C.M.F. Rezende

Fisioterapia após substituição artroscópica do ligamento cruzado cranial em cães: I - avaliação clínica, radiográfica e ultrassonográfica

The reconstruction of experimentally ruptured cranial cruciate ligament (CCL) under arthroscopic guidance and the effects of an early postoperative rehabilitation program by clinical, radiographic, and ultrasonographic exams were evaluated. Sixteen male mongrel dogs weighing from 19.2 to 26.3kg had the CCL experimentally ruptured and the stifle joint was stabilized by the use of an intracapsular arthroscopical technique with fascia lata as an autogenous graft. Eight dogs were included in a postoperative physiotherapy group and the other eight in a temporary immobilization group. From serial clinical, radiographic, and ultrasonographic examinations, no differences between groups were observed, although all dogs had showed signs of degenerative joint disease. Limb function was determined after surgery using force platform analysis, and the animals from physiotherapy group had significantly better results during rehabilitation period. It can be concluded that arthroscopic surgery for reconstruction of the cranial cruciate ligament is an efficient method to be used in dogs, in spite of not preventing the degenerative joint disease, and the physiotherapy has beneficial effects on early limb function during the rehabilitation period.

Effects of chondroitin sulfate and sodium hyaluronate on chondrocytes and extracellular matrix of articular cartilage in dogs with degenerative joint disease

Foram utilizadas amostras de cartilagem articular do femur, tibia e patela de 15 caes com doenca articular degenerativa (DAD), induzida experimentalmente. Foram constituidos tres grupos de cinco animais: grupo 1 - controle, nao medicado; grupo 2 - tratado com sulfato de condroitina e grupo 3 - tratado com hialuronato de sodio. As amostras foram processadas e coradas pelas tecnicas de HE e de azul de toluidina para avaliacao das alteracoes morfologicas, e impregnadas pelo nitrato de prata para analise da atividade metabolica e/ou proliferativa dos condrocitos, por meio da visualizacao e quantificacao de regioes organizadoras do nucleolo (NORs). Nao foram notadas diferencas significativas (P 0,05) na contagem de NORs, celulas e NORs/celula entre os grupos. As maiores contagens de NORs e de celulas no grupo tratado com hialuronato de sodio sugeriram aumento da taxa de proliferacao dos condrocitos. A maior relacao de NORs/celula obtida no grupo tratado com sulfato de condroitina sugere que essa droga estimula a atividade metabolica do condrocito, minimizando as lesoes ocorridas durante a DAD.

Sulfato de condroitina e hialuronato de sódio no tratamento da doença articular degenerativa em cães: estudo histológico da cartilagem articular e membrana sinovial

Fifteen mongrel dogs, both genders, weighting from 18 to 25kg were used and Degenerative Joint Disease (DJD) was induced through cranial cruciate ligament (CCrL) artroscopical section. After three weeks, CCrL was reconstructed by Schawalders (1989) technique. Then, dogs were distributed in three groups and the following protocols were used: group I, control, no other treatment but the CCrL reconstruction; group II received chondroitin sulfate 24mg per animal every five days, intramuscularly, in a total of six injections; and group III received sodium hyaluronate 20mg per animal every five days, intravenously, in a total of three injections. Clinical observation was done until 90 days after treatments. By that time, the articular cartilage and synovium were collected and their morphology was evaluated. In group I, the degenerative alterations of the DJD were the most intense. Thus, decrease of chondrocytes number, pannus, fibrillations, grooves, erosion, and irregular articular surface were observed on the cartilage. In group II, raise of chondrocytes number was observed, with increase of synthesis activity of matrix and decrease of lesions on the articular surface. There was an increase of chondrocytes in group III, but the cells were morphologically unviable. All the groups showed proliferation of the synovial membrane, with limpho-plasma cells infiltrated in subintim and perivascular. In groups I and III, the proliferation of synovium was abundant, with formation of pannus, flattened synoviocytes or synovium absent with granulation tissue. Those results suggest that the chondroitin sulfate stimulated the articular cartilage; decreasing or delaying the alterations of DJD, as well as, the sodium hyaluronate did not interfere on degenerative process in articular cartilage. No favorable action of these drugs in the synovial membrane was verified.

