Heat stress in cows at pasture and benefit of shade in a temperate climate region.

Under temperate climates, cattle are often at pasture in summer and are not necessarily provided with shade. We aimed at evaluating in a temperate region (Belgium) to what extent cattle may suffer from heat stress (measured through body temperature, respiration rate and panting score, cortisol or its metabolites in milk, and feces on hot days) and at assessing the potential benefits of shade. During the summer of 2012, 20 cows were kept on pasture without access to shade. During the summer of 2011, ten cows had access to shade (young trees with shade cloth hung between them), whereas ten cows had no access. Climatic conditions were quantified by the Heat Load Index (HLI). In animals without access to shade respiration rates, panting scores, rectal temperatures, and milk cortisol concentrations increased as HLI increased in both 2011 and 2012. Fecal cortisol metabolites varied with HLI in 2011 only. When cattle had access to shade, their use of shade increased as the HLI increased. This effect was more pronounced during the last part of the summer, possibly due to better acquaintance with the shade construction. In this case, shade use increased to 65% at the highest HLI (79). Shade tempered the effects on respiration, rectal temperature, and fecal cortisol metabolites. Milk cortisol was not influenced by HLI for cows using shade for > 10% of the day. Therefore, even in temperate areas, cattle may suffer from heat when they are at pasture in summer and providing shade can reduce such stress.

Faculty's work engagement in patient care: impact on job crafting of the teacher tasks.

BACKGROUND: High levels of work engagement protect against burnout. This can be supported through the work environment and by faculty themselves when they try to improve their work environment. As a result, they can become more engaged and better performers. We studied the relationship between adaptations by physicians to improve their teaching work environment, known as job crafting, and their energy levels, or work engagement, in their work as care provider and teacher. Job crafting encompasses seeking social (i) and structural (ii) resources and challenges (iii) and avoiding hindrances (iv). METHODS: We established a cross-sectional questionnaire survey in a cohort of physicians participating in classroom and clinical teaching. Job crafting and work engagement were measured separately for physicians' clinical and teaching activities. We analyzed our data using structural equation modelling controlling for age, gender, perceived levels of autonomy and participation in decision making. RESULTS: 383 physicians were included. Physicians' work engagement for patient care was negatively associated with two job crafting behaviors in the teaching roles: seeking structural resources (classroom teaching: ß = - 0.220 [95% CI: -0.319 to - 0.129]; clinical teaching: ß = - 0.148 [95% CI: -0.255 to - 0.042]); seeking challenges (classroom teaching: ß = - 0.215 [95% CI: -0.317 to - 0.113]; clinical teaching:, ß = - 0.190 [95% CI: -0.319 to - 0.061]). Seeking social resources and avoiding hindrances were unaffected by physicians' work engagement for patient care. CONCLUSIONS: High engagement for teaching leads to job crafting in teaching. High engagement for patient care does not lead to job crafting in teaching.

Is being a medical educator a lonely business? The essence of social support.

CONTEXT: Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators. METHODS: We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach. RESULTS: Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role. CONCLUSION: Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met.

Public opinions on seven different stray cat population management scenarios in Flanders, Belgium.

Stray cat population management is an important worldwide issue. Understanding citizen attitudes towards stray cat control options is vital to the success of controlling stray cat numbers, as public perception affects the acceptance of, support for and collaboration in stray cat management policies. Audience segmentation, as to enable each group to be engaged in the stray cat management policy, is important for the success of the interventions. Therefore a web-based survey was conducted among Flemish citizens in order to examine differences in acceptance towards seven management scenarios: household cat neutering with financial support for the owner, household cat neutering without financial support for the owner, encouraging responsible household cat ownership, trapping stray cats and taking them to a shelter, trapping and neutering stray cats for release into a managed "cat colony" (composed by so called "community cats"), trapping and killing of stray cats, and undertaking no action. A total of 4059 valid responses were collected and the proportions of agreement were compared across the different management scenarios using the two-sample z-test. Interactions among factors that influenced each management scenario were investigated using the CHAID (Chi-squared Automatic Interaction Detection) analysis and visualized on a tree. Our results showed that fostering responsible household cat ownership (89.9%) and conversion of stray cats to "community cats" (76.3%) were most supported by respondents in our sample (which consisted mainly of females, cat-lovers, and families without children). Least supported were the killing of stray cats (7.7%) and undertaking no action (3.3%). The demographic analyses revealed that for the acceptance of management scenarios there were three important factors (attitude towards cats, area of residence, and gender), two weaker factors (education and having children) and two which had almost no impact (age and cat ownership). We propose that future studies should focus on the effect of 'area of residence', 'having children' and 'education'. In conclusion, our research confirms that management of and communication on stray cat strategies should not be developed with a one-size-fits-all approach. Efforts should be tailored to each audience segment, thus adapted to the area of residence and human characteristics.

