• 1. Johnson JA, Austin C, Breur GJ, et al. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994;2:518.

    • Search Google Scholar
    • Export Citation
  • 2. Vasser B. Clinical results following nonoperative management for rupture of the cranial cruciate ligament in dogs. Vet Surg 1984;13:243246.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Comerford E, Forster K, Gorton K, et al. Management of cranial cruciate ligament rupture in small dogs: a questionnaire study. Vet Comp Orthop Traumatol 2013;26:493497.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Tonks CA, Lewis DD, Pozzi A. A review of extra-articular prosthetic stabilization of the cranial cruciate ligament-deficient stifle. Vet Comp Orthop Traumatol 2011;24:167177.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993;23:777795.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Lafaver S, Miller NA, Stubbs WP, et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007;36:573586.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987;48:915918.

  • 8. McLaughlin RM. Kinetic and kinematic gait analysis in dogs. Vet Clin North Am Small Anim Pract 2001;31:193201.

  • 9. Budsberg SC, Verstraete MC, Soutas-Little RW, et al. Force plate analyses before and after stabilization of canine stifles for cruciate injury. Am J Vet Res 1988;49:15221524.

    • Search Google Scholar
    • Export Citation
  • 10. Voss K, Damur DM, Guerrero T, et al. Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008;21:243249.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Conzemius MG, Evans RB, Besancon MF, et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005;226:232236.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Au KK, Gordon-Evans WJ, Dunning D, et al. Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization. Vet Surg 2010;39:173180.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Gordon-Evans WJ, Griffon DJ, Bubb C, et al. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. J Am Vet Med Assoc 2013;243:675680.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Krotscheck U, Nelson SA, Todhunter RJ, et al. Long term functional outcome of tibial tuberosity advancement vs. tibial plateau leveling osteotomy and extracapsular repair in a heterogeneous population of dogs. Vet Surg 2016;45:261268.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Budsberg SC. Long-term temporal evaluation of ground reaction forces during development of experimentally induced osteoarthritis in dogs. Am J Vet Res 2001;62:12071211.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Leighton RL. Preferred method of repair of cranial cruciate ligament rupture in dogs: a survey of ACVS diplomats specializing in canine orthopedics (lett). Vet Surg 1999;28:194.

    • Search Google Scholar
    • Export Citation
  • 17. Bergh MS, Sullivan C, Ferrell CL, et al. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. J Am Anim Hosp Assoc 2014;50:315321.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Brown DC, Boston RC, Coyne JC, et al. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007;68:631637.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Quinn MM, Keuler NS, Lu Y, et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007;36:360367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Waxman AS, Robinson DA, Evans RB, et al. Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness. Vet Surg 2008;37:241246.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Vasser PB, Berry CR. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992;28:129136.

    • Search Google Scholar
    • Export Citation
  • 22. Gordon WJ, Conzemius MG, Riedesel E, et al. The relationship between limb function and radiographic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003;32:451454.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Morgan JP, Voss K, Damur DM, et al. Correlation of radiographic changes after tibial tuberosity advancement in dogs with cranial cruciate-deficient stifles with functional outcome. Vet Surg 2010;39:425432.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Evans R, Horstman C, Conzemius M. Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait. Vet Surg 2005;34:445449.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Nelson SA, Krotscheck U, Rawlinson J, et al. Long-term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs. Vet Surg 2013;42:3850.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Rumph PF, Kincaid SA, Visco DM, et al. Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hindlimb lameness. Vet Surg 1995;24:384389.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Voss K, Imhof J, Kaestner S, et al. Force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness. Vet Comp Orthop Traumatol 2007;20:299304.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Madore E, Huneault L, Moreau M, et al. Comparison of trot kinetics between dogs with stifle or hip arthrosis. Vet Comp Orthop Traumatol 2007;20:102107.

    • Search Google Scholar
    • Export Citation
  • 29. Beraud R, Moreau M, Lussier B. Effect of exercise on kinetic gait analysis of dogs afflicted by osteoarthritis. Vet Comp Orthop Traumatol 2010;23:8792.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Dillon DE, Gordon-Evans WJ, Griffon DJ, et al. Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease. Vet Surg 2014;43:446450.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Souza AN, Tatarunas AC, Matera JM. Evaluation of vertical force in the pads of pitbulls with cranial cruciate ligament rupture. BMC Vet Res 2014;10:51.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. O'Connor BL, Visco DM, Heck DA, et al. Gait alterations in dogs after transection of the anterior cruciate ligament. Arthritis Rheum 1989;32:11421147.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Fanchon L, Grandjean D. Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs. Am J Vet Res 2007;68:10891094.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. Fu X, Lin L, Zhang J, et al. Assessment of the efficacy of joint lavage in rabbits with osteoarthritis of the knee. J Orthop Res 2009;27:9196.

  • 35. Pozzi A, Kowaleski MP, Apelt D, et al. Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy. Vet Surg 2006;35:486494.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36. Pozzi A, Litsky AS, Field J, et al. Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2008;21:814.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37. Luther JK, Cook CR, Cook JL. Meniscal release in cruciate ligament intact stifles causes lameness and medial compartment cartilage pathology in dogs 12 weeks postoperatively. Vet Surg 2009;38:520529.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Kim SE, Lewis DD, Pozzi A. Effect of tibial plateau leveling osteotomy on femorotibial subluxation: in vivo analysis during standing. Vet Surg 2012;41:465470.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Evaluation of recovery of limb function by use of force plate gait analysis after tibial plateau leveling osteotomy for management of dogs with unilateral cranial cruciate ligament rupture

Hirokazu Amimoto1Fujiidera Animal Hospital, Animal Joint Reconstruction Center, 1-2-37, Koyama, Fujiidera-City, Osaka 583-0033, Japan
2Department of System Physiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8511, Japan

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Tetsuaki Koreeda1Fujiidera Animal Hospital, Animal Joint Reconstruction Center, 1-2-37, Koyama, Fujiidera-City, Osaka 583-0033, Japan

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Naomi Wada2Department of System Physiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1, Yoshida, Yamaguchi 753-8511, Japan

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Abstract

OBJECTIVE

To evaluate recovery of limb function by use of gait force analysis after tibial plateau leveling osteotomy (TPLO) in dogs with unilateral cranial cruciate ligament (CrCL) rupture.

