compare two 3D stifle (knee) prediction techniques, and 3) compare flexion-extension determined using the multiplane model to a sagittal plane model. Walking gait was recorded in 3 female adult cats (age = 2.9 years, weight = 3.5 ± 0.2 kg). Kinematic outcomes included flexion-extension, internal-external rotation, and abduction-adduction of the hip, stifle, and tarsal (ankle) joints.

Results

Each multiplane stifle prediction technique yielded similar findings. Joint angles determined using markers placed on skin above bony landmarks in vivo were similar to joint angles determined using a feline hind limb skeleton in which markers were placed directly on landmarks ex vivo. Differences in hip, stifle, and tarsal joint flexion-extension were demonstrated when comparing the multiplane model to the sagittal plane model.

Conclusions

This multiplane cat kinematic model can predict joint rotational kinematics as a tool that can quantify frontal, transverse, and sagittal plane motion. This model has multiple advantages given its ability to characterize joint internal-external rotation and abduction-adduction. A further, important benefit is greater accuracy in representing joint flexion-extension movements.

Biomechanics of an orthosis-managed cranial cruciate ligament-deficient canine stifle joint predicted by use of a computer model

OBJECTIVE To evaluate effects of an orthosis on biomechanics of a cranial cruciate ligament (CrCL)-deficient canine stifle joint by use of a 3-D quasistatic rigid-body pelvic limb computer model simulating the stance phase of gait and to investigate influences of orthosis hinge stiffness (durometer). SAMPLE A previously developed computer simulation model for a healthy 33-kg 5-year-old neutered Golden Retriever. PROCEDURES A custom stifle joint orthosis was implemented in the CrCL-deficient pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation in the orthosis-stabilized stifle joint (baseline scenario; high-durometer hinge]) were determined and compared with values for CrCL-intact and CrCL-deficient stifle joints. Sensitivity analysis was conducted to evaluate the influence of orthosis hinge stiffness on model outcome measures. RESULTS The orthosis decreased loads placed on the caudal cruciate and lateral collateral ligaments and increased load placed on the medial collateral ligament, compared with loads for the CrCL-intact stifle joint. Ligament loads were decreased in the orthosis-managed CrCL-deficient stifle joint, compared with loads for the CrCL-deficient stifle joint. Relative tibial translation and rotation decreased but were not eliminated after orthosis management. Increased orthosis hinge stiffness reduced tibial translation and rotation, whereas decreased hinge stiffness increased internal tibial rotation, compared with values for the baseline scenario. CONCLUSIONS AND CLINICAL RELEVANCE Stifle joint biomechanics were improved following orthosis implementation, compared with biomechanics of the CrCL-deficient stifle joint. Orthosis hinge stiffness influenced stifle joint biomechanics. An orthosis may be a viable option to stabilize a CrCL-deficient canine stifle joint.

Surface electromyography in animal biomechanics: A systematic review

The study of muscle activity using surface electromyography (sEMG) is commonly used for investigations of the neuromuscular system in man. Although sEMG has faced methodological challenges, considerable technical advances have been made in the last few decades. Similarly, the field of animal biomechanics, including sEMG, has grown despite being confronted with often complex experimental conditions. In human sEMG research, standardised protocols have been developed, however these are lacking in animal sEMG. Before standards can be proposed in this population group, the existing research in animal sEMG should be collated and evaluated. Therefore the aim of this review is to systematically identify and summarise the literature in animal sEMG focussing on (1) species, breeds, activities and muscles investigated, and (2) electrode placement and normalisation methods used. The databases PubMed, Web of Science, Scopus, and Vetmed Resource were searched systematically for sEMG studies in animals and 38 articles were included in the final review. Data on methodological quality was collected and summarised. The findings from this systematic review indicate the divergence in animal sEMG methodology and as a result, future steps required to develop standardisation in animal sEMG are proposed.

Canine Stifle Biomechanics Associated With a Novel Extracapsular Articulating Implant Predicted Using a Computer Model

OBJECTIVE

To evaluate the influence of the Simitri Stable in Stride™ extracapsular articulating implant (EAI) on canine stifle biomechanics in the cranial cruciate ligament (CrCL)-deficient stifle using a 3-dimensional (3D) quasi-static rigid body canine pelvic limb computer model simulating the stance phase of gait.

STUDY DESIGN

Computer simulations.

ANIMALS

Five-year-old neutered male golden retriever (33 kg).

