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Rivenburg RE, Maxwell EA, Bertran J, Souza CHDM, Smith BL. Biomechanical comparison of canine median sternotomy closure using suture tape and orthopedic wire cerclage. Vet Surg 2023; 52:1057-1063. [PMID: 37603027 DOI: 10.1111/vsu.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/07/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To compare the mechanical properties of suture tape and orthopedic wire cerclage in an ex vivo canine median sternotomy model. STUDY DESIGN Ex vivo. ANIMALS Twelve large-breed canine cadaveric sternums. METHODS Median sternotomies were performed, leaving the manubrium intact. The specimens were randomly assigned to group W (20-gauge stainless steel orthopedic wire cerclage in a figure-of-eight pattern) or group ST (suture tape in a figure-of-eight pattern). Each specimen was laterally distracted until failure using an electrodynamic materials-testing system. RESULTS No differences were observed for displacement, yield load, maximum load, implant failure between the groups. The orthopedic wire construct was stiffer than the suture tape construct. CONCLUSION Suture tape was biomechanically similar to orthopedic wire cerclage for sternotomy closure in dogs, although wire constructs were stiffer. CLINICAL SIGNIFICANCE Suture tape may represent an alternative to cerclage wire for sternotomy closure in dogs. Additional studies evaluating its clinical use are needed.
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Affiliation(s)
- Rachel E Rivenburg
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Elizabeth A Maxwell
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Judith Bertran
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Carlos H De Mello Souza
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Benjamin L Smith
- Arthrex Inc., Department of Orthopedic Research, Naples, Florida, USA
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Del Carpio LI, Petit Y, Diotalevi L, Laroche E, Levasseur A, Lussier B. Three-dimensional kinematic evaluation of lateral suture stabilization in an in vitro canine cranial cruciate deficient stifle model. PLoS One 2021; 16:e0261187. [PMID: 34928969 PMCID: PMC8687534 DOI: 10.1371/journal.pone.0261187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
The impact of surgical correction of cranial cruciate ligament rupture (CCLR) on 3D kinematics has not been thoroughly evaluated in dogs. The success of current techniques remains limited, as illustrated by suboptimal weightbearing and progression of osteoarthritis. The inability to restore the stifle's 3D kinematics might be a key element in understanding these suboptimal outcomes. The objective of this study was to evaluate the impact of lateral suture stabilization (LSS) on the 3D kinematics of the canine stifle joint. We hypothesized that LSS would not restore 3D kinematics in our model. Ten cadaveric pelvic limbs collected from large dogs (25-40 kg) were tested using a previously validated apparatus that simulates gait. Three experimental conditions were compared: (a) intact stifle; (b) unstable stifle following cranial cruciate ligament transection (CCLt) and (c) CCLt stabilized by LSS. Three-dimensional kinematics were collected through 5 loading cycles simulating the stance phase of gait and curves were analyzed using a Wilcoxon signed-rank test. LSS restored baseline kinematics for the entire stance phase for cranial and lateromedial translation, flexion, and abduction. It restored distraction over 90% of the stance phase. Internal rotation was limited, but not restored. This in vitro study had limitations, as it used a simplified model of stifle motion and weight-bearing. The results of this study report that LSS can restore physiologic 3D kinematics largely comparable to those of healthy stifles. Suboptimal outcome in patients following CCLR stabilization by LSS may therefore result from causes other than immediate postoperative abnormal 3D kinematics.
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Affiliation(s)
- Laura-Isabela Del Carpio
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Elisabeth Laroche
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Annie Levasseur
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Bertrand Lussier
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- GREPAQ (Research Group in Animal Pharmacology of Quebec), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Hospital Research Centre (CRCHUM), Université de Montréal, Montreal, Quebec, Canada
- * E-mail:
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Roca RY, Peura A, Kowaleski MP, Watson MT, Lendhey M, Rocheleau PJ, Hulse DA. Ex vivo mechanical properties of a 2.5-mm bone anchor for treatment of cranial cruciate ligament rupture in toy breed dogs. Vet Surg 2020; 49:736-740. [PMID: 32073178 DOI: 10.1111/vsu.13399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/05/2019] [Accepted: 01/18/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the mechanical pull-out properties of a 2.5-mm bone anchor implanted in ex vivo femurs of toy breed dogs and to determine whether there is a difference between knotted and knotless configurations. STUDY DESIGN Experimental study. SAMPLE POPULATION Eight paired harvested femurs. METHODS Femurs were assigned to knotted or knotless configuration. Equal numbers of right and left femurs were tested. The caudolateral femoral condyle at the distal pole of the lateral fabella (F2 site) was drilled. The assigned configuration with braided suture combined with the bone anchor was implanted into the F2 site. Each configuration was positioned into a mechanical testing machine to measure yield load, load at 3-mm displacement, ultimate load, stiffness, and mode of failure at the beginning of the canine standing phase angle (150°). RESULTS Mean ultimate load was 100.14 and 88.69 N (P = .798), mean yield load was 59.72 and 55.85 N (P = .708), load at 3-mm displacement was 46.72 and 43.33 N (P = .656), and stiffness was calculated to be 43.06 and 47.09 N/mm (P = .548) for knotted and knotless configurations, respectively. Mode of failure occurred primarily by anchor pull-out. CONCLUSION The bone anchor withstood deformation at the estimated forces applied on the native cranial cruciate ligament (CCL) of toy breed dogs in both configurations. CLINICAL SIGNIFICANCE This bone anchor may constitute a useful alternative for stabilization of the CCL deficient stifle in toy breed dogs. However, before it can be recommended for widespread use in dogs, closely monitored clinical trials must be conducted to assess outcome and complications associated with this implant.