ANIMALS

19 dogs with unilateral CrCL rupture treated with TPLO.

PROCEDURES

Force plate gait analysis was performed before and 1, 2, 4, and 7 months after TPLO. Ground reaction forces (GRFs; which comprised peak vertical force [PVF], vertical impulse [VI], peak braking force, braking impulse, peak propulsion force [PPF], and propulsion impulse), time to switching from braking to propulsion, and vector magnitude at PVF in the forelimbs and hind limbs were evaluated.

RESULTS

GRFs in the affected hind limb were significantly lower than in the contralateral hind limb before TPLO. These variables, except for PPF, were not significantly different 7 months after TPLO. Time to the switching point in the affected hind limb was significantly less from before to 2 months after TPLO. Vector magnitude at PVF had a similar pattern as PVF and VI during the recovery process. The PVF in the ipsilateral forelimb was significantly higher than in the contralateral forelimb before TPLO.

CONCLUSIONS AND CLINICAL RELEVANCE

A similar pattern was detected between PVF or VI and craniocaudal force during recovery of dogs that underwent TPLO. Rupture of he CrCl resulted in a decrease in GRFs in the affected hind limb as well as in the switching point and PVF of limbs. However, weight distribution for the craniocaudal force was normalized before PVF or VI. Vector magnitude at PVF might be effectively evaluated by combining vertical force and craniocaudal force.

Abstract

OBJECTIVE

To evaluate recovery of limb function by use of gait force analysis after tibial plateau leveling osteotomy (TPLO) in dogs with unilateral cranial cruciate ligament (CrCL) rupture.

ANIMALS

19 dogs with unilateral CrCL rupture treated with TPLO.

PROCEDURES

Force plate gait analysis was performed before and 1, 2, 4, and 7 months after TPLO. Ground reaction forces (GRFs; which comprised peak vertical force [PVF], vertical impulse [VI], peak braking force, braking impulse, peak propulsion force [PPF], and propulsion impulse), time to switching from braking to propulsion, and vector magnitude at PVF in the forelimbs and hind limbs were evaluated.

RESULTS

GRFs in the affected hind limb were significantly lower than in the contralateral hind limb before TPLO. These variables, except for PPF, were not significantly different 7 months after TPLO. Time to the switching point in the affected hind limb was significantly less from before to 2 months after TPLO. Vector magnitude at PVF had a similar pattern as PVF and VI during the recovery process. The PVF in the ipsilateral forelimb was significantly higher than in the contralateral forelimb before TPLO.

CONCLUSIONS AND CLINICAL RELEVANCE

A similar pattern was detected between PVF or VI and craniocaudal force during recovery of dogs that underwent TPLO. Rupture of he CrCl resulted in a decrease in GRFs in the affected hind limb as well as in the switching point and PVF of limbs. However, weight distribution for the craniocaudal force was normalized before PVF or VI. Vector magnitude at PVF might be effectively evaluated by combining vertical force and craniocaudal force.

Cranial cruciate ligament rupture is one of the most important diseases in veterinary medicine and a common cause of hind limb lameness in dogs.1 Conservative management of affected dogs that weigh < 15 kg typically results in acceptable limb function.2,3 However, surgical intervention is recommended for most dogs. The surgical procedures most commonly used for management of CrCLR include extracapsular stabilization, TPLO, and tibial tuberosity advancement.4–6

Force plates are used to measure GRFs in 3 planes (vertical, craniocaudal, and mediolateral) during locomotion.7,8 Effects of surgical techniques have been evaluated by use of force plate gait analysis.9–14 In 1 study,9 the PVF and VI of affected hind limbs that had undergone extracapsular stabilization were not significantly different from those of clinically normal hind limbs at 7 to 10 months after surgery. In another study,10 postoperative outcomes after tibial tuberosity advancement were evaluated, and the PVF and VI in the affected hind limb were significantly higher, compared with preoperative values, and reached approximately 90% of values for control dogs. Outcomes after TPLO in dogs with experimentally induced CrCLR have been evaluated and revealed that PVF and VI in the treated limbs were significantly lower at 8 weeks after surgery15; however, there were no significant differences from the values for control limbs at 18 weeks after surgery. These findings confirm that clinical improvement can be achieved by a number of surgical methods.

The effectiveness of various surgical methods has been compared. Objective limb function was evaluated after intracapsular stabilization, lateral suture stabilization, and TPLO.11 The PVF and VI of limbs treated by use of lateral suture stabilization and TPLO were significantly higher at 2 and 6 months after surgery, and there were no differences between the lateral suture stabilization and TPLO groups over the duration of the study.11 Long-term limb function was evaluated after TPLO versus lateral fabellar suture.12 In that study,12 there were no significant differences in PVF at 24 months after surgery between dogs that underwent TPLO and a lateral fabellar suture procedure. In contrast, TPLO had better outcomes than a lateral fabellar suture procedure in another study,13 with PVF and VI significantly higher in the TPLO group than in the lateral fabellar suture group at 12 months after surgery at both walking and trotting gaits. Objective limb function after extracapsular stabilization by use of tibial tuberosity advancement and TPLO was evaluated, and TPLO resulted in normal limb function 150 to 299 days after surgery at both walking and trotting gaits.14 One of the more common surgical procedures for treatment of CrCL-deficient stifle joints of dogs is TPLO.16,17 The authors typically have been performing TPLO for management of dogs with CrCLR.

