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Clark N, Comerford E. An update on mobility assessment of dogs with musculoskeletal disease. J Small Anim Pract 2023; 64:599-610. [PMID: 37455329 DOI: 10.1111/jsap.13650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/31/2023] [Accepted: 06/10/2023] [Indexed: 07/18/2023]
Abstract
Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose a notable challenge to canine health and welfare. Osteoarthritis causes the remodelling of synovial joints, alongside inflammation and impaired mechanical function which can be extremely debilitating. Secondary osteoarthritis commonly affects dogs and can be exacerbated by previous joint abnormalities, such as patellar luxation or cranial cruciate ligament rupture. Although musculoskeletal diseases can affect dogs of any age, the early subtle signs of gait abnormalities are perhaps missed by owners, thus, dogs may be in the latter stages of osteoarthritis progression when they are presented to veterinarians. Dogs showing subtle signs of gait abnormalities must be presented to veterinary practices for acute diagnosis to prevent long-term deterioration. Musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, are commonly diagnosed via visible radiographic changes. However, veterinarians can use a combination of subjective and objective clinical scoring systems, such as clinical metrology instruments and gait assessment in conjunction with radiography to aid their diagnosis and longitudinal monitoring of musculoskeletal diseases. These scoring systems may be more sensitive to earlier signs of mobility impairments in dogs, ultimately, promoting increased canine health and welfare by enabling pain reduction, improvement of muscle strength and preservation of joint function. Current canine mobility scoring systems available to veterinarians will be discussed in turn throughout this review for implementation into clinical practice.
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Affiliation(s)
- N Clark
- Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
| | - E Comerford
- Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
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Camarasa JJ, Vallefuoco R, De Vicente F. Relationship between the degree of stifle flexion and the proximal patellofemoral angle in the sagittal plane: A radiographic study. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2023; 87:191-195. [PMID: 37397632 PMCID: PMC10291729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/20/2022] [Indexed: 07/04/2023]
Abstract
The objective of this study was to evaluate the position of the patella in relation to the proximal femoral axis in the sagittal plane and to assess its reliability as a surgical landmark for femoral component placement in canine hip replacement. The relationship between the patella and the proximal femoral axis was assessed by defining the proximal patellofemoral angle in medio-lateral radiographic projections with 3 different stifle angles (full flexion, 90°, full extension) in medium to large breed skeletally mature dogs (N = 14). Proximal patellofemoral angle measurements were compared between the 3 different groups of stifle position using ANOVA for statistical analysis. The mean proximal patellofemoral angle measurements were -7.4° (± 1.3°) in the flexion group, -1.6° (± 1.5°) in the 90° group, and 2.1° (± 1.8°) in the extension group. Statistically significant differences were seen in the proximal patellofemoral angle between groups (P ≤ 0.001). These results confirm that position of the patella related to the proximal femoral axis differs depending on the degree of stifle flexion. The degree of stifle flexion should be considered in the preoperative planning and intraoperatively when using the patella as a surgical landmark in the sagittal plane for femoral canal broaching in canine total hip replacement.
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Affiliation(s)
- Juan José Camarasa
- Pride Veterinary Referrals, IVC Evidensia, Riverside Road, Derby, DE24 8HX United Kingdom (Camarasa, Vallefuoco); Veterios. C/ Arrastaria, 23. 28022. Madrid, Spain (De Vicente)
| | - Rosario Vallefuoco
- Pride Veterinary Referrals, IVC Evidensia, Riverside Road, Derby, DE24 8HX United Kingdom (Camarasa, Vallefuoco); Veterios. C/ Arrastaria, 23. 28022. Madrid, Spain (De Vicente)
| | - Felipe De Vicente
- Pride Veterinary Referrals, IVC Evidensia, Riverside Road, Derby, DE24 8HX United Kingdom (Camarasa, Vallefuoco); Veterios. C/ Arrastaria, 23. 28022. Madrid, Spain (De Vicente)
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Giansetto TE, Pierrot E, Picavet PP, Lefebvre M, Rives A, Farnir F, Claeys S, Balligand M. Patellar Proximo-Distal Displacement following Modified Maquet Technique Is Not Predictive of Patellar Luxation. Vet Comp Orthop Traumatol 2023; 36:63-67. [PMID: 36588290 DOI: 10.1055/s-0042-1757590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to test the low sensitivity of the Allberg and Miles index to the stifle opening angle, evaluate the displacement of the patella after a Modified Maquet Technique using this index and assess the incidence of patellar luxation post-Modified Maquet Technique in dogs. STUDY DESIGN Medical records were reviewed from 2012 to 2017. Allberg Miles index were determined for each stifle pre- and postoperatively, as well as the stifle joint opening of each case. Occurrence of patellar luxation was recorded. RESULTS 137 stifles on 116 dogs were reviewed. The stifle opening angle did not influence the Allberg Miles index. Pre- and postoperative index showed a distal displacement of the patella after a Modified Maquet Procedure, especially at 135° of stifle opening angle. Only 1/137 cases demonstrated patellar luxation after the surgery. CONCLUSION Based on our statistical analysis, we were able to conclude that within the maximum stifle opening angle range recorded in our series of cases; the Allberg Miles index variation was not significant. While patellar baja is clearly induced by the Modified Maquet Technique, the latter did not seem to predispose patients to post-operative patellar luxation in our study population.