METHODS

The EAI was implemented in a previously developed 3D CrCL-deficient canine pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared to the CrCL-intact and CrCL-deficient stifle.

RESULTS

The EAI significantly increased peak caudal cruciate and medial collateral ligament loads, significantly changed when peak lateral collateral ligament load occurred, and did not significantly affect peak patellar ligament load compared to the CrCL-intact stifle. Compared to the CrCL-deficient stifle, peak caudal cruciate, lateral collateral, and medial collateral ligament loads significantly decreased in the EAI-managed stifle. Despite decreased peak caudal cruciate ligament loading, the EAI-managed stifle generated local maxima that exceeded those of the CrCL-deficient stifle at various intervals of stance. Peak relative tibial translation and rotation significantly decreased in the EAI-managed stifle compared to the CrCL-deficient stifle.

CONCLUSION

Model-predicted stifle biomechanics differed after EAI system application in the CrCL-deficient stifle, but were not restored to that of the CrCL-intact stifle.

Canine Stifle Biomechanics Associated With Tibial Tuberosity Advancement Predicted Using a Computer Model

OBJECTIVE

To evaluate the effects of tibial tuberosity advancement (TTA) on canine biomechanics in the cranial cruciate ligament (CrCL)-deficient stifle using a 3-dimensional quasi-static rigid body pelvic limb computer model simulating the stance phase of gait.

STUDY DESIGN

Computer simulations.

ANIMALS

A 5-year-old neutered male Golden Retriever weighing 33 kg.

METHODS

A TTA was implemented in a previously developed canine pelvic limb computer model using the tibial plateau slope and common tangent planning techniques. Ligament loads, relative tibial translation, and relative tibial rotation were determined and compared to CrCL-intact and CrCL-deficient stifles.

RESULTS

The TTA significantly decreased peak caudal cruciate ligament load, significantly increased peak lateral collateral ligament load, and significantly changed peak medial collateral ligament load occurrence, while there was no significant difference in peak patellar ligament load compared to the CrCL-intact stifle. Compared to the CrCL-deficient stifle, peak caudal cruciate, lateral collateral and medial collateral ligament loads significantly decreased, while peak patellar ligament load was similar, peak relative tibial translation significantly decreased and peak relative tibial rotation was converted to external rotation in the TTA-treated stifle. Each TTA planning technique generated similar caudal cruciate, medial collateral, and patellar ligament loading as well as relative tibial translation, but lateral collateral ligament loading and occurrence of relative tibial rotation differed significantly across the techniques.

CONCLUSIONS

Model-predicted stifle ligament loads improved following TTA compared to the CrCL-deficient stifle, but TTA did not restore CrCL-intact stifle biomechanics. The TTA effectively reduced tibial translation, but tibial rotation was not stabilized.

Evaluation of varying morphological parameters on the biomechanics of a cranial cruciate ligament-deficient or intact canine stifle joint with a computer simulation model

OBJECTIVE

To investigate the influence of varying morphological parameters on canine stifle joint biomechanics by use of a 3-D rigid-body canine pelvic limb computer model that simulated an intact and cranial cruciate ligament (CrCL)-deficient stifle joint across the stance phase of gait at a walk.

SAMPLE

Data from computer simulations.

PROCEDURES

Computer model morphological parameters, including patellar ligament insertion location, tibial plateau angle (TPA), and femoral condyle diameter (FCD), were incrementally altered to determine their influence on outcome measures (ligament loads, relative tibial translation, and relative tibial rotation) during simulation of the stance phase of gait at a walk. Outcome measures were assessed for each scenario and compared between an intact and CrCL-deficient stifle joint with the sensitivity index (the percentage change in outcome measure divided by the percentage change in input parameter).

RESULTS

In a CrCL-intact stifle joint, ligament loads were most sensitive to TPA. In a CrCL-deficient stifle joint, outcome measures were most sensitive to TPA with the exception of caudal cruciate ligament and lateral collateral ligament loads, which were sensitive to FCD and TPA. Relative tibial translation was sensitive to TPA and patellar ligament insertion location, whereas relative tibial rotation was most sensitive to TPA.

CONCLUSIONS AND CLINICAL RELEVANCE

The computer model sensitivity analyses predicted that individual parameters, particularly TPA and FCD, influence stifle joint biomechanics. Therefore, tibial and femoral morphological parameters may affect the likelihood, prevention, and management of CrCL deficiency.