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PubMed2002

Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 2: tarsus and stifle.

This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the hindlimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the tarsometatarsal, centrodistal and tarsocrural joints, and the 3 synovial compartments of the stifle in 33 fresh equine cadavers. The tarsometatarsal joint and one synovial compartment of the stifle in the left limb and the centrodistal joint and a different synovial compartment of the stifle in the right limbs were injected with mepivacaine. Following flexion and extension of the limb, synovial fluid was aspirated from the noninjected centrodistal and tarsometatarsal joints and the tarsocrural joints of the hock and the noninjected compartments of the stifle. Concentrations of mepivacaine in these samples were assayed using an enzyme linked immunosorbent assay. For samples obtained by dilution of synovial fluid the concentration of mepivacaine was determined by comparing the concentration of urea in the diluted synovial fluid and the concentrations of the serum urea. Mepivacaine was detected in 25/25 (100%) adjacent tarsometatarsal and centrodistal joints after diffusion in both directions, in 23/25 (92%) of tarsocrural joints after diffusion from tarsometatarsal joints and in 22/25 (88%) tarsocrural joints after diffusion from centrodistal joints in the hocks. Diffusion from the femoropatellar to medial and lateral femorotibial joints and between the medial and lateral femorotibial joints in both directions were 20/20 (100%). Diffusion from the lateral femorotibial to the femoropatellar joint was 18/20 (90%) and from the medial femorotibial to femoropatellar joints 17/20 (85%). Mepivacaine was detected at concentrations >0.3 mg/l in a proportion of samples ranging from 15/25 (60%) in the tarsocrural joint following tarsometatarsal joint injection to 18/20 (90%) in the lateral femorotibial joint after femoropatellar joint injection. At mepivacaine concentrations >100 mg/l, detection ranged from 3/20 (15%) in the lateral femorotibial joint from the medial femorotibial joint to 19/25 (76%) in the centrodistal joint from the tarsometatarsal joint. At mepivacaine concentrations >300 mg/l, detection ranged from 1/25 (4%) in the tarsocrural joint from the tarsometatarsal joint to 16/25 (64%) in the from centrodistal joint the tarsometatarsal joint. The results show greater diffusion of mepivacaine between these adjacent synovial structures than assumed from previous anatomical, latex injection and contrast arthrographic studies. Therefore, commonly performed intrasynovial local analgesic techniques in the hindlimb of the horse are not as specific as first thought.

Anesthetics, Local↗
PubMed2005

The evaluation of extracorporeal shockwave therapy in naturally occurring osteoarthritis of the stifle joint in dogs.

Extracorporeal shockwave therapy (ESWT) has expanded from the original uses of human urinary calculi treatment to veterinary orthopaedic applications. This paper investigates the feasibility and efficacy of treating dogs with osteoarthritis of the stifle joint with ESWT. In this study, dogs with persistent stifle lameness despite previous surgical or medical treatment were either treated with ESWT or served as untreated controls. The more lame rear limb of each dog was determined by force platform analysis. The range of motion (ROM) of the stifle joints was assessed by goniometry. Force platform gait analysis and goniometry were performed on both groups for four visits at three-week intervals and a final examination four weeks later. Shock wave therapy was performed three times on the treated dogs, once at each of the first three examinations. A placebo treatment consisting of clipping and wetting the hair was performed on the control dogs. The vertical forces were evaluated for objective analysis of treatment response. For peak vertical force (PVF), four of seven treated dogs improved, while only one of five of control dogs improved. The PVF for the within group analysis did not show any significant change for the treated group, however, the control group has a significant decrease (p = 0.05) in PVF consistent with an increase in lameness. The range of motion (ROM) of the stifle joint improved in five of seven treated dogs and three of five controls. Dogs in the treated group had a trend toward increased ROM (p = 0.07) and a 'positive slope' when compared to dogs in the control group which did not have a significant change (p = 0.78) and had a negative slope indicating the dogs were developing a decrease in ROM. The subjective data provided by client questionnaire did not show significant difference between groups.

Animals↗
PubMed1995

Methods and errors in measurements of synovial fluid volume in stifles with low volume and high viscosity synovial fluid. An experimental study in goats.

