Anterior cruciate ligament replacement with polyester fibre. A long-term study of tissue reactions and joint stability in sheep.

We excised the anterior cruciate ligament from the left stifle of 24 sheep and replaced it by a polyester fibre implant routed 'over the top' of the femoral condyle and fixed, using grommets and screws. All the joints were sound, and the animals moved normally until they were killed at six, 12 and 24 months after operation. We found that the implants were always covered by host tissue, which matured into bundles with a histological appearance similar to the natural ligament. The implants were joined to the bones by organised fibrous tissue and there was no anchorage loosening. There was no synovitis, but the operated joints showed progressive cartilage degeneration. The reconstructed joints became less stable immediately after operation, but regained normal stability as the neoligaments developed. The neoligaments lost strength with time, despite tissue ingrowth. The good functional, biomechanical, and histological results justify clinical trials of this type of implant.

The effect of induced electric currents on bone after experimental osteotomy in sheep.

We have investigated the effect of currents induced by electromagnetic fields on the healing of the tibia of sheep after osteotomy, using objective and quantifiable criteria wherever possible. A battery-powered, induction apparatus was developed and was enclosed within the cast applied to the limb, so that the treated fractures received pulsed magnetic fields for 24 hours a day while the animals were freely mobile. In all, 13 sheep were treated and 13 were used as controls. The response was assessed by radiography of the limb and of the excised bone, by histology, including measurement of the areas of callus, fibrocallus and cortical bone, and by measurement of the uptake and extraction of bone-seeking mineral. All the bones healed and no statistically significant differences between the treated animals and the controls were discovered except (at only P less than 0.05) in the uptake of bone-seeking mineral; this increased more rapidly in treated animals over the two to three weeks after osteotomy, although at six weeks the uptake in both groups was the same.

Comparison of three injectable anaesthetic techniques in pigs.

Forty-six near-adult pigs (mean age 10 months, mean weight 156 kg) were anaesthetised for laparoscopy. After intramuscular azaperone (1.0 mg/kg) and ketamine (2.5 mg/kg), 14 of the pigs received intravenous etomidate (200 micrograms/kg) and midazolam (100 micrograms/kg) and 17 were given ketamine (2 mg/kg) and midazolam (100 micrograms/kg). The other 15 pigs were anaesthetised with pentobarbitone (15 to 20 mg/kg) without pre-anaesthetic medication. The duration and adequacy of anaesthesia, recovery rate, and seven physiological variables (ECG, heart rate, indirect arterial blood pressure, respiratory rate, minute volume, mean end-tidal carbon dioxide concentration and percentage oxygen saturation of haemoglobin) were compared. Repeated injections were needed in 29 of the 46 cases. Pentobarbitone was the least satisfactory drug because although the haemodynamic variables were greater, it caused more respiratory depression and a higher overall complication rate than the other methods. Apnoea occurred in two pigs, and was fatal in one, and positive pressure ventilation with oxygen was needed in three others. Intubation conditions were poorer and the times to standing, walking and rooting were longer in the pigs anaesthetised with pentobarbitone.

A mechanical stimulator for the determination of the minimum alveolar concentration (MAC) of halothane in the rabbit.

The minimum alveolar concentration (MAC) of halothane was determined in New Zealand White rabbits. Tracheal anaesthetic concentrations were measured using a Siemens Servo Gas Monitor. A stimulator was used to deliver precisely controlled mechanical stimuli for the determination of MAC. Movement of the rabbit's head was recorded using a force transducer attached to the teeth. Evidence is presented that for the determination of MAC a precise nociceptive threshold is preferable to the so-called supramaximal stimulus used in clinical anaesthesia and in determination of anaesthetic potency. We conclude that techniques for the determination of MAC which disregard either sensitization of sensory mechanisms by producing tissue inflammation or the possibility of nerve compression by severe mechanical stimuli are of questionable value. The use of the mechanical stimulator described, or a similar device, would help in the standardization of the determination of MAC in all species by facilitating the application of a force of controlled amplitude, duration and velocity, thereby removing some of the variables which confound comparative studies of MAC.

