Disruption of the CCL is common in many species. This injury is considered life threatening in cattle because of the severe debilitation, progressive signs of pain, and poor success rate after surgery. The CCL prevents cranial displacement of the tibia relative to the femur and prevents internal rotation of the stifle joint.1–3 Surgical techniques advocated for returning functionality to dogs with damaged or torn cruciate ligaments include intracapsular, extracapsular, and tibial osteotomy techniques.1 Tibial plateau leveling osteotomy has been successfully performed in a llama4 but potentially has limitations in large animals because of the concern for implant failure prior to bone healing. Thus, most CCL repair techniques in large animals involve intracapsular techniques, extracapsular techniques, or a combination thereof. Cattle lack a fabella upon which to attach extracapsular sutures. Extracapsular techniques, when performed in cattle, are aimed at femorotibial stabilization through formation of restrictive scar tissue. Although success has been reported with use of extracapsular techniques in cattle with CCL rupture,5 successful retinacular tightening by imbrication or a sliding flap technique has been achieved only in lower-weight animals.6 In larger animals, imbrication is typically reserved for those with partial cruciate ruptures or as an adjunctive treatment to other intracapsular techniques. Extracapsular techniques for surgical management of CCL-deficient stifle joints in cattle fail to establish sufficient scar tissue to improve stability of the femorotibial joint long term.
Intracapsular techniques are aimed at stabilization of the femorotibial joint via replacement of the function of the CCL. Potential complications of the procedure include intra-articular infection, foreign body reaction to the prosthetic implant, or rupture of the prosthesis. Intracapsular procedures have not become widely adopted for surgical management of CCL-deficient stifle joints in cattle because a suitable suture material has not been developed.
An ideal prosthetic material for use as a CCL replacement would have similar characteristics to the native CCL. Mechanical evaluation of elongation and failure loads may be used as an initial screening process for candidate materials. Unfortunately, because of their large adult weight, many of the CCL repair techniques fail in cattle.7,8 Failure of the CCL replacement material itself is likely a common cause of the poor outcomes in clinical patients. Natural and synthetic materials have been used as CCL replacements in cattle.9 Synthetic materials are susceptible to cyclic fatigue and rupture because they do not possess the repair mechanisms of biological systems. Candidate materials should have higher tensile strength than the native CCL and be resistant to cyclic failure, inert or of low bioreactivity, and able to be secured without weakening the implant. We hypothesized that polymerized caprolactam and monofilament nylon, suture materials used in orthopedic surgery, could serve as suitable candidates for development of a CCL prosthesis for cattle. The objectives of the study reported here were to determine the tensile strength and elasticity of the CCL of cattle and of large (No. 8) polymerized caprolactam suture and 2 sizes of monofilament nylon, MN80 and MN450. An additional objective was to compare the mechanical characteristics of these suture materials tested as parallel strands versus those of braided strands.
Area under the force-versus-elongation curve
Cranial cruciate ligament
Monofilament nylon fishing line (80-lb test)
Monofilament nylon fishing line (450-lb test)
Braunamid, Jorgensen Laboratories, Loveland, Colo.
Instron 1322 hydraulic load frame, Instron Corp, Norwood, Mass.
GraphPad Prism, GraphPad Software Inc, La Jolla, Calif.
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