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Affiliation(s)
- Rodrigo Y Roca
- Boren Veterinary Teaching Hospital, Oklahoma State University, Stillwater, Oklahoma
| | - Aliisa Peura
- Espanola Animal Hospital, Espanola, Ontario, Canada
| | | | | | | | | | - Donald A Hulse
- Austin Veterinary Emergency and Specialty, Austin, Texas
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Luescher M, Schmierer PA, Park BH, Pozzi A, Gutbrod A, Evans R, Knell SC. Biomechanical comparison of knotted and knotless stabilization techniques of the tarsal medial collateral ligament in cats: A cadaveric study. Vet Surg 2019; 49:390-400. [PMID: 31849076 DOI: 10.1111/vsu.13366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/16/2019] [Accepted: 11/16/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare mechanical properties of intact feline medial collateral ligaments and three techniques for treatment of feline medial tarsal instability. STUDY DESIGN Controlled laboratory study. SAMPLE POPULATION Forty-eight normal, adult feline tarsi. METHODS Three repairs were tested: a bone tunnel with polypropylene (PP) suture, a bone tunnel with polyethylene (PE) cord, and a knotless anchor technique with PE cord. A cyclic (6-N preload; 5-N amplitude; 2-Hz frequency) tensile test (600 cycles) was performed on feline tarsi with either the long or the short medial tarsal ligament intact, with each reconstruction technique followed by a single-cycle load-to-failure test (0.5 mm/s) with a failure point at 2 mm of displacement. Total elongation, peak-to-peak elongation, stiffness, and maximum load to failure point were compared with the intact condition. RESULTS No differences in stiffness, total elongation, or peak-to-peak elongation were found between specimens repaired with the knotless technique and intact controls (P > .04), whereas tarsi repaired with the tunnel technique and PP were weaker (P < .008). Total and conditioning elongation were greater after tunnel reconstruction with PP than after knotless reconstruction (P = .005). Mean load to 2 mm of displacement tended (P = .03) to be higher after knotless than after knotted PP repairs and did not differ (P = .47) between tarsi repaired with the tunnel or anchor repairs with PE. CONCLUSION The mechanical properties of intact tarsi were superior to those of tarsi repaired with tunnel techniques and PP but were similar to those of tarsi repaired with knotless techniques with PE. CLINICAL SIGNIFICANCE Feline tarsal stabilization with the knotless technique for tarsal medial collateral ligament insufficiency may reduce the requirement for or duration of postoperative coaptation.
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Affiliation(s)
- Muriel Luescher
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Philipp A Schmierer
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Brian H Park
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Antonio Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | | | - Rich Evans
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Sebastian C Knell
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
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Racette M, Al saleh H, Waller KR, Bleedorn JA, McCabe RP, Vanderby R, Markel MD, Brounts SH, Block WF, Muir P. 3D FSE Cube and VIPR-aTR 3.0 Tesla magnetic resonance imaging predicts canine cranial cruciate ligament structural properties. Vet J 2015; 209:150-5. [PMID: 26831152 DOI: 10.1016/j.tvjl.2015.10.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 10/24/2015] [Accepted: 10/26/2015] [Indexed: 01/07/2023]
Abstract
Estimation of cranial cruciate ligament (CrCL) structural properties in client-owned dogs with incipient cruciate rupture would be advantageous. The objective of this study was to determine whether magnetic resonance imaging (MRI) measurement of normal CrCL volume in an ex-vivo canine model predicts structural properties. Stifles from eight dogs underwent 3.0 Tesla 3D MRI. CrCL volume and normalized median grayscale values were determined using 3D Fast Spin Echo (FSE) Cube and Vastly under-sampled Isotropic PRojection (VIPR)-alternative repetition time (aTR) sequences. Stifles were then mechanically tested. After joint laxity testing, CrCL structural properties were determined, including displacement at yield, yield load, load to failure, and stiffness. Yield load and load to failure (R(2)=0.56, P <0.01) were correlated with CrCL volume determined by VIPR-aTR. Yield load was also correlated with CrCL volume determined by 3D FSE Cube (R(2)=0.32, P <0.05). Structural properties were not related to median grayscale values. Joint laxity and CrCL stiffness were not related to MRI parameters, but displacement at yield load was related to CrCL volume for both sequences during testing (R(2)>0.57, P <0.005). In conclusion, 3D MRI offers a predictive method for estimating canine CrCL structural properties. 3D MRI may be useful for monitoring CrCL properties in clinical trials.
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Affiliation(s)
- Molly Racette
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Habib Al saleh
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kenneth R Waller
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Jason A Bleedorn
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Ronald P McCabe
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ray Vanderby
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Mark D Markel
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Sabrina H Brounts
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Walter F Block
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Peter Muir
- Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
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