Killing individual poultry on-farm-a survey among veterinarians and farmers.

To date, information about reasons to select and kill poultry on-farm and which method veterinarians and poultry producers preferably use is scarce. Little is also known about their knowledge of the legislation regarding on-farm killing methods and of methods alternative to the one(s) they use, as well as their perception of those alternatives. In this study, Flemish poultry veterinarians (n = 13), broiler chicken producers (n = 27), and turkey producers (n = 4) were surveyed on killing methods they currently use in practice and alternative methods, on their opinion about what constitutes an appropriate method for on-farm killing of poultry, and on their reasons for killing. All poultry veterinarians and chicken producers who filled out the survey kill poultry by manual cervical dislocation (CD), whereas some turkey farmers also indicated killing by percussive blow to the head (n = 1) or exsanguination (n = 1). Turkey producers seem to be more inclined not to kill animals with injuries or symptoms of disease as compared to veterinarians or chicken producers, such that moribund turkeys are more likely to remain in the flock. Veterinarians considered the following properties of a killing method important: animal friendliness, applicability inside the stable, a high success rate, and time efficiency. Producers ranked the properties similarly, but for them, ease of performance and cost-efficiency were more important than applicability inside the stable. Producers scored those killing properties rather positively for manual as well as mechanical CD. Veterinarians and chicken producers considered the captive bolt method to be easy to perform, to have a high success rate, to be feasible to perform in the stable, and to be animal-friendly. Turkey producers, however, had doubts about the latter 2 properties. Gas, injection, and electrocution were inferior methods to kill poultry according to producers. In conclusion, manual CD is the most common method for killing broiler chickens and turkeys, and knowledge of, and experience with, alternative methods is very limited, both among veterinarians and producers. Informing them about legislation and training for the use of alternative killing techniques are recommended.

Physiological stress reactivity and recovery related to behavioral traits in dogs (Canis familiaris).

This study investigated whether stress responsiveness (in one context) can be used to predict dog behavior in daily life. On two occasions (NT1 = 32 puppies; NT2 = 16 young adults), dogs' physiological stress response after a behavioral test at home was measured in terms of reactivity (10 min post-test) and recovery (40 min post-test) for three salivary markers: cortisol, chromogranin A (CgA) and secretory immunoglobulin A (sIgA). For each marker, it was determined whether dogs with a strong physiological response displayed different behavior in daily life compared to dogs with a weaker physiological response. The results revealed three main findings: first, for CgA and cortisol, different patterns were identified according to sample time. High reactivity related to desirable traits, whereas slow recovery after the behavioral test related to undesirable traits. The findings suggest that increased levels of CgA and cortisol 10 minutes after the behavioral test reflected an adaptive stress response, whereas elevated levels 40 minutes after the test reflected unsuccessful coping. Second, patterns for sIgA differed from CgA and cortisol: significant associations were only found with behavioral traits at T2, mostly considered desirable and related to Trainability. Possibly, the delayed reaction pattern of sIgA caused this difference between markers, as sIgA reflects the (secondary) immune response to stress, due to immunosuppressive effects of cortisol. Third, predictive capacity of puppies' physiological stress response (T1) was inconclusive, and contrary relations were found with behavioral traits at T2, suggesting that developmental factors play an important role. This study provides new insights about the relation between stress physiology and behavioral traits, and methodological advice is given to study these patterns further. In conclusion, physiological markers could provide additional insights in dogs' tendencies to display certain behaviors, especially at the young adult stage. Further studies are needed to confirm these patterns.

