Biomechanical comparison of four prosthetic ligament repair techniques for tarsal medial collateral ligament injury in dogs

Yoanna Martin 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.

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 DVM
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Matthew D. Johnson 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.

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 DVM, MVSc
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Collin J. Travers 2Department of Mechanical and Aerospace Engineering, College of Engineering, University of Florida, Gainesville, FL 32608.

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James Colee 3Statistics Division, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL 32608.

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Marina J. McConkey 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.

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Scott A. Banks 2Department of Mechanical and Aerospace Engineering, College of Engineering, University of Florida, Gainesville, FL 32608.

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 PhD

Abstract

OBJECTIVE

To compare joint stability and ultimate strength among 4 prosthetic ligament constructs for repair of tarsal medial collateral ligament (MCL) injury in dogs.

SAMPLE

13 canine cadavers (26 hind limbs).

PROCEDURES

Each limb was stripped of all soft tissues except those associated with the tarsal joint and assigned to 1 of 4 prosthetic ligament constructs. The AN construct consisted of 3 bone anchors connected with monofilament nylon suture. The AU construct consisted of low-profile suture anchors connected with multifilament ultrahigh-molecular-weight polyethylene (UHMWPE) suture. The TN and TU constructs involved the creation of 3 bone tunnels and use of nylon or UHMWPE suture, respectively. Each limb underwent biomechanical testing before and after MCL transection and before and after cyclic range-of-motion testing following completion of the assigned construct. Tarsal joint stability (extent of laxity) was assessed with the joint in each of 3 positions (75°, 135°, and 165°). After completion of biomechanical testing, each limb was tested to failure to determine the ultimate strength of the construct.

RESULTS

Relative to intact tarsal joints, joint laxity was significantly increased following completion of all 4 constructs. Construct type was not associated with the magnitude of change in joint laxity. Ultimate strength was greatest for the UHMWPE-suture constructs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that all 4 constructs effectively stabilized MCL-deficient tarsal joints. Implants used for the TU, TN, and AU constructs had a lower profile than those used for the AN construct, which may be clinically advantageous. In vivo studies are warranted.

Abstract

OBJECTIVE

To compare joint stability and ultimate strength among 4 prosthetic ligament constructs for repair of tarsal medial collateral ligament (MCL) injury in dogs.

SAMPLE

13 canine cadavers (26 hind limbs).

PROCEDURES

Each limb was stripped of all soft tissues except those associated with the tarsal joint and assigned to 1 of 4 prosthetic ligament constructs. The AN construct consisted of 3 bone anchors connected with monofilament nylon suture. The AU construct consisted of low-profile suture anchors connected with multifilament ultrahigh-molecular-weight polyethylene (UHMWPE) suture. The TN and TU constructs involved the creation of 3 bone tunnels and use of nylon or UHMWPE suture, respectively. Each limb underwent biomechanical testing before and after MCL transection and before and after cyclic range-of-motion testing following completion of the assigned construct. Tarsal joint stability (extent of laxity) was assessed with the joint in each of 3 positions (75°, 135°, and 165°). After completion of biomechanical testing, each limb was tested to failure to determine the ultimate strength of the construct.

RESULTS

Relative to intact tarsal joints, joint laxity was significantly increased following completion of all 4 constructs. Construct type was not associated with the magnitude of change in joint laxity. Ultimate strength was greatest for the UHMWPE-suture constructs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that all 4 constructs effectively stabilized MCL-deficient tarsal joints. Implants used for the TU, TN, and AU constructs had a lower profile than those used for the AN construct, which may be clinically advantageous. In vivo studies are warranted.

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