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Affiliation(s)
- Thomas Elie Giansetto
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Emilie Pierrot
- Department of Diagnostic Imaging, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Pierre P Picavet
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Michael Lefebvre
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Albane Rives
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Frédéric Farnir
- Department of Veterinary Management of Animal Ressources, Biostatistics, Université de Liège Clinique Vétérinaire des Anomaix de Compagnie, Liege, Belgium
| | - Stéphanie Claeys
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
| | - Marc Balligand
- Department of Surgery, Université de Liège Clinique Vétérinaire des Animaux de Compagnie, Liege, Belgium
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Lehmann SV, Andrada E, Taszus R, Koch D, Fischer MS. Three-dimensional motion of the patella in French bulldogs with and without medial patellar luxation. BMC Vet Res 2021; 17:76. [PMID: 33579272 PMCID: PMC7881552 DOI: 10.1186/s12917-021-02787-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background French bulldogs exhibit significantly larger femoral external rotation and abduction than other breeds. We were curious as to whether this peculiar leg kinematic affects patellar motion and/or might induce medial patellar subluxation (MPSL) or medial patellar permanent luxation (MPPL). We hypothesized that the more abducted leg posture during stance causes an unusual medial pull direction of the rectus femoris muscle during stance, and that this may facilitate the occurrence of MPSL or even MPPL during locomotion. To test our hypothesis, we analyzed existing stifle-joint X-ray-sequences collected during the treadmill walk and trot of seven adult female French bulldogs. We estimated 3D-patellar kinematics using Scientific Rotoscoping. Results The three-dimensional motion of the patella comprises rotations and translations. From the seven dogs analyzed, three exhibited MPSL and one MPPL during the gait cycle. Medial patellar luxation (MPL) occurred mostly around toe-off in both gaits studied. Patellar position was generally not gait-related at the analyzed timepoints. In dogs with MPL, the patella was placed significantly more distally (p = 0.037) at touch-down (TD) and at midswing (p = 0.024), and significantly more medial at midswing (p = 0.045) compared to dogs without MPL. Conclusions Medial patellar luxation seems to be the consequence of the far from parasagittal position of the stifle joint during stance due to a broad trunk, and a wide pelvis. This peculiar leg orientation leads to a medial sideway pull caused by the rectus femoris muscle and the quadriceps femoris and may initiate plastic deformation of the growing femur and tibia. Thus, a way to avoid MPL could be to control breeding by selecting dogs with lean bodies and narrow pelvis. Actual breeding control programs based on the orthopedic examination are susceptible to errors. Systematic errors arise from the fact that the grading system is highly dependent on the dog’s condition and the veterinarians’ ability to perform the palpation on the stifle. Based on our results, the position of the patella at TD, or even perhaps during stand might offer a possibility of an objective radioscopic diagnostic of the MPL. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-02787-z.
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Affiliation(s)
- Silvia V Lehmann
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany.