Synovial fluid (SF) volume was calculated using various methods in the stifles of goats, in which the cranial cruciate ligament had been transected on one side. Measurements were performed prior to surgery and again 4, 8, and 18 weeks following surgery, by measuring the dilution of an injected radioactive tracer diluted by the SF. Later, 7 months following surgery, SF volume measurements using simple arthrocentesis were performed on stifles in 9 of the goats, and the SF that could not be aspirated, was calculated using 2 indirect methods simultaneously on identical fluids in 3 of these goats. SF was also collected directly during staged arthrotomy of the stifles in 4 goats. There were conflicting results between methods, but the resulting calculated SF volumes seemed to be larger in the operated stifles compared to the controls for all the methods at about the same degree. The 2 indirect methods used to calculate the fluid remaining in the joints following arthrocentesis gave disparate volume calculations. The experiments revealed sources of error in all methods. Direct methods failed to acquire the total fluid volume, and indirect methods were subject to improper mixing and escape of the injected fluid or synovial fluid or both. It was concluded that none of the methods could be used to measure the "true" volume of SF, if such a concept exists and can be defined. None of the methods were considered reliable to compare volumes in different type of joints containing this type of fluid. It was, however, concluded that all the methods gave indication of increased SF volume present on a relative basis when paired joints were compared.

Animals↗
PubMed2006

Dynamic in vivo kinematics of the intact ovine stifle joint.

The ovine stifle joint is a promising model for the investigation of joint mechanobiology in both normal and pathological states. The objectives of this study were to characterize three-dimensional (3D) joint motion in the intact ovine stifle joint during walking, incline walking, and trotting; to determine the range of variability in normal joint motion (intrasubject and intersubject); and to characterize the 3D ground reaction forces in the ovine hind limb during walking. 3D in vivo kinematics were measured in the right hind limb of eight sheep during walking, incline walking, and trotting on a treadmill (accuracy: 0.4 +/- 0.4 mm, 0.4 +/- 0.4 degrees). 3D ground reaction forces were measured in the hind limbs of the same subjects during walking. Joint flexion ranged from 43.1 to 77.0 degrees, and was coupled with abduction (0.0-4.1 degrees ), internal rotation (5.9-17.6 degrees), and translations in the medial (5.1-7.3 mm), anterior (21.9-23.8 mm), and superior (6.0-11.4 mm) directions. Kinematics were similar during walking, incline walking, and trotting. Intrasubject variability was small, ranging from 0.4-2.0 degrees for rotations, and 0.4-0.5 mm for translations. The active range of joint motion was offset between subjects leading to intersubject variability of 4.1-7.4 degrees for rotations and 2.5-4.2 mm for translations. Peak vertical ground reaction forces in the hind limbs ranged from 34.5(+/-1.6) to 50.0(+/-5.6)% body weight. This study establishes the bounds of normal motion in the intact ovine stifle joint and provides baseline data for further studies of joint mechanobiology in this model.

Animals↗
PubMed2006

Ultrasonographic, computed tomographic and magnetic resonance imaging anatomy of the normal canine stifle joint.

Ultrasonographic (US), magnetic resonance (MR) and computed tomographic (CT) images of normal canine stifle joints were obtained and compared with plastinated cross-sectional slices of cadaver specimens from the same dogs. The bony and articular structures were identified and correlated with the three diagnostic imaging modalities. These results provide an atlas of normal cross-sectional US, MR and CT anatomy of the canine stifle, which can be used for the interpretation of stifle images from any of these imaging modalities.

Anatomy, Cross-Sectional↗
PubMedDate not supplied

Effect of tibial plateau leveling on stability of the canine cranial cruciate-deficient stifle joint: an in vitro study.

OBJECTIVE: To evaluate the effect of tibial plateau leveling on joint motion in canine stifle joints in which the cranial cruciate ligament (CCL) had been severed. STUDY DESIGN: In vitro cadaver study. ANIMALS: Six canine cadaver hind legs. METHODS: Radiographs of the stifle joints were made to evaluate the tibial plateau angle with respect to the long axis of the tibia. The specimens were mounted in a custom-made testing device to measure cranio-caudal translation of the tibia with respect to the femur. An axial load was applied to the tibia, and its position was recorded in the normal stifle, after transection of the CCL, and after tibial plateau leveling. Further, the amount of caudal tibial thrust was measured in the tibial plateau leveled specimen while series of eight linearly increasing axial tibial loads were applied. RESULTS: Transection of the CCL resulted in cranial tibial translation when axial tibial load was applied. After tibial plateau leveling, axial loading resulted in caudal translation of the tibia. Increasing axial tibial load caused a linear increase in caudal tibial thrust in all tibial plateau-leveled specimens. CONCLUSIONS: After tibial plateau leveling, axial tibial load generates caudal tibial thrust, which increases if additional axial load is applied. CLINICAL RELEVANCE: Tibial plateau leveling osteotomy may prevent cranial translation during weight bearing in dogs with CCL rupture by converting axial load into caudal tibial thrust. The amount of caudal tibial thrust seems to be proportional to the amount of weight bearing.

