Computed tomographic evaluation of the canine intercondylar notch in normal and cruciate deficient stifles

B. A. Lewis; D. A. Allen; T. D. Henrikson; T. W. Lehenbauer

doi:10.3415/VCOT-07-04-0032

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2008; 21(02): 119-124
DOI: 10.3415/VCOT-07-04-0032

Original Research

Schattauer GmbH

Computed tomographic evaluation of the canine intercondylar notch in normal and cruciate deficient stifles

Authors

B. A. Lewis

¹Mission MedVet, Mission, Kansas, USA
D. A. Allen

¹Mission MedVet, Mission, Kansas, USA
T. D. Henrikson

²Vet-Rad, Cleveland, Ohio, USA
T. W. Lehenbauer

³Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stilwater, Oklahoma,USA

Abstract

Summary

In the human and veterinary orthopaedic literature it has been implied that intercondylar notch stenosis is a mechanical factor in cranial cruciate ligament rupture and intraarticular graft failure. The patients in this study were classified as normal (32), unilateral cruciate rupture (23), or bilateral cruciate rupture (17). The dogs were placed under general anaesthesia and both stifles were scanned via computed tomography (CT) as previously described. Three CT slices at predetermined levels were evaluated within the notch. Measurements included opening notch angle, notch width and height, condyle width, and notch width index (notch width/ condyle width) at two different heights within the notch. Intercondylar notch measurements at the most cranial extent were significantly more narrow in unilateral and bilaterally affected stifles when compared to the normal population. Significant differences were noted in the opening notch angle (ONA), notch width index (NWI), NWI at two thirds notch height (NWI2/3), and tibial slope index (TSI). No significant differences were noted between unilateral and bilateral affected stifles. Increased mechanical contact of the cranial cruciate ligament with a stenotic intercondylar notch may predispose the ligament to mechanical wear and structural weakening. Intercondylar notch measurements have been used as a tool to predict the risk of anterior cruciate ligament injury in young human athletes, and to assess the risk factors for intra-articular graft replacements. Our findings may be useful in developing similar predictive models using stifle CT scans.