Several techniques are available for evaluation of the outcome after treatment of orthopedic disease. These include subjective evaluation of signs of pain or lameness, radiographic scoring, and force platform gait analysis.18–21 Subjective scoring systems may not accurately reflect lameness. The presence of radiographic changes may not be correlated with clinical function. The relationship between limb function and osteoarthritis in dogs with unilateral osteoarthritis of the stifle joint was evaluated, and PVF, VI, braking force, BI, propelling force, and PI were not significantly different between days 1 and 8 after surgery.22 The relationship between osteoarthritis and postoperative limb function after tibial tuberosity advancement was evaluated, and 17 of 38 (45%) joints had no progression of osteoarthritis, whereas 21 of 38 (55%) joints had progression of osteoarthritis.23 However, there were no significant differences in GRFs between 4 to 6 months and 6 to 16 months after surgery.23

Objective outcomes of cruciate ligament surgery have been evaluated by use of hind limb PVF and VI. In dogs, PVF and VI are reliable indicators of lameness.11,15,24 However, there is limited information about craniocaudal force, and the authors are not aware of any reports in which it has clearly been determined that craniocaudal force cannot be used as a reliable indicator. To the authors’ knowledge, there is only 1 report9 in which craniocaudal force was evaluated in dogs after CrCLR. In that study,9 there were changes in hind limb PVF, VI, and craniocaudal force with CrCLR. Preoperative values for PVF, VI, braking, and propulsion force were significantly lower, compared with values for clinically normal hind limbs. These values were significantly higher after surgery, and there were no significant differences from the clinically normal hind limb. Evaluating whether craniocaudal force is a useful variable for evaluating the characteristics and recovery of limb function is important.

Force plates can also be used to calculate contact time and other time variables, including time to peak braking, vertical force, and propulsion force. Force plates have been used to measure PVF, VI, and contact time in dogs with unilateral CrCLR.14,25 In those studies,14,25 before PVF and VI recovered completely, contact time was not significantly different, compared with results for a control group. The authors are also not aware of reports on the evaluation of time to PBF, vertical force, and propulsion force. Dogs control their center of gravity with forelimb and hind limb GRFs. However, many studies conducted to evaluate outcomes of CrCL surgery have included evaluation of PVF and VI of only the hind limbs. Unilateral hind limb lameness affects both the contralateral hind limb and forelimb. Therefore, assessment of the hind limbs as well as the forelimbs is necessary to evaluate gait balance.

The purpose of the study reported here was to evaluate preoperative and postoperative function of the forelimbs and hind limbs (PVF and VI), to describe characteristics of craniocaudal forces and changes over time, and to determine by use of force plate analysis the time variables for dogs with CrCLR that underwent TPLO. We hypothesized that preoperative PVF and VI of the affected hind limb would be significantly lower than those of the contralateral hind limb and that there would be no significant differences between the affected and contralateral hind limbs at the end of the study. We also hypothesized that changes in craniocaudal forces would be similar to changes in PVF and VI during the recovery process.

Materials and Methods

Animals

All dogs examined at the Fujiidera Animal Hospital between June 2015 and June 2017 were eligible for inclusion in the study. Inclusion criteria were a diagnosis of unilateral CrCLR during arthroscopy, force plate gait analysis, treatment with TPLO, and no other neurologic, orthopedic, or neoplastic diseases. The main reasons for exclusion were dogs for which gait analysis could not be performed properly, bilateral CrCLR, and concurrent medial patellar luxation or hip dysplasia. Age, sex, body weight, breed, and tibial plateau angle were recorded. Informed written consent was obtained from all owners before the dogs participated in the study. All experimental procedures were reviewed and approved by the Animal Welfare and Ethics Committee of Yamaguchi University.

Surgical treatment

Dogs were premedicated by IV administration of atropine sulfate (0.01 mg/kg), midazolam (0.2 mg/kg), and fentanyl (5 μg/kg). Propofol (6 mg/kg, IV) was administered to induce anesthesia; dogs were then intubated, and anesthesia was maintained with isoflurane in oxygen. Cefazolin (22 mg/kg, IV, q 90 min) was administered perioperatively. Postoperative antimicrobial treatment consisted of cephalexin (23 mg/kg, PO, q 12 h) for 10 to 14 days. Intraoperative analgesia was provided by a continuous rate infusion of fentanyl (5 to 20 μg/kg/h), and robenacoxib (1 mg/kg, SC, q 24 h) followed by firocoxib (5 mg/kg, PO, q 24 h) were administered for 7 days after surgery.

Each dog was positioned in dorsal recumbency with the hind limbs extending over the edge of the surgical table. Arthroscopy was performed by use of a 1.9- to 2.3-mm 30° fore-oblique arthroscope with video function.a During arthroscopy, partial or complete rupture of the CrCL and meniscal injury were assessed, and the stifle joint was classified as stable or unstable. Ruptured CrCLs were debrided with a shaver. When a meniscus tear was detected, the torn meniscus was removed. Meniscal release was not performed.

The TPLO was performed immediately after arthroscopy was completed; TPLO was performed as described elsewhere.5 The osteotomy was secured with a locking plateb,c of an appropriate size. The same surgeon (TK) performed all surgeries. Postoperative radiographs were assessed to ensure appropriate rotation angle and implant placement. All dogs were hospitalized for 2 weeks after TPLO. Postoperatively, the incision was covered with a sterile adhesive bandage. Ice was placed on the surgical site for 20 minutes 3 times/d for 1 week. Massage and passive range of motion exercises were performed until dogs were discharged from the hospital. At the time dogs were discharged, owners were instructed to exercise the dogs at home. Radiographic examination was performed at 1, 2, 4, and 7 months after TPLO.

Force plate gait analysis

Force plate gait analysis was performed before and 1, 2, 4, and 7 months after TPLO. Two force platesd embedded in a 7.2 × 0.9-m runway were used to measure GRFs. Sampling rate for the force plate was 1,200 Hz. Dogs were allowed to acclimatize to the room and walkway for at least 5 minutes; a veterinary technician then led dogs across the force plate by use of a leash. Data were collected for ≥ 6 valid trials for forelimbs and hind limbs during trotting (velocity, 1.5 to 2.0 m/s). A valid trial was defined as the forelimb and hind limb each striking the force plate separately. Force plate data were processed and synchronized by use of a digital video camera (120 Hz).e Data verification and analysis were performed by 2 veterinarians. Foot placement was confirmed by evaluation of the video camera recording.

Data analysis

Peak forces and impulses, vector magnitudes, and time variables were analyzed. Peak forces and impulses included PBF, PVF, PPF, VI, BI, and PI. Vector magnitudes included evaluation of PBF, PVF, and PPF. Time variables included contact time, time to PBF, time to PVF, time to PPF, and time to switching point from braking force to propulsion force.