Animals↗
PubMedDate not supplied

Changes in the local regulation of insulin-like growth factors I and II and insulin-like growth factor-binding proteins in osteoarthritis of the canine stifle joint secondary to cruciate ligament rupture.

OBJECTIVES: To investigate changes in concentrations of insulin-like growth factors I (IGF-I) and II (IGF-II) and the expression of IGF-binding proteins (IGFBP) in synovial fluids from dogs with naturally occurring osteoarthritis (OA) of the canine stifle joint secondary to cranial cruciate ligament (CCL) rupture. STUDY DESIGN: Prospective study with synovial fluid sampling from diseased and contralateral unaffected joints at 0, 1.5, and 5 months. SAMPLE POPULATION: Eleven dogs with unilateral CCL deficiency, with unaffected contralateral joints. METHODS: IGF-I and IGF-II concentrations in synovial fluids were estimated by radioimmunoassay at 0, 1.5, and 5 months; Western ligand blotting was performed for intact IGFBPs at 0, 1.5, 5, and 9 months. Both stifle joints were radiographed at 0, 7, and 13 months. RESULTS: The IGF system is altered after CCL rupture and during development of early OA. Mean IGF-I and IGF-II concentrations in index stifle joints at study entry were 201.6 microg/mL and 345.7 microg/mL, respectively, compared with 57.7 microg/mL and 79.4 microg/mL, respectively, for contralateral joints. Index joint IGF concentrations increased after surgical treatment and then declined, although they remained higher than contralateral joints. Index joints had increases in IGFBP-3 and -4, and a decrease in IGFBP-2 expression compared with contralateral joints. CONCLUSIONS: Although IGF concentrations are increased in canine OA, alterations in IGFBP profiles may limit the tissue availability of IGF. CLINICAL RELEVANCE: Manipulation of the IGF system may provide an opportunity for novel treatments of OA in dogs.

Animals↗
PubMed1999

Ultrasonographic examination of the stifle region in cattle--normal appearance.

The stifle region of 18 healthy cattle (14 cows, four bull calves) and the stifles of five bovine cadavers were examined using 7.5 MHz linear or convex and 5 MHz sector transducers. The normal ultrasonographic appearance of soft tissues and bony structures was studied.The homogeneously echogenic patellar and collateral ligaments, the combined tendon of the long digital extensor and peroneus tertius muscles, the popliteus tendon, the anechoic articular cartilage of the femoral trochlea, the echogenic menisci and the hyperechoic bone surfaces were imaged successfully in all cattle and cadavers. The boundaries of the joint pouches only became partially identifiable, when small amounts of anechoic fluid were present in the medial and lateral femorotibial joint pouches. After experimental filling in cadavers, the distended synovial cavities were imaged as clearly demarcated, anechoic areas. Measurement values of cross-sectional diameters of the ligaments, tendons and the popliteal lymph node, the width of normal joint pouches, where visible, and articular cartilage thickness are presented. The established results should serve as reference data for ultrasonography of bovine stifle disorders.

Animals↗
PubMedDate not supplied

Effects of immobilization on cartilage formation after periosteal grafting in the rabbit stifle.

Autogenous periosteal grafts were harvested and placed in the trochlear grooves of the stifles of 32 rabbits. Postoperative immobilization periods of 0, 7, and 14 days were compared. Grafted areas were evaluated for gross appearance, histologic morphology, attachment of cartilage to subchondral bone, cartilage depth, chondrocyte density, proteoglycan presence, collagen fiber orientation, and mitotic activity. Nonimmobilized stifles had increased gross coverage of subchondral bone, better histologic quality, increased safranin O stain uptake, and more normal collagen fiber orientation at 60 days than stifles immobilized for 7 ir 14 days. Postoperative immobilization did not affect attachment of the graft to the subchondral bone.

Animals↗
PubMedDate not supplied

The effect of trans-stifle external skeletal fixation and hyaluronic acid therapy on articular cartilage in the dog.

Transarticular external skeletal (TES) fixators were applied unilaterally to the stifle joints of 10 young adult dogs. After 4 weeks, the fixators were removed from all dogs. Two dogs were not allowed a remobilization period, whereas 8 dogs were provided with 4 additional weeks of weight-bearing activity in a kennel run. Four dogs were given high-molecular weight hyaluronic acid by intra-articular injection weekly during the remobilization period. Clinical gait evaluations and range of motion were determined during the remobilization period. Articular cartilage samples from both stifle joints of all dogs were evaluated histologically and histochemically. No significant differences in gait scores or range of motion were noted between treated and untreated dogs. Articular cartilage proteoglycan content was reduced after 4 weeks of trans-stifle external skeletal fixation as determined by loss of alcian blue (AB) histochemical staining. Improved homogeneity of histochemical staining was observed after remobilization. However, remobilization was associated with histological damage to the surface and tangential layers of articular cartilage. Remobilization combined with hyaluronic acid (HA) therapy improved histochemical staining and reduced structural damage to articular cartilage when compared with remobilization alone.

