Tripping Elicits Earlier and Larger Deviations in Linear Head Acceleration Compared to Slipping.

Slipping and tripping contribute to a large number of falls and fall-related injuries. While the vestibular system is known to contribute to balance and fall prevention, it is unclear whether it contributes to detecting slip or trip onset. Therefore, the purpose of this study was to investigate the effects of slipping and tripping on head acceleration during walking. This information would help determine whether individuals with vestibular dysfunction are likely to be at a greater risk of falls due to slipping or tripping, and would inform the potential development of assistive devices providing augmented sensory feedback for vestibular dysfunction. Twelve young men were exposed to an unexpected slip or trip. Head acceleration was measured and transformed to an approximate location of the vestibular system. Peak linear acceleration in anterior, posterior, rightward, leftward, superior, and inferior directions were compared between slipping, tripping, and walking. Compared to walking, peak accelerations were up to 4.68 m/s2 higher after slipping, and up to 10.64 m/s2 higher after tripping. Head acceleration first deviated from walking 100-150ms after slip onset and 0-50ms after trip onset. The temporal characteristics of head acceleration support a possible contribution of the vestibular system to detecting trip onset, but not slip onset. Head acceleration after slipping and tripping also appeared to be sufficiently large to contribute to the balance recovery response.

Effect of 9 mm tibial tuberosity advancement on cranial tibial translation in the canine cranial cruciate ligament-deficient stifle.

OBJECTIVE: To assess the effect of 9 mm tibial tuberosity advancement (TTA) on cranial tibial translation (CTT) in a cranial cruciate ligament (CCL)-deficient canine stifle model. STUDY DESIGN: In vitro cadaveric study. ANIMALS: Canine pelvic limbs (n=12). METHODS: Each stifle was placed in a jig at 135 degrees with a simulated quadriceps force and tibial axial force. CTT distance was measured with the CCL intact (iCCL), transected (tCCL), and after performing TTA using a 9 mm cage. RESULTS: Mean CTT for iCCL was 0.42 mm, 1.58 mm after severing the CCL, and 1.06 mm post-TTA. The tCCL CTT measured without any quadriceps force was 2.59 mm. Differences between the intact and tCCL (P<.0001) and tCCL and TTA (P=.0003) were significant. The difference between the tCCL with and without the quadriceps force was not significant (P=.0597). CONCLUSIONS: These data confirm that TTA does reduce CTT in tCCL stifles in this model. The CTT noted was less than that noted clinically. The addition of a simulated quadriceps force to a CCL-deficient stifle before a TTA, by itself, may not significantly lessen CTT. CLINICAL RELEVANCE: Whereas this in vitro model demonstrated that TTA reduced CTT in canine stifles with CCL transected, the model limitations preclude extrapolation to the effect of TTA in a live dog.

An in vitro study to determine the effectiveness of a patellar ligament/fascia lata graft and new tibial suture anchor points for extracapsular stabilization of the cranial cruciate ligament-deficient stifle in the dog.

OBJECTIVE: (1) To determine whether an extracapsular patellar ligament/fascia lata graft would provide stability in the cranial cruciate ligament (CrCL)-deficient stifle comparable with that of the intact stifle. (2) To determine if different tibial anchor points would enhance stability of the CrCLdeficient stifle when compared with the standard fabellar-tibial suture (FTS) placement. STUDY DESIGN: Experimental. ANIMALS: Twenty-eight canine cadaver hind limbs. METHODS: Stifles were mounted in a jig and tested between loads of -65 and 80 N. After testing the intact CrCL, 4 stabilization techniques were tested after CrCL transection: lateral graft technique (LGT) and 3 FTS with different tibial anchor points. RESULTS: There were no significant differences in displacement between the LGT and standard FTS, between the LGT and the intact CrCL, or between the FTS and the intact CrCL, in either the Securos or the Screw-washer experiments. Stiffness of the intact CrCL was significantly greater than that of any stabilization technique and the cut CrCL. The standard FTS showed the least displacement of all suture stabilization techniques. Differences in stiffness were not significant between the suture stabilization techniques. CONCLUSIONS: Securely anchored, the LGT results in a reduction in drawer motion similar to that of the intact CrCL and the standard FTS. Altering the tibial anchor point for the FTS does not improve stiffness or enhance stabilization of the CrCL-deficient stifle. CLINICAL RELEVANCE: The LGT could be used for the treatment of CrCL ruptures in the dog. A clinical study is recommended.

An in vitro study to determine the effectiveness of a patellar ligament/fascia lata graft and new tibial suture anchor points for extracapsular stabilization of the cranial cruciate ligament-deficient stifle in the dog

OBJECTIVE: (1) To determine whether an extracapsular patellar ligament/fascia lata graft would provide stability in the cranial cruciate ligament (CrCL)-deficient stifle comparable with that of the intact stifle. (2) To determine if different tibial anchor points would enhance stability of the CrCLdeficient stifle when compared with the standard fabellar-tibial suture (FTS) placement. STUDY DESIGN: Experimental. ANIMALS: Twenty-eight canine cadaver hind limbs. METHODS: Stifles were mounted in a jig and tested between loads of -65 and 80 N. After testing the intact CrCL, 4 stabilization techniques were tested after CrCL transection: lateral graft technique (LGT) and 3 FTS with different tibial anchor points. RESULTS: There were no significant differences in displacement between the LGT and standard FTS, between the LGT and the intact CrCL, or between the FTS and the intact CrCL, in either the Securos or the Screw-washer experiments. Stiffness of the intact CrCL was significantly greater than that of any stabilization technique and the cut CrCL. The standard FTS showed the least displacement of all suture stabilization techniques. Differences in stiffness were not significant between the suture stabilization techniques. CONCLUSIONS: Securely anchored, the LGT results in a reduction in drawer motion similar to that of the intact CrCL and the standard FTS. Altering the tibial anchor point for the FTS does not improve stiffness or enhance stabilization of the CrCL-deficient stifle. CLINICAL RELEVANCE: The LGT could be used for the treatment of CrCL ruptures in the dog. A clinical study is recommended.