Clinical outcomes after common calcanean tendon rupture repair in dogs with a loop‐suture tenorrhaphy technique and autogenous leukoreduced platelet‐rich plasma

Abstract

Objective To report outcomes of dogs with common calcanean tendon (CCT) ruptures treated with a platelet‐rich plasma (PRP) enhanced nonabsorbable loop‐suture technique. Study design Retrospective case series. Animals Client‐owned dogs (n = 12). Methods Medical records (2015–2017) of dogs with CCT ruptures repaired with a loop‐suture tenorrhaphy and autogenous leukoreduced PRP were reviewed for signalment, history, type of injury, treatment, and clinical follow‐up. Outcomes were assessed by functional anatomic measurements and Canine Orthopedic Index (COI) scores transformed to percentages, with 100% representing no problems. Results Twelve tendons were treated. Two dogs had major complications that were successfully revised. Follow‐up was available in 11 of 12 dogs, with a median time of 12 months (range, 4–36), including COI for 11 dogs and anatomic measurements for 6 dogs. Anatomic measurements did not differ between treated and normal contralateral limbs (midthigh muscle mass P > .99, cranial tibial muscle mass P = .37, CCT diameter P = .08, tibiotarsal joint angle P > .99). Owners scored function (COI) as 96.4% (range, 93.3%–97.8%) and quality of life as 94.6% (range, 92%–98.2%). Conclusion Loop‐suture tenorrhaphy with application of autogenous leukoreduced PRP at the repair site resulted in restoration of functional anatomic measurements, high COI, and client satisfaction. Clinical significance Loop‐suture tenorrhaphy with local application of autogenous leukoreduced PRP appears to offer an acceptable option to treat CCT injuries in dogs.

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

“…That procedure used autogenous leukoreduced PRP, injected into the site of tendon repair or delivered in a collagen sponge soaked with PRP, when a gap remained in addition to augmentation using a GalaFLEX P4HB mesh. 15 The fibre loop was chosen in that case series for its biomechanical properties and ease of application, although the braided nature of the material may increase the risk of infection. 15 The efficacy of PRP in surgical repair of AT injuries in humans and dogs is not clear and further studies are needed.…”

“…15 The fibre loop was chosen in that case series for its biomechanical properties and ease of application, although the braided nature of the material may increase the risk of infection. 15 The efficacy of PRP in surgical repair of AT injuries in humans and dogs is not clear and further studies are needed. In the present case, the use of the 3LP and LL suture patterns did not completely eliminate the gap between the tendon stumps.…”

“…2,[5][6][7][8][9][10][11][12] Current repair techniques involve excision of fibrous scar tissue and reattachment of the common calcaneal tendon stumps with or without augmentation techniques. 6,7,9,[13][14][15][16] Suture patterns commonly used are the locking loop (LL), three-loop pulley (3LP), Bunnell-Mayer and Krackow. 7,14 The risk of gapping and suture pull-out are reduced by grasping and locking of collagen fibres within the tendon using the LL suture pattern and by multiple divergent needle passes using the 3LP suture pattern.…”

“…17 Another option, in combination with surgical repair, is the use of autogenous platelet-rich plasma (PRP), which has been evaluated as a means of improving tendon healing in clinical and laboratory models. 15 Augmentation techniques to strengthen the repair and shorten the postoperative immobilization period are recommended. Methods used in dogs include autogenous tissue flaps derived from the semitendinosus muscle, fascia lata, fibularis brevis, fibularis longus and flexor digitorum lateralis tendons.…”

“…19 Synthetic implants such as polyethylene terephthalate, synthetic gastrocnemius tendon, carbon fibre mesh and poly-4-hydroxybutyrate (P4HB) mesh, as well as application of bone plates have been described for tendon repair. 15,[22][23][24][25][26] In human medicine, the central gastrocnemius turnover aponeurosis flap technique is less invasive than other methods and has been associated with a good outcome in patients with AT rupture and gap formation. 8,27,28 Augmented repair techniques are associated with high tensile strength and a low incidence of wound complications in human patients.…”