Guia de perfuração tíbio-femoral no tratamento de ruptura do ligamento cruzado cranial

Abstract

The objective of this work was to prepare an adjustable guide for tibio-femoral perforation in dogs' cadavers from ex-vivo measurements and 3D prototype printing. We used 43 cadaver´s dogs with sex or race no defined, with macroscopically normal femorotibiopatellar joints, divided into three groups of body weight: G1: 10 to 20.9 kg; G2: 21 and 30.9 kg; G3: 31 and 40 kg. The femorotibiopatellar joints of the right and left pelvic limbs were used. The width of the femoral condyles in the proximal and medial proximal thirds, the height of the condyle, the extension of the trochlear surface and the extension of the perforation holes in the femur and the tibia were measured using an analog caliper. With the aid of a specific drill and drill, the femur and the tibia were drilled concomitantly for passage through the LCCr insertion areas in both bones. With the help of a goniometer, the flexion angles of the femorotibiopatellar joint and the angle of the drill in the femur and the tibia were measured with respect to the axis of the limb. A photograph was taken of the lateral surface of the intercondylar incision of the lateral condyle of the femur (previous sagittal cut) and of the articular surface of the tibia. A 4x4 frame in the case of the femur and 6x6 in the tibia were placed on the photographs to delineate the areas of insertion of the LCCr and their respective perforation. The data obtained were analyzed by different statistical tests. For all analyzes, the level of significance considered was 5%. Statistical analyzes were performed using SAS 9.4 software. A strong correlation was observed between the condylar dimensions and the extent of perforations with body mass of cadavers of dogs. There was no correlation between the angles and the body mass. There was a strong correlation between the fit vs error in relation to the angle of femorotibiopatellar flexion. From the results from the study it can be concluded that the proper angle of flexion of the FTP joint and the angle with respect to the cranial femoral axis are essential to obtain a femorotibial perforation in the LCCr insertions. The absence of a static fixator aiming to maintain constant FTP bending induces failure in drilling.