Surgery period was classified as before and 1 through 45, 46 through 90, 91 through 150, and 151 through 300 days after surgery. Peak forces and vector magnitudes were expressed as a percentage of body weight, and impulses were expressed as a percentage of body weight multiplied by time. Time to PBF, PVF, PPF, and switching point from braking force to propulsion force were normalized on the basis of contact time. Time to each peak force and the switching point from braking force to propulsion force were expressed as a percentage of contact time. Data for the affected hind limb were compared with data for the contralateral hind limb. Similarly, data for the ipsilateral forelimb were compared with data for the contralateral forelimb.

Statistical analyses were performed with commercial software.f Normally distributed data were compared by use of the Student t test or Welch t test. Nonnormally distributed data were compared by use of the Mann-Whitney U test. Normally distributed data were expressed as mean ± SD, and nonnormally distributed data were expressed as median and range. Significance was set at values of P < 0.05.

Results

Animals

A total of 19 dogs met the inclusion criteria. Ten were females (8 spayed) and 9 were males (8 castrated). Mean ± SD age was 7.0 ± 3.1 years, and mean body weight was 19.6 ± 9.6 kg. Dogs comprised 3 Golden Retrievers, 3 Labrador Retrievers, 2 Jack Russell Terriers, 2 American Cocker Spaniels, 2 Pembroke Welsh Corgis, and 1 each of Border Collie, Siberian Husky, Bouvier des Flandres, German Shorthaired Pointer, Toy Poodle, and Shiba Inu; there was 1 mixed-breed dog.

Complete CrCLR was identified in 10 of 19 dogs, and partial CrCLR was identified in 9 dogs. For complete CrCLR, all stifle joints were unstable. For the 9 stifle joints with partial CrCLR, 5 were stable and 4 were unstable. Meniscal lesions were detected in 7 dogs with complete CrCLR and were treated by partial meniscectomy. Mean ± SD preoperative tibial plateau angle was 29.4 ± 4.0°, and mean postoperative tibial plateau angle was 7.6 ± 4.9°. Postoperative complications developed in 3 dogs and included fibula fracture, plate cracks, and screw loosening. Revision surgery was not necessary in any of these 3 dogs, and bony fusion of the osteotomy site was confirmed.

Force plate gait analysis

Peak forces and impulses, vector magnitudes, and time variables were analyzed.

Peak force and impulse—The PVF in the ipsilateral forelimb was significantly (P = 0.01) higher than the PVF in the contralateral forelimb before surgery and at 46 through 90 days after surgery (Table 1). The PBF in the ipsilateral forelimb was significantly (P = 0.01) higher than the PBF in the contralateral forelimb at 46 through 90 days after surgery. The PPF in the ipsilateral forelimb was not significantly different from the PPF in the contralateral forelimb throughout the duration of the study. Values for VI, BI, and PI in the ipsilateral forelimb were not significantly different from values in the contralateral forelimb throughout the duration of the study (Table 2).

Table 1—

Peak force values for the forelimbs and hind limbs of 19 dogs with unilateral CrCLR treated by use of TPLO.

   Days after surgery
VariableLimbBefore surgery1 through 4546 through 9091 through 150151 through 300
PVF (% of BW)Ipsilateral forelimb107.9 (63.9–161.7)*114.3 (79.9–168.7)113.5 (76.0–159.6)*112.5 (86.8–130.3)110.2 (75.5–175.6)
 Contralateral forelimb104.1 (62.9–148.7)113.1 (67.7–152.9)110.0 (83.5–145.0)110.1 (86.2–128.2)105.8 (76.9–153.6)
 Affected hind limb35.0 (5.7–71.5)46.4 (10.6–77.9)62.2 (36.9–85.0)65.7 (47.0–82.4)73.1 (49.6–93.9)
 Contralateral hind limb76.2 (59.0–103.8)75.4 (56.4–110.9)74.2 (56.9–97.0)71.1 (49.5–86.5)73.0 (94.8–61.5)
PBF (% of BW)Ipsilateral forelimb15.5 (3.8–29.1)16.9 (1.6–25.0)16.9 (3.4–31.6)*16.3 (3.8–27.9)15.8 (6.7–22.7)
 Contralateral forelimb14.9 (2.4–28.4)15.1 (3.5–31.0)15.7 (0.2–29.9)16.2 (2.1–24.5)16.5 (9.1–23.0)
 Affected hind limb2.5 (0.1–8.8)3.2 (0.3–8.7)3.7 (0.7–11.6)4.6 (0.1–9.7)5.2 (1.0–12.1)
 Contralateral hind limb7.2 (0.3–13.3)4.6 (0.9–16.3)6.0 (0.1–12.7)5.9 (0.4–11.1)5.5 (0.3–12.4)
PPF (% of BW)Ipsilateral forelimb7.3 (0.7–16.5)6.5 (0.4–13.7)6.6 (0.5–15.2)7.0 (0.9–11.4)7.4 (3.0–11.0)
 Contralateral forelimb7.9 (2.4–12.3)7.3 (0.7–12.8)6.7 (0.4–17.2)6.7 (0.8–11.1)6.9 (3.7–10.2)
 Affected hind limb7.2 (0.9–18.8)7.4 (1.2–16.1)8.2 (1.9–16.1)8.5 (1.4–13.1)9.1 (4.5–20.2)
 Contralateral hind limb11.9 (0.6–35.0)10.7 (1.3–21.9)10.0 (3.1–18.3)9.6 (2.0–19.1)9.7 (4.0–19.8)

Values reported are median (range).

Within a time period, value differs significantly (P < 0.05) from the value for the contralateral forelimb.

Within a time period, value differs significantly (P < 0.05) from the value for the contralateral hind limb.

Table 2—

Impulse values for the forelimbs and hind limbs of dogs with unilateral CrCLR treated by use of TPLO.