Focal heat stimulation for the determination of the minimum alveolar concentration of halothane in the rabbit.

A focal heat stimulus of 54.37 +/- 0.07 (SD) degrees C was applied for 30 s to the inner aspect of the pinna of the ear for the determination of the minimum alveolar concentration (MAC) of halothane in New Zealand White rabbits. The latency before head movement was measured electromanometrically. The MAC value was 1.05 +/- 0.09 (SD)%. Other physiological responses occurred inconsistently and could not be used as reliable end points for the determination of the MAC in the rabbit.

Gastro-oesophageal reflux in halothane anaesthetized sheep. The effects of feeding and positioning.

The frequency of gastro-oesophageal reflux (GOR) in sheep anaesthetized with halothane was reduced by withholding food and water for 24 hours. The total reflux volume increased. The effect of body position on GOR was studied by inclining the operating table at angles to the horizontal and positioning the head up or down on sand bags. The operative positions investigated were: right and left lateral recumbency with head down, dorsal recumbency with head down and right lateral recumbency with head up. Least GOR occurred when the sheep was in right lateral recumbency with a head up tilt and the body inclined at 20 degrees from the horizontal. A cuffed oesophageal drainage tube increased the incidence of GOR but prevented the chances of the aspiration of rumen material.

Motility of the oesophagus and gastro-oesophageal junction during halothane anaesthesia in sheep.

Electromanometry and electromyography were used to study gastro-oesophageal motility in two planes of halothane anaesthesia in sheep. Gastro-oesophageal motility when present was greater in light than in deep anaesthesia. The caudal thoracic oesophagus contracted more frequently and for longer than the rostral thoracic oesophagus. In light anaesthesia oesophageal movements were peristaltic in direction with a propagation velocity of 26-29 cm sec-1. Rumen pressures increased throughout anaesthesia and the rate of increase was greatest when the plane of anaesthesia was deep at the start. Gastro-oesophageal reflux (GOR) occurred in both planes of anaesthesia and must occur by passive mechanisms during deep anaesthesia because gastro-oesophageal motility was inhibited. A high pressure zone (HPZ) was demonstrated for a length of 2.9 cm at the gastro-oesophageal junction with a balloon-tipped catheter and a 'pull through' technique. Open-tipped catheters could detect the HPZ but were less sensitive. The pressure in the HPZ was not significantly influenced by the depth of anaesthesia used. In 80% of cases of light anaesthesia an increase in HPZ pressure preceeded the contraction of the cranial sac of the rumen. In deep anaesthesia the HPZ continued to have rhythmic changes in tone. Spontaneous GOR coincided with a maximum gastro-oesophageal pressure gradient in 24% of cases. Rumen insufflation with oxygen provoked GOR at a rumen pressure above 33 mmHg compared with 7.2 mmHg during spontaneous reflux. The study demonstrates that a gastro-oesophageal pressure gradient was not primarily responsible for the initiation of GOR during anaesthesia and that the HPZ at the gastro-oesophageal junction of sheep had some of the properties of a lower oesophageal sphincter and played an important role in the initiation of GOR during anaesthesia.

A comparative study of single- and double-bundle ACL reconstructions in sheep.

Work in vitro has previously shown superior restoration of knee stability using a double-bundle anterior cruciate ligament (ACL) reconstruction compared with single bundles taken through the condyle or 'over the top'. This paper describes an animal study designed to compare the three ACL reconstructions in vivo, in order to collect data that could support the clinical use of a double-bundle reconstruction. The three methods were compared in three groups of eight sheep, the ovine ACL having a distinct double-bundle structure. Biomechanically matched polyester fibre implants were used, with 6 months in vivo. The three methods led to similar intra-articular fibrous tissue integration of the implants and no evidence of implant damage, and biomechanical testing found greater laxity than normal for all three groups. The double-bundle group, however, had more joint surface degeneration than the other groups. It was concluded that clinical use of the double-bundle reconstruction was not indicated by the results of this experiment, in view of the more complex surgery and lack of superior performance.