On the origin of puppies: breeding and selling procedures relevant for canine behavioural development.

The success of the dog as a companion animal has undeniably led to a shift in dog breeding practices. While effects of inbreeding or large-scale breeding have given rise to numerous studies about potentially related health issues, it remains unclear to what extent behavioural development of dogs is influenced. By investigating the environment of puppies while at the breeder, the authors aimed to make an inventory of current practices regarding management, socialisation and environmental learning and subsequently to identify potential differences between breeder types. The cross-sectional study, conducted during 2016, revealed considerable variability in environment among dog breeders. Small-scale breeders, and especially occasional breeders (less than 10 adult dogs on-site) provided most enrichment, both social and non-social, by, for instance, providing more outdoor access for pregnant dams and puppies or by providing access to visitors more freely. Environmental stimuli were less controlled in occasional breeders, raising the debate about quantity versus quality of stimuli at a young age. Large-scale breeders declared to screen potential owners less intensely and time to advise them was limited. To the authors' knowledge, this is the first study that compares a large number of environmental factors between the different dog breeding categories.

Rejections in an non-purpose bred assistance dog population: Reasons, consequences and methods for screening.

Assistance dogs aid people with various impairments on a daily basis. To become an assistance dog, a strict selection procedure and intensive training period must be successfully completed. Consequently, not every dog acquired for this purpose, becomes an assistance dog. The purpose of this study was to investigate reasons for failure and the financial consequences thereof for assistance dog associations that do not have a dedicated breeding program for their dogs. Data were collected for a total of 537 dogs enlisted between 2001 and 2015 and purchased out of the general dog population by five Belgian assistance dog associations. Only 60 percent of the dogs actually became an assistance dog and the main reasons for failure were related to undesirable behavioural characteristics and orthopaedic disorders. The estimated average financial loss per rejected dog was found to be 10524 euro. A detailed comparison of the two most popular breeds (Golden Retriever and Labrador Retriever) within the guide dogs and mobility assistance dogs revealed no significant difference in probability of successfully completing the training. However, a comparison of orthopaedic screening methods revealed a higher rejection with computed tomography for elbow dysplasia and laxity-based radiographical techniques for hip dysplasia compared to radiography and the standard ventrodorsal hip extend radiograph alone, respectively. Based on these results, we provide several suggestions to increase the probability of success.

Intraperitoneal versus subcutaneous telemetry devices in young Mongolian gerbils (Meriones unguiculatus).

Radiotelemetry has become a very popular biotelemetric tool for measuring physiological parameters such as heart rate, blood pressure, body temperature and muscle activity, as well as general behavioural activity in undisturbed, freely moving animals. In most studies using this technique, adult subjects are used. However, sometimes an ontogenetic approach is required to clarify whether changes in one parameter are preceeded or followed by changes in another parameter. Tracking physiological changes in young, developing individuals could explain given states of these animals as adults. Implanting telemetry devices can be done subcutaneously and intraperitoneally, the former method posing less of a challenge on the animal and its recovery from surgery. Because telemetry will be used in weanling gerbils during subsequent studies, we needed to investigate whether subcutaneous implantation of telemetric devices is preferable to intraperitoneal surgery with respect to animal welfare. This is a technical paper describing anaesthetic and surgical techniques in detail during a pre-trial involving subcutaneous (n=10, aged 21-29 days) and intraperitoneal (n=10, aged 19-34 days) implantation of dummy telemetry transmitters (1.9 cm3, 3.6 g after shortening of leads) in weanling gerbils, Meriones unguiculatus. Body weight was measured and analysed over four-day intervals. Optimizing anaesthetic dosages was a first step in this pilot trial. This occurred during the first few subcutaneous implantations. Three animals died while anaesthetized during the subcutaneous procedure but none post-surgery. All animals survived anaesthesia during the intraperitoneal implantation, but two died in the first three days post-surgery. In the former method, the tension on the dermal sutures caused by the presence of the transmitters was too great, resulting in the animals opening the sutures by chewing them. The animals died during the latter procedure probably due to strangulation of the intestine by the excess lead that was coiled in the abdomen. Furthermore, placement of the exposed negative lead of the transmitter on the underlying muscle had to be done on the m. pectoralis transversus in order for it to stay in place as the animal developed. This paper showed that the implantation of a telemetric device in weanling gerbils is feasible and is best executed through the intraperitoneal technique.

