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Artificial tendons have been developed as a replacement for biological tendons with irreparable pathologies and defects. Previous studies reported the mechanical strength and tissue integration of a polyester suture-based artificial tendon, but not its effect on locomotor function. The objective of this study was to quantify the hindlimb biomechanics during hopping gait of New Zealand White rabbits with surgical replacement of either the Achilles (n=2) or tibialis cranialis (TC, n=2) biological tendons with artificial tendons. Once pre-surgery and for five consecutive weeks post-surgery (starting at about two weeks post-surgery), we measured hindlimb kinematics and ground contact pressures with a video camera and pressure mat, respectively. Promisingly, post-surgical locomotor function was either consistent or improved over time in both tendon replacement groups. However, Achilles rabbits exhibited greater immediate post-surgery functional decline and less post-surgical functional recovery than TC rabbits. Compared to healthy rabbits, at the study endpoint, (1) TC rabbits had a 17.3-degree higher (i.e., more plantarflexed) ankle angle at foot strike; and (2) Achilles rabbits had a 39.2-degree lower (i.e., more dorsiflexed) ankle angle at toe off. These functional deficits suggest that the muscles attached to the artificial tendons had lower force-generating capacity. Future studies of artificial tendons are needed to quantify long-term function, determine the effectiveness of structured rehabilitation exercises, and refine surgical implementation.

Prosthetic limbs that are completely implanted within skin (i.e., endoprostheses) could permit direct, physical muscle–prosthesis attachment to restore more natural sensorimotor function to people with amputation. The objective of our study was to test, in a rabbit model, the feasibility of replacing the lost foot after hindlimb transtibial amputation by implanting a novel rigid foot–ankle endoprosthesis that is fully covered with skin. We first conducted a pilot, non-survival surgery in two rabbits to determine the maximum size of the skin flap that could be made from the biological foot–ankle. The skin flap size was used to determine the dimensions of the endoprosthesis foot segment. Rigid foot–ankle endoprosthesis prototypes were successfully implanted in three rabbits. The skin incisions healed over a period of approximately 1 month after surgery, with extensive fur regrowth by the pre-defined study endpoint of approximately 2 months post surgery. Upon gross inspection, the skin surrounding the endoprosthesis appeared normal, but a substantial subdermal fibrous capsule had formed around the endoprosthesis. Histology indicated that the structure and thickness of the skin layers (epidermis and dermis) were similar between the operated and non-operated limbs. A layer of subdermal connective tissue representing the fibrous capsule surrounded the endoprosthesis. In the operated limb of one rabbit, the subdermal connective tissue layer was approximately twice as thick as the skin on the medial (skin = 0.43 mm, subdermal = 0.84 mm), ventral (skin = 0.80 mm, subdermal = 1.47 mm), and lateral (skin = 0.76 mm, subdermal = 1.42 mm) aspects of the endoprosthesis. Our results successfully demonstrated the feasibility of implanting a fully skin-covered rigid foot–ankle endoprosthesis to replace the lost tibia–foot segment of the lower limb. Concerns include the fibrotic capsule which could limit the range of motion of jointed endoprostheses. Future studies include testing of endoprosthetics, as well as materials and pharmacologic agents that may suppress fibrous encapsulation.

Though the rabbit is a common animal model in musculoskeletal research, there are very limited data reported on healthy rabbit biomechanics. Our objective was to quantify the normative hindlimb biomechanics (kinematics and kinetics) of six New Zealand White rabbits (three male, three female) during the stance phase of gait. We measured biomechanics by synchronously recording sagittal plane motion and ground contact pressure using a video camera and pressure-sensitive mat, respectively. Both foot angle (i.e., angle between foot and ground) and ankle angle curves were unimodal. The maximum ankle dorsiflexion angle was 66.4 ± 13.4° (mean ± standard deviation across rabbits) and occurred at 38% stance, while the maximum ankle plantarflexion angle was 137.2 ± 4.8° at toe-off (neutral ankle angle = 90 degrees). Minimum and maximum foot angles were 17.2 ± 6.3° at 10% stance and 123.3 ± 3.6° at toe-off, respectively. The maximum peak plantar pressure and plantar contact area were 21.7 ± 4.6% BW/cm2 and 7.4 ± 0.8 cm2 respectively. The maximum net vertical ground reaction force and vertical impulse, averaged across rabbits, were 44.0 ± 10.6% BW and 10.9 ± 3.7% BW∙s, respectively. Stance duration (0.40 ± 0.15 s) was statistically significantly correlated (p < 0.05) with vertical impulse (Spearman’s ρ = 0.76), minimum foot angle (ρ = −0.58), plantar contact length (ρ = 0.52), maximum foot angle (ρ = 0.41), and minimum foot angle (ρ = −0.30). Our study confirmed that rabbits exhibit a digitigrade gait pattern during locomotion. Future studies can reference our data to quantify the extent to which clinical interventions affect rabbit biomechanics.