Animals↗
PubMedDate not supplied

Collagenolytic protease expression in cranial cruciate ligament and stifle synovial fluid in dogs with cranial cruciate ligament rupture.

OBJECTIVE: To determine expression of collagenolytic genes and collagen degradation in stifle tissues of dogs with ruptured cranial cruciate ligament (CCL). ANIMALS: Six dogs with CCL rupture and 11 dogs with intact CCL. PROCEDURES: Gene expression in CCL tissue and synovial fluid cells was studied using reverse transcriptase-polymerase chain reaction (RT-PCR). Collagen degradation was studied using CCL explant cultures and a synovial fluid bioassay. RESULTS: Expression of matrix metalloproteases (MMP) was not found in young Beagles with intact CCL; however, increased expression of MMP-3 was found in CCL tissue from older hounds with intact CCL, when compared with young Beagles. In dogs with ruptured CCL, expression of MMP-2 and -9 was increased in stifle tissues, when compared with dogs with intact CCL. Similar to MMP-9, expression of tartrate-resistant acid phosphatase (TRAP) and cathepsin S was only found in stifle tissues from dogs with ruptured CCL; in contrast, expression of cathepsin K was found in all ruptured and intact CCL. Collagen degradation was increased in ruptured CCL, when compared with intact CCL. CONCLUSION: Rupture of the CCL is associated with up-regulation of expression of MMP-2 and -9 (gelatinase A and B), TRAP, and cathepsin S, and increased degradation of collagen. CLINICAL RELEVANCE: These findings suggest that MMP-2, -9, cathepsin S, and TRAP may be important mediators of progressive joint destruction in dogs with CCL rupture. These genes are markers for macrophages and dendritic cells. MMP and cathepsin S pathways may offer novel targets for anti-inflammatory medical therapy aimed at ameliorating joint degradation associated with inflammatory arthritis.

Animals↗
PubMedDate not supplied

Magnetic resonance arthrography of the canine stifle joint: technique and applications in eleven military dogs.

The stifle joints of eleven military working dogs were evaluated using conventional magnetic resonance (MR) imaging and MR arthrography. A protocol optimizing MR imaging of the canine stifle joint is discussed, as well as potential uses for administration of intra-articular gadolinium. The technique for performing MR arthrography is described, and post-contrast image findings are reviewed. MR arthrography was performed by using an intra-articular injection of diluted gadolinium. Consistently good quality images were obtained, and no complications were clinically detected following MR arthrography. Cranial cruciate ligament abnormalities were seen in six dogs, meniscal abnormalities were visualized in nine menisci, and synovitis and medial ligament strain were seen in eight dogs. Surgical and post-mortem confirmation of these findings is discussed in seven dogs. Although MR arthrography adds an invasive procedure to conventional MR imaging, it can provide useful information on pathologic changes in the canine stifle joint.

Animals↗
PubMedDate not supplied

Radiographic progression of osteoarthritis of the canine stifle joint: a prospective study.

A radiographic scoring system for features of osteoarthritis of the canine stifle joint was devised. Intra- and inter-rater agreement was assessed by calculation of unweighted kappa statistics. "Global score," "effusion," "osteophytosis," and "intra-articular mineralization" were all features that had acceptable reliability, but "subchondral sclerosis" did not. The scoring system was used in a 13-month prospective study of the radiographic progression of osteoarthritis of the stifle joint, secondary to cranial cruciate ligament deficiency, in 58 dogs. In the index stifle joints all features were characterized by significant change over time, but osteophytosis had the greatest degree of change. In addition, 40% of contralateral joints showed progressive osteophytosis.

Animals↗
PubMed2000

Use of a circular external skeletal fixator for stifle arthrodesis in a dog.

Arthrodesis of the right stifle was performed in a 21 kg German shepherd dog that had sustained a comminuted fracture of the lateral femoral condyle as a result of a gunshot wound. The arthrodesis was stabilised with a circular external skeletal fixator. A simplified technique to facilitate creation of the osteotomies of the femur and tibia, and positioning of the stifle at the desired angle, is described. Compression of the subchondral bone surfaces of the distal femur and proximal tibia was achieved using tensioned coiled transarticular Kirschner wires. Arthrodesis of the stifle was confirmed radiographically 21 weeks following surgery, and the fixator was removed. After union of the arthrodesis and removal of the fixator, the dog was fully weightbearing when standing or walking, and intermittently weightbearing or non-weightbearing at faster gaits.

