Publication Database

In vivo rotational movement of the radius in healthy canine elbow joints and elbows with medial coronoid process disease (2021)

Art

Vortrag

Autor

Rohwedder, Thomas (WE 20)

Kongress

ESVOT Congress

online, 05. – 08.05.2021

Quelle

Sprache

Englisch

Verweise

URL (Volltext): https://www.researchgate.net/publication/355575260_In_vivo_rotational_movement_of_the_radius_in_healthy_canine_elbow_joints_and_elbows_with_medial_coronoid_process_disease

Kontakt

Klein- und Heimtierklinik

Oertzenweg 19 b
14163 Berlin
+49 30 838 62422
kleintierklinik@vetmed.fu-berlin.de

Abstract / Zusammenfassung

Introduction:
Developmental elbow disease is a frequent cause of front limb lameness in mid to large breed dogs and medial coronoid process disease (MCPD) is the most common symptom of the disease (Kirberger and Fourie 1998, Samoy et al. 2006, Lavrijsen et al. 2012, Veksins et al. 2019). However, the etiopathogenesis of this complex disease is not completely understood yet. Mechanical overload is discussed to be one main factor in the disease process, leading to damage of the subchondral bone and joint cartilage (Danielson et al. 2006, Fitzpatrick et al. 2016). Multiple forms of incongruence and dynamic changes within the humero-radioulnar joint were proposed to initiate this mechanical overload (Wind 1986, Fitzpatrick and Yeadon 2009, Hulse et al. 2010, Krotscheck et al. 2014, Eljack and Böttcher 2015, Rohwedder et al. 2018). Some authors suggested increased rotational movement of the radius relative to the ulna leading to abnormal pressure along the radial incisure and subsequent MCPD (Fitzpatrick and Yeadon 2009, Hulse et al. 2010). However, in vivo rotational motion between the radius and the ulna was only described in healthy canine elbows so far (Guillou et al. 2011). Therefore the objective of the present study was to investigate in vivo rotational movement of the radius relative to the ulna in healthy elbow joints and elbows with MCPD during the walk.

Materials and Methods:
Six normal elbows (5 dogs) and 8 joints (6 dogs) with coronoid disease were examined. Only dogs without any history of lameness and an inconspicuous orthopedic, radiographic and computed tomographic exam were included into the control group. Inclusion criteria for the MCPD group was presence of coronoid disease, which had to be confirmed by clinical exam, radiography, computed tomography and arthroscopy. Presence or absence of static radio-ulnar incongruence (RUI) was not defined as an exclusion criteria. Any other orthopedic pathology led to exclusion from the study. After implantation of at least 3 tantalum beads into the radius and ulna each, biplanar fluoroscopic movies (500 fps, shutter 0.5 ms) of the respective elbow were taken while the dogs were walking on a treadmill. Based on the 2D bead coordinates of the synchronized biplanar x-ray movies virtual 3D radio-ulnar animations were calculated. Bead trajectories started 30 frames before weight bearing and lasted for 120 frames, representing the first third of whole stance phase. Rotation of the radius relative to the ulna was measured in these 3D animations using a joint coordinate system, which was orientated along the long axis of the radius. Radio-ulnar motion was evaluated during the end of the swing phase, just before weight bearing (frame 1-30), and the first third of the stance phase (frame 31-151). Movies of the walking dog, taken by a third synchronized high-speed video camera, were used to define moment of ground contact. Data was expressed as maximal rotational amplitude. Further internal and external rotation were measured. Measurements from three consecutive steps were averaged and group wise compared using an unpaired t-test, with alpha set to 5%. Normality was confirmed using the Kolmogorov-Smirnov test. Normally distributed values were expressed as mean values with standard deviation (SD) and non-normally distributed values as median with interquartile range (IQR). Results: Groups were comparable in median age (control 17.0 months [IQR: 14.8 – 33.8] vs. MCPD 17.5 months [IQR: 15.0 – 21.0], p = 0.8551), as well as mean body weight (control 27.9 kg [SD: 4.76] vs. MCPD 27.6 kg [SD: 3.98], p = 0.8551). Total amount of rotation was 11.4° (SD: 2.0) in the control group and 9.8° (SD: 3.2) in the MCPD group, being not significantly different between each other (p = 0.2904). Also internal/external rotation did not differ significantly between healthy and diseased elbows (internal: 5.7° [SD 2.1] vs. 5.3° [SD 2.6]; p = 0.1727; external: -5.8° [SD 1.3] vs. -4.5° [SD 1.7]; p = 0.7705).

Discussion:
Relative radio-ulnar rotation is not increased in joints with MCPD, at least during the end of the swing phase and the first third of stance phase. Therefore, dynamic rotational changes within the radio-ulnar joint don´t seem to be a pathologic factor in the development of MCPD. However, small sample size, investigation of only one third of the whole stance phase and investigation of only one gait pattern are limitations of the present study. Taking into account that in a walking dog maximal peak vertical force occurs early during stance phase (Budsberg et al. 1987), makes us confident that evaluation of the first third of the stance phase leads to valuable results. Nevertheless, dynamic changes during the swing phase and the later stance phase could not be evaluated in the present study. Further, the MCPD group consisted of dogs with and without static axial radio-ulnar incongruence. Due to the small sample size it was not possible to compare elbows with RUI against joints without RUI. Thus, the influence of this bony deformity on biomechanics within the radio-ulnar joint remains unclear. Future studies with larger numbers of dogs and investigation of the whole gait cycle are needed to fully understand the complex biomechanics in elbow joints with MCPD.

Conclusion:
Results imply that rotation of the radius relative to the ulna is not increased in elbow joints with MCPD. Therefore other causes of mechanical overload at the medial coronoid process have to be considered in the disease process.