| | - Emanuel Andrada
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Roxana Taszus
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Daniel Koch
- Daniel Koch Kleintierchirurgie AG, Diessenhofen, Switzerland
| | - Martin S Fischer
- Institute of Zoology and Evolutionary Research, Friedrich-Schiller-University Jena, Jena, Germany
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Agnello KA, Hayashi K, Brown DC. Arthroscopic Articular Cartilage Scores of the Canine Stifle Joint with Naturally Occurring Cranial Cruciate Ligament Disease. Vet Comp Orthop Traumatol 2020; 34:153-160. [PMID: 33142348 DOI: 10.1055/s-0040-1719064] [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 This study aimed to evaluate frequency, location and severity of cartilage pathology in dogs with naturally occurring cranial cruciate ligament (CCL) disease. STUDY DESIGN Stifle arthroscopic video recordings (n = 120) were reviewed. A modified Outerbridge classification system (MOCS) (0-4) was used to score cartilage at 10 locations in the femorotibial (medial and lateral femoral condyles and tibial plateaus) and patellofemoral compartments (proximal, middle and distal locations of the patella and femoral trochlear groove) of the stifle joint. Synovial pathology was scored and the presence of a medial meniscal tear was recorded. A Kruskal-Wallis test was used to evaluate association of location and synovitis with cartilage score; and presence of meniscal tear with cartilage and synovitis scores. Bonferroni correction was utilized and p < 0.05 was considered significant. RESULTS Cartilage pathology and synovitis were identified in all joints. Overall cartilage severity scores were low (median MOCS 1). The median MOCS of the proximal trochlear groove (2) was significantly higher than all other locations evaluated. Higher synovitis scores were significantly associated with higher cartilage severity scores and a medial meniscal tear had no association with cartilage severity scores or synovitis. CONCLUSION Arthroscopic articular cartilage lesions are common in dogs with CCL disease at the time of surgical intervention, although the severity of cartilage damage is mild. The proximal trochlear groove of the femur had the most severe cartilage score in the stifle joint.
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Affiliation(s)
- Kimberly A Agnello
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania, United States
| | - Kei Hayashi
- Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, New York, United States
| | - Dorothy Cimino Brown
- Companion Animal Research, Elanco Animal Health, Greenfield, Indiana, United States
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Yoo YH, Lee SJ, Jeong SW. Effects of quadriceps angle on patellofemoral contact pressure. J Vet Sci 2020; 21:e69. [PMID: 33016016 PMCID: PMC7533392 DOI: 10.4142/jvs.2020.21.e69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/06/2020] [Accepted: 07/29/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND An inappropriate Q angle may affect the biomechanics of the canine patellofemoral joint. OBJECTIVES The purpose of this study was to evaluate the effects of changes in quadriceps angle (Q angle) on patellofemoral joint pressure distribution in dogs. METHODS Eight stifles were positioned at 45, 60, 75, 90, 105, and 120° of flexion in vitro, and 30% body weight was applied through the quadriceps. Patellofemoral contact pressure distribution was mapped and quantified using pressure-sensitive film. For the pressure area, mean pressure, peak pressure, medial peak pressure, and lateral peak pressure, differences between groups according to conditions for changing the Q angle were statistically compared. RESULTS Increases of 10° of the Q angle result in increases in the pressure area (P = 0.04), mean pressure (P = 0.003), peak pressure, and medial peak pressure (P ≤ 0.01). Increasing the Q angle by 20° increases the pressure area (P = 0.021), mean pressure (P ≤ 0.001), peak pressure (P ≤ 0.01), and medial peak pressure (P ≤ 0.01) significantly, and shows higher mean (P ≤ 0.001) and peak pressures than increasing by 10°. Decreasing the Q angle increases the mean pressure (P = 0.013), peak pressure, and lateral peak pressure (P ≤ 0.001). CONCLUSIONS Both increases and decreases in the Q angle were associated with increased peak patellofemoral pressure, which could contribute to the overloading of the cartilage. Therefore, the abnormal Q angle should be corrected to the physiologically normal value during patellar luxation repair and overcorrection should be avoided.
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Affiliation(s)
- Yoon Hyeong Yoo
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Sung Jun Lee
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Soon Wuk Jeong
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.
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Sandberg GS, Torres BT, Budsberg SC. Review of kinematic analysis in dogs. Vet Surg 2020; 49:1088-1098. [PMID: 32609926 DOI: 10.1111/vsu.13477] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 05/17/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022]
Abstract
Objective gait analysis techniques aid investigators in the study of motion. Kinematic gait analysis techniques that objectively quantitate motion are valuable tools used to understand normal and abnormal motion in domestic animals. Recent advances in video technology have made the study of motion more readily accessible. Available systems can document gait in two or three dimensions (2D or 3D, respectively). Knowledge of fundamental gait analysis concepts is critical to generating meaningful data. The objective of this report is to review principles of kinematic data collection and analyses, with a focus on differences between 2D and 3D systems.