Prepubertal gonadectomy in cats: different injectable anaesthetic combinations and comparison with gonadectomy at traditional age.

Anaesthetic and analgesic effects of three different injectable anaesthetic combinations for prepubertal gonadectomy (PPG) in cats were studied. One anaesthetic protocol was compared with a similar one for gonadectomy at traditional age (TAG). Kittens were randomly assigned to PPG or TAG. For PPG, three different protocols were compared: (1) intramuscular (IM) administration of 60 µg/kg dexmedetomidine plus 20 µg/kg buprenorphine followed by an IM injection of the anaesthetic agent (20 mg/kg ketamine) (DB-IM protocol); (2) oral transmucosal (OTM) administration of 80 µg/kg dexmedetomidine plus 20 µg/kg buprenorphine followed by an IM injection of 20 mg/kg ketamine combined with 20 µg/kg dexmedetomidine (DB-OTM protocol); (3) IM injection of a 40 µg/kg medetomidine-20 µg/kg buprenorphine-20 mg/kg ketamine combination (MBK-IM protocol). For TAG, a DB-IM protocol was used, but with different doses for dexmedetomidine (40 µg/kg) and ketamine (5 mg/kg). All cats (PPG and TAG) received a non-steroidal anti-inflammatory before surgery. Anaesthetic and analgesic effects were assessed pre- and postoperatively (until 6 h). Cumulative logit, linear and logistic regression models were used for statistical analysis. Compared with the DB-OTM protocol, the DB-IM and MBK-IM protocols provided better anaesthesia with fewer adverse effects in PPG cats. Postoperative pain was not significantly different between anaesthetic protocols. PPG and TAG cats anaesthetised with the two DB-IM protocols differed significantly only for sedation and pain scores, but sedation and pain scores were generally low. Although there were no anaesthesia-related mortalities in the present study and all anaesthetic protocols for PPG in cats provided a surgical plane of anaesthesia and analgesia up to 6 h postoperatively, our findings were in favour of the intramuscular (DB-IM and MBK-IM) protocols.

In vivo degradation of massive poly(alpha-hydroxy acids): validation of in vitro findings.

The degradation of various high-molecular-weight aliphatic polyesters derived from glycolic acid and/or lactic acid enantiomers was previously investigated in vitro. It was demonstrated that the bulk degradation mechanism proposed in the literature actually proceeds heterogeneously and proceeds faster in the centre than at the surface of large specimens. In order to compare them, similar compression-moulded specimens were implanted intramuscularly in the backs of rabbits, namely PLA50 (poly(DL-lactic acid)), PLA37.5GA25 (75% DL-lactide and 25% glycolide in the feed) and PLA75GA25 (75% L-lactide and 25% glycolide). These three intrinsically amorphous compounds exhibited faster central degradation. Furthermore, preferential degradation of glycolic acid units and induced crystallization of L-lactic acid enriched fragments were observed in the case of PLA75GA25. These findings are comparable to phenomena observed in vitro and are conclusively supported by the re-examination of some old in vivo results. Accordingly, data reported in this paper validate both the in vitro modelling and new understanding of the degradation of lactic acid/glycolic acid-based aliphatic polyesters reported previously.

A reflection scanning acoustic microscope for bone and bone-biomaterials interface studies.

A relatively simple scanning acoustic microscope (SAM) that operates in the reflection mode has been constructed. The system uses a 20 MHz spherically focused transducer, acting both as transmitter and as detector, to obtain acoustic impedance information on a thin surface layer at a maximum resolution of approximately 100 micron. The specimen is mounted on an X-Y driving system (precision, 5 micron) under computer control in order to scan a grid of 256 x 256 points across areas ranging from 6.5 to 1300 mm2. An algorithm is used to reference the data against standards; specially developed software provides for pseudo-color mapping, three-dimensional images, zooming to 16 x magnification, contouring, and single line profiles of the data. The system has been used to determine inhomogeneities in surface acoustic properties of mineralized tissues and implant materials, in many cases as a complement to using ultrasonic wave propagation techniques to measure the bulk anisotropic properties.