Keywords

Intercondylar notch - computed tomography - cruciate ligament - canine

Full Text

References

References
1 Johnson Johnson, Johnson AL. Cranial cruciate ligament rupture: Pathogenesis, diagnosis, and postoperative rehabilitation. Vet Clin North Am Small Anim Pract 1993; 23: 717-733.
2 Patsaama S. Ligament injuries of the canine stifle joint: A clinical and experimental study (Thesis). University of Helsinki; 1952
3 Patsaama S. Ligament injuries in the canine stifle joint. J Small Anim Med 1953; 1: 329-332.
4 Marshall Marshall, Olsson SE. Instability of the knee. A long term experimental study in dogs. J Bone Joint Surg 1971; 53: 1561-1570.
5 Elkins AD. A retrospective study evaluating the degree of degenerative joint disease in the stifle joint of dogs following surgical repair of anterior cruciate ligament rupture. J Am Anim Hosp Assoc 1991; 27: 533-539.
6 Vasseur Vasseur, Berry CR. Progression of stifle as- teoarthritis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992; 28: 129-136.
7 Galloway Galloway, Lester SJ. Histopathological evaluation of canine stifle joint synovial membrane collected at the time of repair of cranial cruciate ligament rupture. J Am Anim Hosp Assoc 1995; 3: 289-294.
8 Niebauer GW, Wolf B, Bashey RI. et al. Antibodies to canine collagen types I and II in dogs with spontaneous cruciate ligament rupture and osteoarthritis. Arthritis Rheum 1987; 30: 319-327.
9 Vasseur PB, Pool RR, Arnoczky SP. et al. Correlative biomechanical and histologic study of the cranial cruciate ligament in dogs. Am J Vet Res 1985; 46: 1842-1854.
10 Whitehair JG, Vasseur PB, Willits NH. Epidemiology of cranial cruciate ligament rupture in dogs. J Am Vet Med Assoc 1993; 203: 1016-1019.
11 Morris Morris, Lipowitz AJ. Comparison of tibial plateau angles in dogs with and without cranial cruciate ligament injuries. J Am Vet Med Assoc 2001; 218: 363-366.
12 Reif U, Probst CW. Comparison of tibial plateau angles in normal and cranial cruciate deficient stifles of Labrador Retrievers. Vet Surg 2003; 32: 385-389.
13 Venzin C, Howard J, Rytz U. Tibial plateau angles with and without cranial cruciate ligament rupture. Vet Comp Orthop Traumatol 2004; 17: 232-236.
14 Aiken SW, Kass PH, Toombs JP. Intercondylar notch width in dogs with and without cranial cruciate ligament injuries. Vet Comp Orthop Traumatol 1995; 8: 128-132.
15 Souryal Souryal, Freeman TR. Intercondylar notch size and anterior cruciate ligament injuries in athletes. Am J Sports Med 1993; 21: 535-539.
16 Souryal TO, Moore HA, Evans JP. Bilaterality in anterior cruciate ligament injuries: Associated in- tercondylar notch stenosis. Am J Sports Med 1988; 16: 449-454.
17 Anderson Anderson, Lipscomb AB. Analysis of the inter- condylar notch by computed tomography. Am J Sports Med 1987; 15: 547-552.
18 Evans Evans, deLahunta M. Miller's Guide to the dissection of the dog. Elsevier Saunders; 92-95.
19 Fitch RB, Hathcock JT, Montgomery RD. Radio- graphic and computed tomographic evaluation of the canine intercondylar fossa in normal stifles and after notchplasty in stable and unstable stifles. Vet Radiol Ultrasound 1996; 37: 266-274.
20 Norwood Norwood, Cross MJ. The intercondylar shelf and the anterior cruciate ligament. Am J Sports Med 1977; 5: 171-176.
21 Duval JM, Budsberg SC, Flo GL. Breed, sex, and body weight as risk factors for rupture of the cranial cruciate ligament in young dogs. J Am Vet Med Assoc 1999; 215: 811-814.
22 Slocum B, Devine-Slocum T. Vet Clinics North America. 1993 23. 777-795
23 Fitch RB, Montgomery RD, Milton JL. et al. The intercondylar fossa of the normal canine stifle: Anatomical and radiographic study. Vet Surg 1995; 24: 148-155.
24 Girgis FG, Marshall JL, Monagem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop 1975; 106: 216-231.
25 Feagin JA, Cabaud JE, Curl WW. The anterior cruciate ligament: Radiographic and clinical signs of successful and unsuccessful repairs. Clin Orthop 1982; 164: 54-58.
26 Fitch RB, Montgomery RD, Kincaid SA. et al. The effect of intercondylar notchplasty on the normal canine stifle. Vet Surg 1995; 24 2 156-164.
27 Montgomery RD, Fitch RB, Hathcock JT. et al. Radiographic imaging of the canine intercondylar fossa. Vet Radiol Ultrasound 1995; 36: 276-282.
28 Sellmeyer TWH, Allen DA, Wilson ER. et al. The effect of computed tomographical gantry angle on the measurement of the canine intercondylar notch. Vet Comp Orthop Traumatol 2007; 20: 113-118.
29 LaPrade RF, Burnett II QM. Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med 1994; 22: 198-202.
30 Moriggl B, Jax P, Milz S. et al. Fibrocartilage at the entheses of the suprascapular (superior transverse scapular) ligament of man -a ligament spanning two regions of a single bone. J Anat 2001; 199: 539-545.
31 Benjamin Benjamin, Ralphs JR. Fibrocartilage in tendons and ligaments - an adaptation to a compressive load. J Anat 1998; 193: 481-484.
32 Comerford EJ, Tarlton JF, Avery NC. Distal femoral intercondylar notch dimensions and their relationship to composition and metabolism ofthe canine anterior cruciate ligament. Osteoarthiritis Cartilage 2006; 14: 273-278.