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Affiliation(s)
- Gabriella S Sandberg
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia
| | - Bryan T Torres
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri
| | - Steven C Budsberg
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia.,Department of Comparative Physiology and Pharmacology, University of Georgia, Athens, Georgia
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Zann GJ, Kim SE, Tinga S, Pozzi A, Banks SA. The effect of tibial plateau leveling osteotomy on patellofemoral kinematics in dogs: An in vivo study. Vet Surg 2019; 49:207-213. [PMID: 31373719 DOI: 10.1111/vsu.13300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/11/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To quantitatively evaluate patellofemoral (PF) kinematics during walking in dogs with cranial cruciate ligament (CrCL) deficiency treated by tibial plateau leveling osteotomy (TPLO). STUDY DESIGN Longitudinal observational study. ANIMALS Dogs with unilateral CrCL deficiency treated by TPLO (n = 10). METHODS Horizontal beam fluoroscopic images of the stifles during treadmill walking were acquired 6 months after TPLO. Computed tomography was performed, and digitized bone models of both femurs and patellae were created. These digital models were superimposed over the fluoroscopic images with shape-matching software, and sagittal plane PF kinematics for TPLO-treated and normal contralateral stifles were calculated. Patellofemoral kinematics were described according to phase of gait cycle as well as relative to femorotibial flexion angle. RESULTS In TPLO-treated stifles, there was an approximately 1-mm increase in cranial displacement of the patella (P < .05) compared with the normal stifle at equivalent femorotibial flexion angles between 120° and 140° and predominately during the stance phase. Proximal-distal translation and patellar flexion angle were mostly unaffected by TPLO when they were assessed according to either equivalent phase of gait cycle or femorotibial flexion angles. CONCLUSION In vivo PF kinematics in TPLO-treated stifles were subtly different from normal, characterized by slight cranial shifting of the patella relative to the trochlear groove. CLINICAL SIGNIFICANCE The clinical significance of these results remains unknown. These results may provide further understanding into extensor mechanism abnormalities associated with TPLO.
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Affiliation(s)
- Geoffrey J Zann
- Comparative Orthopaedics Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Stanley E Kim
- Comparative Orthopaedics Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Selena Tinga
- Comparative Orthopaedics Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Antonio Pozzi
- Comparative Orthopaedics Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Scott A Banks
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida
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Kim SE, Zann GJ, Tinga S, Moore EJ, Pozzi A, Banks SA. Patellofemoral kinematics in dogs with cranial cruciate ligament insufficiency: an in-vivo fluoroscopic analysis during walking. BMC Vet Res 2017; 13:250. [PMID: 28818107 PMCID: PMC5561607 DOI: 10.1186/s12917-017-1186-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 08/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Complete rupture of the cranial cruciate ligament (CrCL) in dogs causes profound disturbance to stifle joint biomechanics. The objective of this study was to characterize the effects of cranial cruciate ligament (CrCL) insufficiency on patellofemoral (PF) kinematics in dogs during walking. Ten client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Dogs underwent computed tomographic scans to create digital bone-models of the patella and femur. Lateral projection fluoroscopy of the stifles was performed during treadmill walking. Sagittal plane PF kinematics were calculated throughout the gait cycle by overlaying digital bone models on fluoroscopic images using a previously described 2D-3D registration technique. For acquisition of kinematics in the contralateral (control) stifle, fluoroscopy was repeated 6-months after stabilizing surgery of the affected side. Results were compared between the pre-operative CrCL-deficient and 6-month post-operative control stifles. Results Craniocaudal PF translation was similar between CrCL-deficient and control stifles throughout the gait cycle. The patella was more distal and positioned in greater flexion throughout the gait cycle in CrCL-deficient stifles when compared to the control stifle at equivalent time points. There was no significant difference in PF poses between CrCL-deficient and control stifles at equivalent femorotibial flexion angles; however, common femorotibial flexion angles were only found over a small range during the swing phase of gait. Conclusions CrCL insufficiency altered PF kinematics during walking, where the changes were predominately attributable to the femorotibial joint being held in more flexion. Abnormal PF kinematics may play a role in the development of osteoarthritis that is commonly observed in the PF joint CrCL-deficient stifles.
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Affiliation(s)
- Stanley E Kim
- Department of Mechanical & Aerospace Engineering and Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave, Gainesville, FL, 32610-0126, USA.
| | - Geoffrey J Zann
- Department of Mechanical & Aerospace Engineering and Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave, Gainesville, FL, 32610-0126, USA
| | - Selena Tinga
- Department of Mechanical & Aerospace Engineering and Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave, Gainesville, FL, 32610-0126, USA
| | - Erica J Moore
- Department of Mechanical & Aerospace Engineering and Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave, Gainesville, FL, 32610-0126, USA
| | - Antonio Pozzi
- Department of Mechanical & Aerospace Engineering and Comparative Orthopaedics and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, PO Box 100126, 2015 SW 16th Ave, Gainesville, FL, 32610-0126, USA
| | - Scott A Banks
- Department of Mechanical & Aerospace Engineering, University of Florida, 231 MAE-A, PO Box 116250, Gainesville, FL, 32611, USA
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