The evaluation of bone remodeling about orthopaedic implants with ultrasound.

Total hip arthroplasty causes biomechanical changes in the normal femur, including a redistribution and concentration of stress. These mechanical alterations in the femur cause local remodeling and resorption that affect the geometry and mechanical properties of the bone. Two complementary ultrasonic techniques were used to study the local adaptive remodeling of bone due to prosthesis implantation. An ultrasonic wave propagation technique was used to determine elastic properties and a new scanning acoustic microscope (SAM) mapped the acoustic impedance profile of each section. The effects of the implantation of two types of hip prostheses, an uncemented bipolar prosthesis with an Austin-Moore type stem and a cemented Charnley prosthesis, were investigated. Both prostheses had a detrimental effect on local elastic properties as determined by acoustic velocity measurements. The SAM system provided information about local inhomogeneities in bone properties not obtainable by any other means. The acoustic impedance maps highlighted bone resorption and bone remodeling on a microstructural level.

The evaluation of cortical bone remodeling with a new ultrasonic technique.

Total hip arthroplasty causes biomechanical changes in the normal femur including a redistribution and concentration of stress. These mechanical alterations in the femur cause local remodeling and resorption that affect the geometry and mechanical properties of the bone. Three complementary techniques were used to study the local adaptive remodeling of bone due to prosthesis implantation. A graphics package was used to obtain section geometrical information, an ultrasonic wave propagation technique to determine elastic properties, and a new scanning acoustic microscope (SAM) to map the acoustic impedance profile of each section. The effects of the implantation of two different types of hip prostheses were investigated, an uncemented bipolar prosthesis with an Austin-Moore type stem and a cemented Charnley prosthesis. Prosthesis implantation resulted in an increase in cortical area and mediolateral diameter and a decrease in anterio-posterior diameter. Both prostheses had a detrimental effect on local elastic properties as determined by acoustic velocity measurements. Finally, the SAM system provided information about local inhomogeneities in bone properties not obtainable by any other means. The acoustic impedance maps highlighted bone resorption and bone remodeling on a microstructural level.

Alumina-on-alumina hip replacement. Results and survivorship in young patients.

Total hip replacement using an alumina head and socket and a titanium alloy stem is evaluated in a series of patients under 50 years of age. Between April 1977 and December 1986, 86 such replacements were performed in 75 patients, but mainly because patients had difficulty travelling from Africa, only 71 hips were followed up adequately; of these, 56 were primary procedures and 15 revisions. Survivorship analysis showed that 98% of the prostheses were retained for 10 years. On clinical and radiological examination 51 of the 71 hips were stable and acceptable, 15 had radiological changes on the acetabular side, and one on the femoral side; four other cases had clinical and radiological changes suggesting impending failure, possibly because fixation of the socket was inadequate. There were no differences between the results of the primary procedures and those of revisions. In these young patients, the results seem better with alumina-on-alumina hips than with other varieties, possibly because of their remarkably low wear.

To enrich or not to enrich: providing shelter does not complicate handling of laboratory mice.

Environmental enrichment (EE) is used in laboratory animal housing to provide stimuli exceeding those of barren cages and is intended to improve the welfare of captive animals. It is argued that when laboratory mice can routinely retreat in sheltering objects when humans are present, they do not habituate to humans and continue to shy away, thereby increasing the time needed for husbandry and testing procedures. To this date very limited research has been carried out to determine whether providing EE in the form of shelter interferes with the habituation of mice to humans and thus complicates catching and handling them. We housed 20 FVB (inbred) and 20 NMRI (outbred) male mice in standard cages and another 20 FVB and 20 NMRI male mice in cages enriched with two PVC conduits. When the mice were 10 weeks old, measurements of food and water consumption, weight, latency of catching, and a behavior score in response to handling during a sham subcutaneous injection were performed weekly for 4 consecutive weeks. Food and water consumption and weight were influenced by strain, but the presence of EE in the home cage did not affect these parameters as much. Outbred mice ate, drank, and weighed more than did the inbred animals, but they did not significantly gain weight during the course of the 4 testing weeks. Cage enrichment in the form of PVC conduits decreased the time needed to catch outbred animals and did not increase the time needed to catch mice from the inbred strain. Furthermore, no differences in resistance to being held during the sham injection could be detected between animals from the enriched versus non-enriched group. These results indicate that EE in the form of sheltering objects does not complicate catching or handling mice and that allowing access to enrichment in the laboratory cage, which has been shown to have positive effects on welfare, does not interfere with the management or cost of laboratory animals.

