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Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
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Surgical Treatments for Canine Anterior Cruciate Ligament Rupture: Assessing Functional Recovery Through Multibody
Giovanni Putame1, Mara Terzini1, Cristina Bignardi1
1PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
Frontiers in Bioengineering and Biotechnology
|August 27, 2019
Summary
Tibial plateau leveling osteotomy (TPLO) and center of rotation of angulation leveling osteotomy (CBLO) both treat anterior cruciate ligament (ACL) deficiency. While TPLO may increase intra-articular forces, both methods show comparable results in simulations.
Area of Science:
- Veterinary Surgery
- Biomechanics
- Orthopedics
Background:
- Anterior cruciate ligament (ACL) deficiency leads to degenerative stifle joint injuries.
- Tibial plateau leveling osteotomy (TPLO) is a common surgical treatment, but alternatives like center of rotation of angulation leveling osteotomy (CBLO) are being explored.
Purpose of the Study:
- To compare the effectiveness of TPLO and CBLO in treating canine ACL rupture using computational modeling.
- To evaluate biomechanical outcomes including tibial translation and joint forces.
Main Methods:
- A 3D computational multibody model of a canine stifle joint was created.
- Ligament forces and articular contacts were simulated.
- ACL deficiency was modeled, followed by virtual TPLO and CBLO procedures.
- Drawer tests and weight-bearing squat simulations were performed.
Main Results:
- ACL deficiency increased anterior tibial translation by 5.2 mm; CBLO and TPLO showed similar results in simulations.
- Both osteotomies increased joint forces compared to the physiological model.
- TPLO resulted in higher intra-articular compressive forces at wider flexion angles (117°-135°) compared to CBLO.
Conclusions:
- Both TPLO and CBLO can address tibial translation following ACL deficiency.
- TPLO may lead to higher intra-articular compressive forces, warranting careful consideration in clinical application.
- Further research is needed to establish CBLO as a viable alternative to TPLO.
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