   Period after surgery
VariableLimbBefore surgery1 through 4546 through 9091 through 150151 through 300
VI (% of BW)Ipsilateral forelimb14.5 (6.8–18.6)14.8 (1.9–18.2)13.7 (8.2–17.8)14.4 (10.1–18.0)13.9 (9.8–18.0)
 Contralateral forelimb13.1 (3.9–18.8)14.0 (2.2– 22.1)13.4 (8.2–17.9)14.5 (8.3–19.1)13.8 (8.8–17.8)
 Affected hind limb4.3 (0.4– 8.2)4.5 (0.7–9.0)6.1 (3.4–8.6)7.5 (4.6–9.3)8.4 (3.5–10.1)
 Contralateral hind limb8.8 (3.0–14.5)7.8 (1.0–14.6)8.0 (3.7–13.4)8.1 (4.6–12.7)8.1 (4.3–11.4)
BI (% of BW)Ipsilateral forelimb1.11 (0.20–2.68)1.12 (0.05–2.53)1.26 (0.13–2.63)1.27 (0.32–2.60)1.21 (0.46–2.22)
 Contralateral forelimb1.18 (0.27–2.18)1.01 (0.14–2.57)1.23 (0.01–2.35)1.31 (0.16–1.95)1.26 (0.27–2.11)
 Affected hind limb0.04 (0.00–0.69)0.04 (0.00–0.46)0.09 (0.01–0.64)0.13 (0.01–0.43)0.20 (0.01–0.43)
 Contralateral hind limb0.21 (0.00–0.71)0.10 (0.00–1.30)0.21 (0.01–0.64)0.17 (0.01–1.01)0.19 (0.01–1.01)
PI (% of BW)Ipsilateral forelimb0.45 (0.01–1.42)0.43 (0.02–1.05)0.40 (0.03–0.85)0.42 (0.01–1.24)0.44 (0.13–0.87)
 Contralateral forelimb0.43 (0.03–0.96)0.29 (0.04–1.03)0.37 (0.03–1.23)0.41 (0.02–0.78)0.41 (0.13–0.87)
 Affected hind limb0.58 (0.04–1.24)0.53 (0.03–1.68)0.57 (0.10–1.15)0.60 (0.08–1.39)0.60 (0.25–1.86)
 Contralateral hind limb0.87 (0.11–1.97)0.73 (0.05–2.13)0.71 (0.06–1.75)0.73 (0.13–1.55)0.69 (0.02–1.87)

See Table 1 for key.

Values for PVF, PBF, PPF, VI, BI, and PI in the affected hind limb were significantly (P = 0.01) lower than values for the contralateral hind limb from before surgery to 91 through 150 days after surgery. Values for PVF, VI, PBF, BI, and PI in the affected hind limb were not significantly different from values for the contralateral hind limb at 151 through 300 days after surgery. However, PPF in the affected hind limb was significantly (P = 0.04) lower than PPF in the contralateral hind limb at 151 through 300 days after surgery.

Vector magnitude—Vector magnitudes for PBF and PVF were significantly higher, and vector magnitude for PPF was significantly lower, in the ipsilateral forelimb than in the contralateral forelimb before surgery (Table 3). Vector magnitude for PBF in the affected hind limb was significantly (P = 0.01) lower than the value in the contralateral hind limb from before surgery to 46 through 90 days after surgery. Vector magnitudes for PVF and PPF in the affected hind limb were significantly (P = 0.01) lower than those in the contralateral hind limb from before surgery to 91 through 150 days after surgery.

Table 3—

Vector magnitudes for the forelimbs and hind limbs of 19 dogs with unilateral CrCLR treated by use of TPLO.

   Days after surgery
VariableLimbBefore surgery1 through 4546 through 9091 through 150151 through 300
PBF (% of BW)Ipsilateral forelimb81.7 (23.9–134.0)*88.6 (19.2–154.3)85.3 (35.8–144.4)*85.8 (58.9–115.0)83.5 (26.3–161.0)
 Contralateral forelimb70.9 (21.4–135.0)87.2 (48.9–130.0)79.4 (35.5–132.0)84.6 (61.0–108.0)79.5 (53.7–135.0)
 Affected hind limb10.3 (0.5–55.8)13.6 (3.0–60.4)18.2 (6.7–70.5)22.2 (5.7–67.9)30.9 (11.6–71.3)
 Contralateral hind limb37.0 (8.7–76.1)28.5 (9.2–65.5)22.6 (4.7–75.5)19.3 (7.9–70.0)21.4 (7.5–74.5)
PVF (% of BW)Ipsilateral forelimb107.0 (64.5–162.0)*115.0 (80.1–168.8)114.0 (76.0–159.6)113.0 (87.1–131.0)111.0 (75.6–176.0)
 Contralateral forelimb104.0 (63.1–150.0)113.0 (68.4–153.7)110.9 (83.5–146.0)110.0 (86.3–129.0)106.0 (77.0–154.0)
 Affected hind limb35.0 (5.7–72.3)46.4 (11.6–77.9)62.5 (37.2–85.1)65.8 (47.8–97.7)73.6 (49.7–93.9)
 Contralateral hind limb76.6 (59.0–105.0)75.5 (56.5–111.3)74.3 (57.5–97.3)71.9 (50.4–86.5)71.3 (61.8–95.2)
PPF (% of BW)Ipsilateral forelimb58.4 (3.1–113.0)*62.0 (14.2–98.5)58.4 (26.2–105.2)56.4 (14.3–120.0)57.7 (39.2–106.0)
 Contralateral forelimb62.2 (5.3–100.0)63.0 (14.2–100.0)58.2 (11.4–96.4)55.3 (10.4–87.0)54.1 (29.6–112.0)
 Affected hind limb27.8 (2.3–66.7)35.7 (6.5–77.7)40.5 (26.0–73.3)45.5 (19.6–64.3)50.4 (28.3–68.2)
 Contralateral hind limb57.9 (29.3–86.4)59.6 (29.5–85.9)54.1 (25.8–88.7)51.8 (32.4–73.8)52.7 (31.6–76.9)

See Table 1 for key.

