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      Aspectos clínicos e radiográficos do pericárdio bovino como substituto do ligamento cruzado cranial de cães Translated title: Clinical and radiographic aspects of the bovine pericardium as a substitute of the canine cranial cruciate ligament

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          Abstract

          Avaliaram-se os aspectos clínicos e radiográficos do enxerto de pericárdio bovino, preservado em glicerina, como substituto do ligamento cruzado cranial. Quinze cães machos, sem raça definida, pesando entre 17,4 e 31,6 kg, foram submetidos à ruptura experimental do ligamento cruzado cranial e à substituição por pericárdio, via videoartroscopia. Os cães foram divididos em três grupos de cinco e avaliados aos 30, 90 e 120 dias. O membro operado foi imobilizado por duas semanas e procederam-se avaliações clínicas semanais. Radiografias foram feitas mensalmente e foram realizadas colheita de líquido sinovial nos tempos descritos. Clinicamente, os cães mostraram claudicação acentuada a moderada, hipotrofia muscular no membro operado e acentuado deslocamento cranial da tíbia em relação ao fêmur. As alterações degenerativas foram observadas nas radiografias. Observou-se instabilidade acentuada em todos os animais. O líquido sinovial tinha características de inflamação. Concluiu-se que o enxerto rompeu precocemente, provocou reação inflamatória persistente e fenômenos de rejeição, não sendo, portanto, recomendado para substituição do ligamento cruzado cranial de cães.

          Translated abstract

          The clinical and radiographic aspects of the bovine pericardium preserved in glicerin, were evaluated as a substitute for canine cranial cruciate ligament. Fifteen male mongrel dogs weighing between 17.4 and 31.6kg had the ligament experimentally ruptured and the stifle joint stabilized by an arthroscopical technique with bovine pericardium as a graft. The dogs were divided into three groups of five animals each. They were evaluated at 30, 90 and 120 days. The operated limb was imobillized for two weeks and clinical examination was performed weekly. Radiographs were taken monthly and the sinovial fluid was collect at 30, 90 and 120 days. Clinically, dogs presented high to moderate lameness, muscle hipotrophy in the operated limb and accentuated cranial drawer movement. Degenerative disease was detected in radiography. All dogs showed total rupture of the graft. Sinovial fluid analysis showed characteristics of inflammation. It can be concluded that pericardium graft failed prematurely, incited persistent inflammatory reaction and rejection phenomena. Thus, it cannot be recommended as a xenograft for cranial cruciate ligament replacement.

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          Cranial cruciate ligament rupture. Pathogenesis, diagnosis, and postoperative rehabilitation.

          Rupture of the cranial cruciate ligament is the most common cause of stifle lameness in the adult dog. An understanding of the pathogenesis of cranial cruciate ligament rupture and the resulting degenerative joint disease is crucial in establishing an accurate diagnosis and implementing appropriate treatment. Early diagnosis of the cruciate-deficient stifle with appropriate therapeutic intervention may minimize degenerative joint disease but does not prevent it in all cases. Rehabilitation of the surgically corrected cruciate-deficient stifle may influence the success of the surgical outcome.
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            Graft selection in anterior cruciate ligament reconstruction.

            Selecting the appropriate graft for ACL reconstruction depends on numerous factors including surgeon philosophy and experience, tissue availability (affected by anatomical anomalies or prior injury or surgery), and patient activity level and desires. Although the patella tendon autograft has the widest experience in the literature, and is probably the most commonly used graft source, this must be tempered with the higher reported incidences of potential morbidity and pitfalls associated with its use. The hamstring tendons are gaining increasing popularity, mostly due to reduced harvest morbidity and improved soft tissue fixation techniques, and many recent studies in the literature report equal results to BTB ACL reconstruction with respect to functional outcome and patient satisfaction. On the other hand, many of these studies report higher degrees of instrument (KT-100) tested laxity for hamstring reconstruction, and some have reported lower returns to preinjury levels of activity. One question that remains to be addressed is how closely objectively measured laxity tests correlate with subjectively assessed outcomes and ability to return to high levels of competitive sports. Allograft use, which decreased in popularity during the 1990s, appears to be undergoing a resurgence, with better sterilization processes and new graft sources (tibialis tendons), leading to increased availability and improved fixation techniques. The benefits of decreased surgical morbidity and easier rehabilitation must be weighed against the potential for greater failure of biologic incorporation, infection, and possibly slower return to activities. In our practice, for high-demand individuals (those playing cutting, pivoting, or jumping sports and skiing) BTB tends to be the graft of choice. For lower demand or older individuals, hamstring reconstructions will be performed. Allograft tissue will be used in older individuals (generally over 45 years old), those with signs of arthritis (and compelling evidence of instability), or those individuals who understand the pros and cons of allograft use fully and do not want their own tissue used.
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              Correlation between subjective and objective measures used to determine severity of postoperative pain in dogs.

              To determine the association between subjective and objective variables commonly used to evaluate severity of postoperative pain in dogs. Prospective double-blind study. 36 dogs with unilateral rupture of the cranial cruciate ligament that underwent surgery to stabilize the stifle. Each dog was assessed to determine severity of pain before and after surgery, using various subjective and objective criteria. Subjective measures of pain (scores for visual analogue and numerical rating scales) correlated poorly or were not correlated with heart rate, respiratory rate, blood pressure, and results of a pain threshold test. Scores for visual analogue and numerical rating scales correlated with each other and with the amount of vocalization at most time periods. We detected a weak association between commonly employed subjective and objective measures of pain. This indicated that some of these measurement techniques do not predictably reflect severity of postoperative pain in dogs. Therefore, clinicians should not rely too heavily on these variables when assessing severity of postoperative pain in dogs.
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                Author and article information

                Journal
                abmvz
                Arquivo Brasileiro de Medicina Veterinária e Zootecnia
                Arq. Bras. Med. Vet. Zootec.
                Universidade Federal de Minas Gerais, Escola de Veterinária (Belo Horizonte, MG, Brazil )
                0102-0935
                1678-4162
                August 2007
                : 59
                : 4
                : 920-931
                Affiliations
                [01] Betim MG orgnamePUC-Minas
                [02] Belo Horizonte MG orgnameUFMG orgdiv1Escola de Veterinária
                Article
                S0102-09352007000400017 S0102-0935(07)05900417
                9425134a-3d7b-4df8-8988-32ff958b40b0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 January 2007
                : 31 July 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 12
                Product

                SciELO Brazil

                Categories
                Medicina Veterinária

                dog,xenograft,orthopedic,radiology,ortopedia,cão,xenoenxerto,radiologia

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