Sulfato de condroitina e hialuronato de sódio no tratamento da doença articular degenerativa experimental em cäes. Aspectos clínicos e radiológicos

The aim of this study was the evaluation of the effects of chondroitin sulfate and sodium hyaluronate in the knee joint of dogs with experimentally induced degenerative joint disease (DJD). Fifteen mongrel dogs, weighing 18 to 25kg were used. DJD was induced by cranial cruciate ligament (CCL) arthroscopical transection. After three weeks, CCL was repaired by an intrarticular technique, which uses fascia lata. The dogs were then divided into three groups as follows: group I received no other treatment, but the CCL reconstitution, group II received 24mg/animal of chondroitin sulfate/IM every five days, totaling six injections, and group III received 20mg/animal of sodium hyaluronate /IV every five days, totaling three injections. All dogs were examined clinically and radiographically for 90 days after the repairment surgery. The clinical evaluation was performed by assessment of lameness, weight-bearing, limb muscle atrophy and range of motion. The results demonstrated that the group treated with sodium hyaluronate had lower degree of lameness in comparison with other groups. The radiographic evaluation showed marginal osteophytes and subchondral bone sclerosis. These changes were more severe in the group treated with sodium hyaluronate. The better clinical results observed in this group, compared with the others, was probably due to the greater action of the drug in the synovium, decreasing the pain and lameness. Radiographic findings correlated poorly with the clinical signs in the group treated with sodium hyaluronate.

Emprego experimental da placa de compósito poli-hidroxibutirado/hidroxiapatita na fixação femoral em gatos

The composite of polyhydroxybutyrate (PHB) 70% and hydroxyapatite (HA) 30% was evaluated as plate for bone fixation in cats. The employed composite plates presented six orifices and measured 60 x 10mm, length and width, respectively, with thickness ranging from 3 to 5mm according to the region. The composite plate was used in the fixation of femoral osteotomy in four cats, in a total of six interventions. There were ruptures in five plates (83.3%) until day 4 and in one plate (16.7%) on the day 21, when it was possible to observe an exuberant osseous callus. The result of the plate deployment in the cat showed that the composite does not have sufficient strength to be used as plate of femoral fixation in cats.

Pós-operatório tardio da substituição do ligamento cruzado cranial no cão

After the replacement of the cranial cruciate ligament (CrCL) with an autogenous fascia lata graft, radiographic and clinic post-surgical evaluation were performed. Fourteen male and female dogs averaging 68 month-old and 28.6kg body weight with unilateral rupture of CrCL were selected. Twenty-eight joints were studied. The treated joints consisted of the treated and non-treated animals. The mean time from the initial onset of the symptoms to the surgery was five months and 15 days and the mean interval between the surgery and the follow-up examination was 14 months. No lameness was observed in 57.1% of the treated dogs and mild lameness in 42.9% of them. In this group, articular crepitus, pain, reduced articular motion amplitude and muscular atrophy were observed. No lameness was observed in 98.2% of the non-treated dogs. These joints showed mild arthrosis. Degenerative joint disease was observed in both groups. The surgical technique was efficient, the dogs showed clinical improvement after surgery, regardless of radiographic signs. The results were better in the dogs submitted to surgery soon after the onset of the symptoms. The interval between the injury and the treatment was the most important factor involved in the recovering after surgery.