Time variables—Time to PVF and time to PPF in the ipsilateral forelimb were significantly (P = 0.01) less than those in the contralateral forelimb (Table 4). Time to switching from braking to propulsion in the ipsilateral forelimb was significantly (P = 0.01) less than the value in the contralateral forelimb. Time to PBF and time to switching from braking to propulsion in the affected hind limb were significantly (P = 0.01) less than those in the contralateral hind limb before surgery. However, time to PVF in the affected hind limb was significantly (P = 0.01) greater than the value in the contralateral hind limb. Time to PVF in the ipsilateral forelimb was significantly (P = 0.01) less than that in the contralateral forelimb from 1 through 45 days to 91 through 150 days after surgery. Time to switching from braking to propulsion in the ipsilateral forelimb was significantly (P = 0.01) less than that in the contralateral forelimb from 1 through 45 days to 46 through 90 days after surgery. Contact time in the ipsilateral and contralateral forelimbs was not significantly different throughout the duration of the study. Time to switching from braking to propulsion in the affected hind limb was significantly (P = 0.01) less than that in the contralateral hind limb from before surgery to 46 through 90 days after surgery.

Table 4—

Time variables for the forelimbs and hind limbs of 19 dogs with unilateral CrCLR treated by use of TPLO.

   Days after surgery
VariableLimbBefore surgery1 through 4546 through 9091 through 150151 through 300
Contact time (s)Ipsilateral forelimb0.228 (0.098–0.599)0.229 (0.101–0.361)0.221 (0.116–0.283)0.228 (0.156–0.301)0.234 (0.139–0.276)
 Contralateral forelimb0.212 (0.103–0.397)0.212 (0.127–0.446)0.215 (0.127–0.280)0.235 (0.148–0.297)0.237 (0.133–0.276)
 Affected hind limb0.193 (0.068–0.274)0.180 (0.084–0.320)0.188 (0.083–0.270)0.200 (0.142–0.305)0.204 (0.078–0.260)
 Contralateral hind limb0.198 (0.080–0.344)0.179 (0.076–0.410)0.196 (0.089–0.267)0.199 (0.148–0.264)0.203 (0.089–0.243)
Time to PBF (%)Ipsilateral forelimb28.1 (8.1–65.5)27.5 (8.4–38.7)*27.7 (12.3–45.1)28.5 (17.9–38.1)*27.3 (10.4–40.2)
 Contralateral forelimb27.4 (11.4–44.0)29.5 (16.7–39.9)28.2 (13.3–44.6)29.4 (17.7–37.9)26.6 (18.8–39.3)
 Affected hind limb7.8 (0.3–36.6)9.9 (2.8–30.1)10.2 (0.9–31.6)10.5 (1.5–36.1)12.1 (4.4–32.1)
 Contralateral hind limb11.3 (0.5–31.4)8.3 (2.1–27.5)9.2 (1.7–29.0)8.7 (3.3–29.7)9.7 (3.0–29.8)
Time to PVF (%)Ipsilateral forelimb46.5 (36.0–76.2)*45.3 (36.2–3.4)*46.2 (34.6–55.1)*46.7 (37.4–54.5)47.0 (39.7–52.6)
 Contralateral forelimb50.8 (37.7–66.4)47.8 (34.1–59.4)48.7 (31.5–79.9)48.1 (38.5–58.1)46.7 (38.6–62.5)
 Affected hind limb49.2 (6.4–72.6)46.9 (30.3–73.7)45.2 (33.3–59.5)44.4 (22.7–64.7)45.1 (38.0–50.9)
 Contralateral hind limb44.2 (29.0–59.0)45.3 (23.2–53.4)44.7 (37.2–54.0)45.1 (39.3–56.3)43.8 (34.5–54.5)
Time to PPF (%)Ipsilateral forelimb75.4 (63.3–99.5)*73.7 (62.3–84.8)*74.6 (63.6–86.8)*76.2 (65.9–97.4)75.1 (67.8–82.3)
 Contralateral forelimb79.6 (62.4–99.1)76.0 (66.4–96.0)78.1 (64.4–97.4)76.6 (63.7–92.7)75.7 (65.7–85.0)
 Affected hind limb68.0 (41.2–88.5)64.6 (44.1–81.0)66.9 (49.3–79.4)65.8 (53.2–89.4)68.5 (60.2–81.7)
 Contralateral hind limb69.0 (48.9–91.0)65.2 (47.3–82.5)67.8 (51.4–78.0)66.8 (51.5–78.5)66.5 (57.2–77.3)
Time to switchingIpsilateral forelimb56.5 (38.9–97.9)*55.9 (29.8–74.2)*57.8 (46.8–81.5)*57.9 (49.4–73.5)56.8 (48.9–69.1)*
from breaking toContralateral forelimb58.8 (47.3–92.5)58.7 (31.4–91.5)58.5 (42.9–92.3)59.5 (46.4–77.2)58.6 (48.4–67.1)
propulsion (%)Affected hind limb18.7 (2.4–57.2)24.3 (7.6–48.8)30.0 (8.3–59.4)35.4 (3.1–50.7)37.5 (9.7–54.2)
 Contralateral hind limb36.2 (3.8–65.8)31.4 (9.9–50.3)36.5 (2.9–49.8)36.3 (11.1–49.2)33.6 (9.0–52.6)

See Table 1 for key.

Discussion

In veterinary medicine, force plate gait analysis is a valuable method for use in the objective evaluation of limb function of dogs and is increasingly being used to evaluate therapeutic outcomes.26–29 Authors of some studies12,14,25,30–32 have reported that PVF and VI are reliable indicators of lameness in dogs, and gait analysis has been used to evaluate hind limb PVF and VI after CrCLR in dogs.24,33 In the study reported here, the preoperative gait pattern of dogs with CrCLR and postoperative recovery processes after TPLO were evaluated by use of force plate gait analysis. Before surgery, the affected hind limb had a significantly lower PVF, VI, PBF, BI, PPF, and PI than the contralateral hind limb, and the ipsilateral forelimb had a significantly higher PVF than the contralateral forelimb. However, craniocaudal force in the ipsilateral forelimb was not significantly different from that in the contralateral forelimb before surgery. In the affected hind limb, all GRFs were lower than values for the contralateral hind limb.

