Anatometric Point Guide for Canine Cranial Cruciate Ligament Suture Repair A Major Qualifying Project Report Submitted to the Faculty of WORCESTER POLYTECHNIC INSTITUTE In partial fulfillment of the requirements for Degree of Bachelor of Science Submitted by: Roman Gutierrez _____________________ Brittany Rhodes _____________________ Aimee St. Germain _____________________ Elliott Wiegman _____________________ Submitted to: Glenn Gaudette _____________________ Date of Submission: April 27, 2015 1 Contents Authorship............................................................................................................................................. 4 Table of Figures .................................................................................................................................... 5 Table of Tables ..................................................................................................................................... 6 Chapter 1: Introduction ......................................................................................................................... 7 Chapter 2: Literature Review .............................................................................................................. 11 2.1 Cranial Cruciate Ligament ........................................................................................................ 11 Biomechanics of the CCL ............................................................................................................ 13 2.2 Cranial Cruciate Ligament Injuries ........................................................................................... 14 2.3 CCL Repair Options .................................................................................................................. 15 2.3.1 Osteotomy Repair Techniques ............................................................................................ 16 2.3.2 Suture Repair Techniques ................................................................................................... 17 2.3.3 Failed suture placement ...................................................................................................... 18 2.4 Isometric Points ......................................................................................................................... 19 2.5 Surgical Aiming Guides ............................................................................................................ 21 3.5.1 Visual Guiding Devices ...................................................................................................... 21 3.5.2 Mechanical Guidance ......................................................................................................... 24 2.6 Gap in Current Research ........................................................................................................... 28 Chapter 3: Project Strategy ................................................................................................................. 29 3.1 Initial Client Statement.............................................................................................................. 29 3.2 Objectives .................................................................................................................................. 29 3.2.1 Accuracy and Precision ...................................................................................................... 29 3.2.2 Safety .................................................................................................................................. 29 3.2.3 Reusable.............................................................................................................................. 30 3.2.4 Universal ............................................................................................................................. 30 3.2.5 User Friendly ...................................................................................................................... 30 3.2.6 Ergonomic .......................................................................................................................... 30 3.2.7 Pairwise Comparison Chart ................................................................................................ 31 3.3 Constraints ................................................................................................................................. 32 3.3.1 Accurately locate points to nearest ±2mm ......................................................................... 32 3.3.2 Size of device ...................................................................................................................... 32 3.3.3 Cost ..................................................................................................................................... 32 2 3.3.4 Training time ...................................................................................................................... 32 3.3.5 Testing ................................................................................................................................ 33 3.4 Functions ................................................................................................................................... 33 3.5 Revised Client Statement .......................................................................................................... 33 3.6 Strategy for Finding the Most Isometric Points ........................................................................ 34 Chapter 4: Alternative Designs ........................................................................................................... 35 4.1 Needs analysis ........................................................................................................................... 35 4.2 Conceptual Design #1 ............................................................................................................... 35 4.3 Conceptual Design #2 ............................................................................................................... 36 4.4 Conceptual Design #3 ............................................................................................................... 39 4.5 Feasibility and Design Selection: .............................................................................................. 41 4.6 Design Functions: ...................................................................................................................... 43 4.7 Optimization and Decisions ...................................................................................................... 45 4.8 Design specifications: ............................................................................................................... 47 Chapter 5: Design Verification ........................................................................................................... 49 5.1 Questionnaire Development ...................................................................................................... 49 5.2 Surgeon Validation .................................................................................................................... 49 Chapter 6: Discussion ......................................................................................................................... 51 6.1 Limitations ................................................................................................................................ 51 6.2 Impact ........................................................................................................................................ 51 Chapter 7: Final Design ...................................................................................................................... 55 Chapter 8: Conclusions and Recommendations ................................................................................. 57 References ........................................................................................................................................... 58 Appendix A: ........................................................................................................................................ 60 Appendix B: Blank Surgeon Questionnaire ........................................................................................ 64 Appendix C: Surgeon Questionnaire - Dr. Faircloth .......................................................................... 66 Appendix D: Surgeon Questionnaire - Dr. Murphy............................................................................ 68 Appendix E: Marketing Brochure ....................................................................................................... 71 Appendix F: Device Instructions ........................................................................................................ 73 Appendix G: Dimension Table ........................................................................................................... 77 3 Authorship All authors contributed equally to the writing of this report. 4 Table of Figures Figure 1: Canine Directional Terms ................................................................................................... 11 Figure 2: CCL Anatomy (Muir, 2011) ................................................................................................ 12 Figure 3: Healthy Ligament Tensile Results (Muir, 2011) ................................................................