Mechanical strength of four allograft fixation techniques for ruptured cranial cruciate ligament repair in dogs

Jeffery J. Biskup Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Daniel G. Balogh Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Kevin H. Haynes Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Andy L. Freeman Excelen: Center for Bone and Joint Research and Education, 700 10th Ave S, Minneapolis, MN 55415.

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Michael G. Conzemius Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Abstract

OBJECTIVE To test ex vivo mechanical properties of 4 allograft fixation techniques for cranial cruciate ligament (CCL) replacement.

SAMPLE 30 stifle joints from canine cadavers.

PROCEDURES CCL-deficient stifle joints repaired by 1 of 4 techniques (n = 6/group) and CCL-intact stifle joints (control group; 6) were mechanically tested. Three repair techniques involved a patella-patella ligament segment (PPL) allograft: a tibial and femoral interference screw (PPL-2S), a femoral interference screw and the patella seated in a tapering bone tunnel in the tibia (PPL-1S), or addition of a suture and a bone anchor to the PPL-1S (PPL-SL). The fourth technique involved a deep digital flexor tendon (DDFT) allograft secured with transverse femoral fixation and stabilized with a tibial interference screw and 2 spiked washers on the tibia (DDFT-TF). The tibia was axially loaded at a joint angle of 135°. Loads to induce 3, 5, and 10 mm of femoral-tibia translation; stiffness; and load at ultimate failure with the corresponding displacement were calculated. Group means were compared with a multivariate ANOVA.

RESULTS Mean ± SD load for the intact (control) CCL was 520.0 ± 51.3 N and did not differ significantly from the load needed to induce 3 mm of femoral-tibial translation for fixation techniques PPL-SL (422.4 ± 46.3 N) and DDFT-TF (654.2 ± 117.7 N). Results for the DDFT-TF were similar to those of the intact CCL for all outcome measures.

CONCLUSIONS AND CLINICAL RELEVANCE The DDFT-TF yielded mechanical properties similar to those of intact CCLs and may be a viable technique to test in vivo.

Abstract

OBJECTIVE To test ex vivo mechanical properties of 4 allograft fixation techniques for cranial cruciate ligament (CCL) replacement.

SAMPLE 30 stifle joints from canine cadavers.

PROCEDURES CCL-deficient stifle joints repaired by 1 of 4 techniques (n = 6/group) and CCL-intact stifle joints (control group; 6) were mechanically tested. Three repair techniques involved a patella-patella ligament segment (PPL) allograft: a tibial and femoral interference screw (PPL-2S), a femoral interference screw and the patella seated in a tapering bone tunnel in the tibia (PPL-1S), or addition of a suture and a bone anchor to the PPL-1S (PPL-SL). The fourth technique involved a deep digital flexor tendon (DDFT) allograft secured with transverse femoral fixation and stabilized with a tibial interference screw and 2 spiked washers on the tibia (DDFT-TF). The tibia was axially loaded at a joint angle of 135°. Loads to induce 3, 5, and 10 mm of femoral-tibia translation; stiffness; and load at ultimate failure with the corresponding displacement were calculated. Group means were compared with a multivariate ANOVA.

RESULTS Mean ± SD load for the intact (control) CCL was 520.0 ± 51.3 N and did not differ significantly from the load needed to induce 3 mm of femoral-tibial translation for fixation techniques PPL-SL (422.4 ± 46.3 N) and DDFT-TF (654.2 ± 117.7 N). Results for the DDFT-TF were similar to those of the intact CCL for all outcome measures.

CONCLUSIONS AND CLINICAL RELEVANCE The DDFT-TF yielded mechanical properties similar to those of intact CCLs and may be a viable technique to test in vivo.

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