Only PVF and VI of the hind limbs of dogs with CrCLR have been evaluated in some studies.31,32 Changes in the vertical forces of the forelimbs and hind limbs have been detected in dogs with CrCLR. Authors of 1 study32 reported gait alterations in dogs after transection of the CrCL. In that study,32 PVF values of the affected hind limb and ipsilateral forelimb were significantly lower after CrCL transection; however, there was no difference in PVF values of the forelimbs 6 weeks after CrCL transection. In contrast, investigators of another study31 reported that PVF and VI were lower in the affected hind limb than in the contralateral hind limb and were higher in the forelimbs of the affected dogs than in the forelimbs of a control group. They concluded that these results were compensatory effects. In the present study, preoperative PVF in the ipsilateral forelimb was significantly higher than the PVF in the contralateral forelimb. It was possible that hind limb abnormalities affected forelimb PVF and did not affect craniocaudal peak force and impulse. This result seemed to be influenced by the type of gait. Force plate gait analysis was performed on trotting dogs because investigators of 1 study27 reported that use of a trotting gait was more accurate than use of a walking gait for diagnosing low-grade lameness. In that study,27 PVF and VI of healthy dogs during trotting and walking were compared with values for lame dogs. Sensitivity for detection of lameness by use of force plate gait analysis with walking dogs was 0.63, and specificity was 0.95. In contrast, sensitivity for the detection of lameness by use of force plate gait analysis with trotting dogs was 0.90, and specificity was 1.00. Trotting is a symmetric gait in which the diagonally paired forelimb and hind limb touch the ground at the same time. The affected hind limb and contralateral forelimb land at the same time. When the affected hind limb of a dog with CrCLR lands, the body moves upward because of the pain from the ruptured CrCL. On the other hand, when the contralateral hind limb lands, the body moves downward. These gait abnormalities are known as hip hike. In the present study, we could not quantify these movements; however, this might have been the reason that ipsilateral forelimb PVF before surgery was higher than the PVF for the contralateral forelimb.

During the postoperative recovery period, PVF and VI in the affected hind limb increased gradually, and there were no significant differences in these values, compared with values for the contralateral hind limb, at 151 through 300 days after surgery. Long-term function has been evaluated after tibial tuberosity advancement, TPLO, and extracapsular repair.14 In that study,14 limb function was evaluated as the symmetry index for PVF, VI, and contact time of the hind limbs during walking and trotting; the TPLO group had normal function during both walking and trotting at 150 through 299 days after surgery. The recovery period in that report14 was similar to the recovery period in the study reported here. However, craniocaudal force was not evaluated as a component of limb function in that previous report.14 In another study,9 investigators evaluated the clinical effects of extracapsular stabilization. In that study,9 vertical force and craniocaudal force were evaluated as limb functions before surgery and 7 to 10 months after surgery. Values of PVF, VI, PBF, BI, PPF, and PI in the affected hind limb before surgery were significantly lower than values in the clinically normal limb. At 7 to 10 months after surgery, these variables were not significantly different between the affected and clinically normal hind limbs. To our knowledge, craniocaudal force after TPLO has not been evaluated.

In the present study, craniocaudal peak force and impulse in the affected hind limb increased gradually after surgery. Values for PBF, BI, and PI in the affected hind limb and contralateral hind limb were not significantly different at 151 through 300 days after surgery. Characteristic changes in each peak force and impulse in the forelimbs were not observed during the postoperative recovery process. It was possible that the craniocaudal force in the affected hind limb would recover in the same manner as vertical force. However, only PPF did not achieve the value of the contralateral hind limb by 300 days after surgery. It was possible that TPLO may be able to result in functions similar to those of clinically normal dogs for PVF, VI, BI, and PI at 151 through 300 days after surgery. It was thought that TPLO may not have been able to result in full return of PPF because of changes in the proximal aspect of the tibial segment or because the repair process required > 300 days after surgery.

In the present study, contact time, time to PBF, time to PVF, time to PPF, and time to switching point from braking force to propulsion force were evaluated as time variables. Investigators of 1 study25 reported that contact time is an insensitive indicator of lameness. In that study,25 contact time returned to a normal control value before PVF and VI returned to normal control values. In the study reported here, contact time differed significantly during only 1 period (46 through 90 days after surgery). Evaluation of time variables for the affected hind limb before surgery revealed that the time to PBF and time to switching point were significantly less, and time to PVF was significantly greater, than values for the contralateral hind limb. These results suggested that the affected hind limb could not support braking and weight because of pain at the time of landing. These changes in balance characteristics also affected the forelimbs. Evaluation of time variables of the ipsilateral forelimb before surgery revealed that the time to PBF, time to PVF, and time to the switching point were significantly less than for the contralateral forelimb. These results suggested that obstacles to cooperative movement of the forelimbs and hind limbs were caused by an abnormality of the hind limbs. Evaluation of the time variables for the ipsilateral forelimb revealed that only the time to the switching point was still significantly less than the corresponding value for the contralateral forelimb at 151 through 300 days after surgery. It should be mentioned that even when the GRF was symmetric, the forelimb balance of braking and propulsion was still not symmetric. Changes in vector magnitude in the affected hind limb at PVF were similar to those of PVF and VI during the recovery process. The advantage of measuring vector magnitude was that it was possible to concurrently evaluate the resultant vertical and craniocaudal forces.

In the study reported here, there were no significant differences between forslimbs at 151 through 300 days after surgery. However, PPF of the affected hind limb and several time variables had not attained values similar to those of the contralateral limb at 151 through 300 days after surgery. Several factors may affect postoperative recovery of limb function. Arthroscopic joint lavage, partial menisectomy, and change in body weight may affect postoperative recovery of limb function. Joint lavage associated with the arthroscopic examination has the potential to exert a disease-modifying effect by reducing synovial inflammation and the production of proinflammatory cytokines (eg, tumor necrosis factor-α) in rabbits with osteoarthritis of the stifle joints.34 The meniscus is a structure that contributes to joint stability, and partial meniscectomy and meniscal release influence pressure distribution, stability, and arthritis progression in the stifle joints.35–38 In the present study, the lack of clinically affected dogs did not allow us to compare the effect of arthroscopic joint lavage, partial meniscectomy, and change in body weight on postoperative recovery of limb function.

Acknowledgments

The authors did not receive financial assistance for this study.

ABBREVIATIONS

BI

Braking impulse

CrCL

Cranial cruciate ligament

CrCLR

Cranial cruciate ligament rupture

GRF

Ground reaction force

PBF

Peak braking force

PI

Propulsion impulse

PPF

Peak propulsion force

PVF

Peak vertical force

TPLO

Tibial plateau leveling osteotomy

VI

Vertical impulse

Footnotes

a.