[Magnetic resonance imaging in lesions of the plantar aponeurosis]. / Imagerie par résonance magnétique (IRM) des lésions de l'aponévrose plantaire.

Exploration of sporting injures to plantar aponeurosis (PA) has up to now been based mainly on clinical examination, from which the diagnosis was established. Imaging technics such as standard radiography and ultrasound scanning have limitations allowing diagnosis to be made usually only by elimination, the lesion being very rarely visualized directly. Ten patients with hyperalgic lesion of plantar arch and functional impotence were explored by MR imaging, and in all cases this examination provided superior data confirmed at operation. The examination is painless and little invasive and can be carried out during the acute phase. The plantar aponeurosis is visualized directly between the muscle mass of the plantar arch and the fatty cushion. All three spatial planes can be investigated, most interesting data being obtained from the sagittal (in the PA axis) and frontal (comparative) planes.

[Normal and pathological MRI aspects of the posterolateral corner of the knee]. / Aspects IRM normaux et pathologiques du point d'angle postéro-externe (PAPE) du genou.

The purpose of the study is to compare normal PLC anatomy and its MRI appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit with gradient echo T1, T1 and T1 GD-DOTA IV. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilisation of lateral condyle. Unrecognised and untreated posterolateral instability may result in failure of ACL reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC.

[Anterio-lateral extra-articular tenodesis of the knee using a short strip of fascia lata]. / Plastie extra-articulaire antéro-latérale du genou utilisant une ténodèse courte au fascia lata.

This study describes a lateral extra-articular tenodesis using a short strip of ilio-tibial band. The tenodesis consists of a 12 x 75 mm strip of iliotibial band remaining attached to the Gerdy's tubercle. An isometric point in the region of Krackow's point F-9 is determined with a callipers. The strip of iliotibial band is twisted by 180 degrees to enhance its isometry. Then it is either onlay with a screw and spiked washer on the F-9 point, or within a transverse tunnel drilled through the lateral femoral condyle, from the F-9 point, using and interference screw. Thus, the uses of a short ilio-tibial band tenodesis with a 180 degrees twist in combination with a BPTB reconstruction of the ACL, leads to similar results that the combined classic Lemaire tenodesis, with shorter skin incision, shorter graft harvesting, and at least on the biomechanical standpoint a better graft isometry.

[Influence of the suture technique and material on the mechanical behavior of a reinforced Mac Intosh graft]. / Influence de la technique et du matériel de suture sur le comportement mécanique du transplant de Mac Intosh renforcé.

The anterior cruciate ligament reconstruction by a biological graft augmented by a synthetic device allows theoretically to increase the strength of the composite graft during the remodeling period. The technical realization of the reinforcement is still controversial because it is difficult to obtain a mechanical compromise between a real effect of protection of the graft and a load sharing to favour the remodeling. When the graft and the augmentation device are tied together the ligature between them plays a fundamental mechanical role. The first goal of the present study was to define by calculation and experimentation the influence of the suturing method on the strength of the graft-device ligature. The second goal was to appreciate the possibility of using absorbable suture in such an application. Calculation allowed to show that the weakest area of the composite graft was the junction between the augmented and unaugmented parts of the graft. When increasing number and anchorage of sutures in this critical area it was possible to double the resistance of the ligature. To define the outcome of absorbable suture the strength decrease was measured during the resorption period. Two threads were tested: the polyglactin 910 (Vicryl) and the polydioxanon (PDS). The strength decrease was sudden and rapid for the Vicryl (50 p. cent in 3 weeks). For the PDS the strength loss was more gradual (50 p. cent in 8 weeks). With these two threads the strength duration appeared as incompetent to allow the augmentation to protect the graft during all the remodeling period.