Distrator articular no diagnóstico radiográfico precoce da displasia coxofemoral em cães

Aiming the canine hip dysplasia (CHD) early diagnosis, 60 dogs of both sexes (32 females and 28 males) and of different breeds had their hip joints radiographically studied. The X ray examinations were taken in early age (7.2± 1.2 months) and repeated at adult age (14.4± 1.6 months) using the conventional radiographic method (CRM) and the radiographic distraction method (RDM) performed, by its turn, with a new device, specially designed or this experiment. In order to quantify the relationship between the femoral head and the acetabulus the Norberg Angle (NA) was measured at CRM and the distraction index (DI) was calculated at RDM. There was a significant statistical correlation (P<0.001) between DI of the first examination and NA of the second examination. The cut off for sick and normal subjects for DI was 0.35. The dogs with DI values greater than 0,35 presented radiographic signals of degenerative joint disease (DJD). Interestingly, the highest was the DI; the greatest were the radiographic signals of DJD. Four animals considered normal when CRM was performed at second examination had DI superior than 0.35 at first examination. This fact shows that false negative results can occur when only the conventional method is used. Two of three sick dogs that had DI values bellow 0.35 were classified as borderline by CRM. This confirms the indefinite of this class. The association of CRM and the proposed method showed to be extremely useful in early age CHD diagnosis, as it can predict the adult age phenotype.

Associação entre o ângulo de Norberg, o percentual de cobertura da cabeça femoral, o índice cortical e o ângulo de inclinação em cães com displasia coxofemoral

A total of 386 radiographs of the pelvis were evaluated, being 220 of German Shepherd dogs (112 males and 108 females) and 166 of Labrador Retrievers (69 males and 97 females). The radiographs were degree classified regarding the of hip dysplasia (DHD). The Norberg and inclination angles, the cortico-medullary index, and the percentage coverage of the femoral head were measured and associated using multivariate statistical technique (principal component analysis). The cortico-medullary index and the inclination angle were inversely associated. The results indicated that German Shepherd Dogs showed lower cortico-medullary index and DHD compared with Labrador Retrievers. The higher the inclination angle, the lower the Norberg angle and percentage coverage of the femoral head. It was observed that with age, animals showed lower Norberg angles and percentage coverage of the femoral head, thus more hip dysplasia severity. Females were associated to lower femoral head coverage and Norberg angles, and more severe DHD. Femoral inclination angle and cortico-medullary index did not demonstrate a correlation to DHD.

Avaliação radiológica e artroscópica e histologia da membrana sinovial do joelho de cães tratados com associação de sulfato de condroitina e hialuronato de sódio, após doença articular degenerativa induzida experimentalmente

The aim of this study was the assessment of hyaluronic acid and chondroitin sulphate association in the therapy of degenerative joint disease (DJD) in dogs. Ten mongrel dogs underwent arthroscopic section of cruciate cranial ligament aiming the development of DJD. Twenty one days after the procedure, surgical substitution of cruciate cranial ligament was carried out in all animals. Then five animals were treated with the combination of hyaluronic acid and chondroitin sulphate. The other five dogs were used as controls. Arthroscopical and radiological evaluations of the left fore limb were carried out before arthroscopic section at the some day and 90 days after cruciate cranial ligament substitution. Histologically the effect of the association of hyaluronic acid and chondroitin sulphate was more evident in the synovial membrane that had regeneration of the intimal layer and reduced lympho-plasmocitic infiltrate in the sub-intimal layer. However, the treatment did not prevent DJD cartilage lesions evaluated by arthroscopy and radiology.

Avaliação mecânica da placa de compósito de poli-hidroxibutirato e hidroxiapatita em modelos ósseos de gato

Fixation bone plates made of 70% polyhydroxybutyrate and 30% hydroxyapatite composite were mechanically evaluated. The fifteen composite plates employed presented six holes and measured 60 x 10mm, length and width, respectively, with thickness ranging from 3 to 5mm according to the region. The plates were fixed in acrylic models of cat femur, then were subjected to tests of four-points bending, axial compression, and torsion, using as reference 2mm stainless steel plates. The means of the maximum force in flexion and compression tests were, respectively, 323.20N and 617,70N for the composite plates and 352.33N and 547.70N for the steel plates. In the torsional test, the means of torque were 1.01Nm for the composite plates and 1.15Nm for steel plates. There were no statistical differences between the plates of composite and steel. The physical behavior of the material was different once the composite plates broke up while the stainless steel ones only presented deformation, revealing the low ductility of the composite plates