Animals↗
PubMed1982

Radiographic examination of the equine stifle.

A radiographic technique is described for the equine stifle joint with the horse in the standing position or under general anaesthesia. The method with the animal anaesthetised in the dorsal recumbency and the leg extended was preferred because it gave greater flexibility with a better range of views and greatly reduced the safety hazards. In the standing position a useful practical tip for the lateral view was to raise and extent the limb caudally. This provides some flexion and ventral movement of the stifle allowing improved access for the cassette, a more accurate lateral view of the joint and a reduction in exposure. Some of the features of radiographic anatomy, from birth to adulthood, of this rather complex joint are described to form a basis for radiological interpretation in cases of suspected stifle lameness.

Anesthesia↗
PubMed1982

Stifle lameness in the horse: a survey of 86 referred cases.

The clinical and radiological characteristics of stifle lameness in 86 horses are described. The majority of these cases had been lame for some weeks before referral. The most frequent diagnoses made were osteochondrosis dissecans (13 per cent) and subchondral bone cyst (38 per cent). Both of these conditions were seen principally in Thoroughbreds at or before the onset of training. The other bone lesions encountered were osteoarthritis (3 per cent), fractures (4 per cent) and "epiphysitis" (1 per cent). The commonest soft tissue condition was an atypical or partial upward fixation of the patella (15 per cent), ligamentous/meniscal damage comprised 12 per cent of the cases and the remaining 13 per cent were attributed to non-specific strain of the stifle joint. Treatment in most of these chronic stifle injuries consisted of a period of rest followed by a gradual return to exercise; in some cases this was combined with a short course of a non-steroidal anti-inflammatory drug. The prognosis in most cases of osteochondrosis dissecans was grave to hopeless, while the majority of the horses with a subchondral bone cyst improved clinically after an extended period of rest (ie, 6 months). Ligamentous/meniscal damage usually responded satisfactorily to rest, provided there was no gross tearing or rupture of the structures involved. The outcome in cases of chronic osteoarthritis was always poor and these cases did not respond satisfactorily to analgesic and anti-inflammatory medication.

Animals↗
PubMed1975

Arthritis of the canine stifle joint.

A survey of cadaver material was undertaken in order to determine the prevalence of arthritis of the canine stifle joint. One hundred and fifty unselected cadavers were obtained from veterinary practices for this purpose, and their stifle joints were radiographed and dissected to discover abnormalities. Thirty-one dogs (20 per cent) had stifle arthritis and in all except one the lesions were characteristic of osteoarthritis. In the exceptional case infection was the cause. A mechanical derangement was present in 20 of the 54 affected joints, in the form of rupture of the anterior cruciate ligament (10), meniscal tears (9) and patellar dislocation (1). The cause of the arthritis in the other 33 joints is unknown.

Animals↗
PubMed1998

Malignant fibrous histiocytoma of the deep peri-articular tissue of the stifle in a dog.

A Belgian shepherd dog aged 4 years and 9 months was presented with acute onset of non-weight bearing lameness and stifle effusion of the left hind limb, caused by the deep form of a malignant fibrous histiocytoma originating in the deep musculature and fascia surrounding the stifle joint. The tumour progressed rapidly in the tissues along the femoral diaphysis with marked periosteal new bone formation. Cytology of a stifle joint aspirate revealed numerous large polygonal neoplastic cells with considerable anisocytosis and anisokaryosis. These cells were present in clusters, with cytoplasmic projections between the cells, but occasionally also occurred singly. Several cells contained multiple cytoplasmic vacuoles and occasional giant cells were also encountered. Adequate tumour-free margins were not possible with radical limb amputation and the dog was euthanased. Macroscopically the tumour appeared as an extensive pale tan, firm mass with scattered small haemorrhages and foci of yellow discolouration. Histologically the tumour consisted of dense neoplastic expanses or multiple nodules, composed of spindle-shaped fibroblastic cells, polygonal histiocytic cells or cell clusters and scattered giant cells with 2-3 nuclei. The polygonal neoplastic cells were frequently present around and invading lymphatics and blood vessels, causing neoplastic emboli. This is the 1st report of the clinical behaviour, radiography and cytology of the deep form of malignant fibrous histiocytoma in the dog.

Animals↗