Stryker, Tokyo, Japan.

b.

Fixin, Intrauma S.p.A, Rivoli, Italy.

c.

TPLO plate, DePuy Synthes Vet, Tokyo, Japan.

d.

AccuGait, 500 × 500 × 44 mm, Advanced Mechanical Technology Inc, Watertown, Mass.

e.

ToMoCo-FPm, Toso System Inc, Saitama, Japan.

f.

Ekuseru-Toukei 2015, Social Survey Information Co, Tokyo, Japan.

References

  • 1. Johnson JA, Austin C, Breur GJ, et al. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994;2:518.

    • Search Google Scholar
    • Export Citation
  • 2. Vasser B. Clinical results following nonoperative management for rupture of the cranial cruciate ligament in dogs. Vet Surg 1984;13:243246.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Comerford E, Forster K, Gorton K, et al. Management of cranial cruciate ligament rupture in small dogs: a questionnaire study. Vet Comp Orthop Traumatol 2013;26:493497.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Tonks CA, Lewis DD, Pozzi A. A review of extra-articular prosthetic stabilization of the cranial cruciate ligament-deficient stifle. Vet Comp Orthop Traumatol 2011;24:167177.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993;23:777795.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Lafaver S, Miller NA, Stubbs WP, et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007;36:573586.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987;48:915918.

  • 8. McLaughlin RM. Kinetic and kinematic gait analysis in dogs. Vet Clin North Am Small Anim Pract 2001;31:193201.

  • 9. Budsberg SC, Verstraete MC, Soutas-Little RW, et al. Force plate analyses before and after stabilization of canine stifles for cruciate injury. Am J Vet Res 1988;49:15221524.

    • Search Google Scholar
    • Export Citation
  • 10. Voss K, Damur DM, Guerrero T, et al. Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008;21:243249.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Conzemius MG, Evans RB, Besancon MF, et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005;226:232236.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Au KK, Gordon-Evans WJ, Dunning D, et al. Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization. Vet Surg 2010;39:173180.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Gordon-Evans WJ, Griffon DJ, Bubb C, et al. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. J Am Vet Med Assoc 2013;243:675680.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Krotscheck U, Nelson SA, Todhunter RJ, et al. Long term functional outcome of tibial tuberosity advancement vs. tibial plateau leveling osteotomy and extracapsular repair in a heterogeneous population of dogs. Vet Surg 2016;45:261268.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Budsberg SC. Long-term temporal evaluation of ground reaction forces during development of experimentally induced osteoarthritis in dogs. Am J Vet Res 2001;62:12071211.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Leighton RL. Preferred method of repair of cranial cruciate ligament rupture in dogs: a survey of ACVS diplomats specializing in canine orthopedics (lett). Vet Surg 1999;28:194.

    • Search Google Scholar
    • Export Citation
  • 17. Bergh MS, Sullivan C, Ferrell CL, et al. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. J Am Anim Hosp Assoc 2014;50:315321.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Brown DC, Boston RC, Coyne JC, et al. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007;68:631637.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Quinn MM, Keuler NS, Lu Y, et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007;36:360367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Waxman AS, Robinson DA, Evans RB, et al. Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness. Vet Surg 2008;37:241246.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Vasser PB, Berry CR. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992;28:129136.

    • Search Google Scholar
    • Export Citation
  • 22. Gordon WJ, Conzemius MG, Riedesel E, et al. The relationship between limb function and radiographic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003;32:451454.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Morgan JP, Voss K, Damur DM, et al. Correlation of radiographic changes after tibial tuberosity advancement in dogs with cranial cruciate-deficient stifles with functional outcome. Vet Surg 2010;39:425432.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Evans R, Horstman C, Conzemius M. Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait. Vet Surg 2005;34:445449.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Nelson SA, Krotscheck U, Rawlinson J, et al. Long-term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs. Vet Surg 2013;42:3850.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Rumph PF, Kincaid SA, Visco DM, et al. Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hindlimb lameness. Vet Surg 1995;24:384389.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Voss K, Imhof J, Kaestner S, et al. Force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness. Vet Comp Orthop Traumatol 2007;20:299304.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Madore E, Huneault L, Moreau M, et al. Comparison of trot kinetics between dogs with stifle or hip arthrosis. Vet Comp Orthop Traumatol 2007;20:102107.

    • Search Google Scholar
    • Export Citation
  • 29. Beraud R, Moreau M, Lussier B. Effect of exercise on kinetic gait analysis of dogs afflicted by osteoarthritis. Vet Comp Orthop Traumatol 2010;23:8792.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Dillon DE, Gordon-Evans WJ, Griffon DJ, et al. Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease. Vet Surg 2014;43:446450.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Souza AN, Tatarunas AC, Matera JM. Evaluation of vertical force in the pads of pitbulls with cranial cruciate ligament rupture. BMC Vet Res 2014;10:51.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. O'Connor BL, Visco DM, Heck DA, et al. Gait alterations in dogs after transection of the anterior cruciate ligament. Arthritis Rheum 1989;32:11421147.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Fanchon L, Grandjean D. Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs. Am J Vet Res 2007;68:10891094.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. Fu X, Lin L, Zhang J, et al. Assessment of the efficacy of joint lavage in rabbits with osteoarthritis of the knee. J Orthop Res 2009;27:9196.

  • 35. Pozzi A, Kowaleski MP, Apelt D, et al. Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy. Vet Surg 2006;35:486494.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36. Pozzi A, Litsky AS, Field J, et al. Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2008;21:814.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37. Luther JK, Cook CR, Cook JL. Meniscal release in cruciate ligament intact stifles causes lameness and medial compartment cartilage pathology in dogs 12 weeks postoperatively. Vet Surg 2009;38:520529.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Kim SE, Lewis DD, Pozzi A. Effect of tibial plateau leveling osteotomy on femorotibial subluxation: in vivo analysis during standing. Vet Surg 2012;41:465470.

    • Crossref
    • Search Google Scholar
    • Export Citation

Contributor Notes

Address correspondence to Dr. Amimoto (hirokazu_amimoto@yahoo.co.jp).