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Tierarztl Prax Ausg K Kleintiere Heimtiere 2010; 38(02): 61-69
DOI: 10.1055/s-0038-1622834
Originalartikel
Schattauer GmbH

Kniegelenkstabilität nach lateraler Fadenzügelung mit Ethibond Excel®: frühzeitige Destabilisierung nach passiver Gelenkbewegung

Stifle stability after lateral suture stabilisation using Ethibond Excel®: early destabilisation following cyclic passive joint motion
P. Böttcher
1   Klinik für Kleintiere (Direktor: Prof. Dr. G. Oechtering) der Universität Leipzig
,
C. Fischer
1   Klinik für Kleintiere (Direktor: Prof. Dr. G. Oechtering) der Universität Leipzig
,
H. Werner
1   Klinik für Kleintiere (Direktor: Prof. Dr. G. Oechtering) der Universität Leipzig
,
V. Grevel
1   Klinik für Kleintiere (Direktor: Prof. Dr. G. Oechtering) der Universität Leipzig
,
G. Oechtering
1   Klinik für Kleintiere (Direktor: Prof. Dr. G. Oechtering) der Universität Leipzig
› Author Affiliations
Further Information

Publication History

Eingegangen: 01 May 2009

Akzeptiert: 29 November 2009

Publication Date:
05 January 2018 (online)

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Zusammenfassung

Gegenstand und Ziel: 1) Bestimmung der kraniokaudalen Kniegelenkstabilität nach lateraler Fadenzügelung und passiver Kniegelenkbewegung. 2) Bestimmung der Schlaufenspannung nach Knotung. Material und Methoden: Die kraniokaudale Kniegelenkstabilität (KKStab) wurde anhand von lateromedialen Röntgenaufnahmen an zehn rechten Kniegelenken orthopädisch gesunder Hunde (> 20 kg KM) ex vivo bestimmt. Die Messung erfolgte am gesunden Gelenk nach Durchtrennung des vorderen Kreuzbandes und nach lateraler Ethibondfadenzügelung. Anschließend wurde das Kniegelenk 350 Mal passiv bewegt und die KKStab nach 50, 100, 250 und 350 Bewegungszyklen gemessen. Des Weiteren wurden sieben Ethibondfadenschlaufen an einer Materialprüfmaschine geknüpft und die Spannung in der Schlaufe nach dem ersten (FMax) und nach dem letzten Knoten (FEnd) ge messen. Ergebnisse: Die KKStab nach Rekonstruktion betrug 3,7 mm und war um 2,7 mm größer als bei intaktem Kreuzband. Bereits 250 passive Bewegungszyklen bewirkten eine signifikante Destabilisierung um 1,5 mm. FMax lag bei 133 N und fiel auf 6 N (FEnd) nach dem fünften Knoten. Schlussfolgerung: Die laterale Fadenzügelung mit Ethibondfäden und Anlegen von fünf einfachen Knoten ermöglicht es nicht, die physiologische Gelenkstabilität herzustellen. Bereits wenige Bewegungszyklen bewirken eine signifikante weitere Destabilisierung. Einer der Gründe für das unbefriedigende Ergebnis ist die hier angewendete Knotentechnik, die es nicht erlaubt, die nötige Fadenspannung zu konservieren. Klinische Relevanz: Die Anwendung von Ethibond in Kombination mit einfacher Knotentechnik scheint für die Durchführung einer lateralen Fadenzügelung nicht geeignet.

Summary

Objective: 1) To report cranio-caudal stifle stability (ccStab) following lateral suture stabilisation (LSS) and passive joint motion. 2) To report tension within the suture following knotting. Material and methods: ccStab was measured in vitro on latero-medial radiographs in 10 stifles of orthopaedically sound dogs (> 20 kg BW). ccStab was assessed in the intact joint, after transection of the cranial cruciate ligament and following LSS using a multi strand Ethibond loop and clamped square knots, as well as after 50, 100, 250 and 350 cycles of passive joint motion. Tension within seven suture loops was measured using a material testing machine. Tension was measured after the first (FMax) and last knot (FEnd). Results: ccStab following LSS was 3.7 mm und was greater by 2.7 mm than with intact cruciate ligament. Already 250 passive cycles of passive joint motion induced significant destabilisation by 1.5 mm. FMax was 133 N und dropped to 6 N (FEnd) after completion of the last knot. Conclusion: LSS using Ethibond and clamped square knots do not allow for restoration of physiological stifle stability. Already few cycles of passive joint motion further destabilise the joint. One of the reasons for these disappointing results is the method of suture fixation as clamped square knots did not allow for conservation of initial loop tension. Clinical relevance: LSS using a multi strand Ethibond loop and clamped square knots should be avoided.

Schlüsselwörter

Vorderer Kreuzbandriss - Hund - Kniegelenk - lateraler Fadenzügel

Key words

Cranial cruciate ligament rupture - dog - stifle - lateral suture stabilisation
 

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