Ex vivo evaluation of the effect of various surgical procedures on blood delivery to the patellar tendon of dogs

Abstract

OBJECTIVE To determine the effect of arthrotomy alone or in combination with osteotomy of the proximal portion of the tibia on blood delivery to the patellar tendon of dogs. SAMPLE 24 canine cadavers. PROCEDURES One hind limb from each cadaver was assigned to 1 of 4 treatment groups: medial arthrotomy (MA; MA group), lateral arthrotomy (LA; LA group), MA and LA with tibial tuberosity transposition (MALA group), and MA with tibial plateau leveling osteotomy (TPLO; TPLO group). The contralateral hind limb served as the control sample. Contrast solution (barium [33%], India ink [17%], and saline [0.9% NaCl] solution [50%]) was injected through an 8F catheter inserted in the caudal portion of the abdominal aorta. Limbs were radiographed to allow examination of vascular filling. The patella, patellar tendon, and tibial crest were harvested, radiographed to allow examination of tissue vascular filling, and fixed in 4% paraformaldehyde. Vessels perfused with contrast solution were counted in sections obtained from the proximal, middle, and distal regions of each patellar tendon. RESULTS Vessel counts did not differ significantly among the 3 tendon regions. Compared with results for the control group, delivery of contrast solution to the patellar tendon was significantly decreased in the MALA and TPLO groups but was not changed in the MA or LA groups. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that surgical procedures used to treat cranial cruciate injuries (ie, TPLO) and patellar luxation decreased blood delivery to the patellar tendon of canine cadavers, at least acutely.

Influence of methods of joint inspection during tibial plateau leveling osteotomy on the radiographic appearance of the patellar tendon

“…The mean body weight was 33.4 kg (range, 12.7-68.5). The most common breeds represented were Labrador retriever (57), mixed breeds (42), pit bull (13), and golden retriever (11). The mean preoperative TPA was 28.6 (range 20-38).…”

“…Reported risk factors for this PTT include tibial tuberosity fractures, a partial CCL tear in conjunction with a small remnant of the tibia cranial to the osteotomy, increased body weight, and a postoperative TPA less than 6 ° . Alterations in patellar tendon blood supply secondary to surgical approach may also lead to patellar tendon thickening . In a cadaveric study of the influence of medial and lateral parapatellar arthrotomies with or without TPLO on the blood supply to the patellar tendon, researchers found that delivery of contrast solution to the patellar tendon was decreased immediately after a medial arthrotomy with TPLO.…”

“…5,9 Alterations in patellar tendon blood supply secondary to surgical approach may also lead to patellar tendon thickening. 11 In a cadaveric study of the influence of medial and lateral parapatellar arthrotomies with or without TPLO on the blood supply to the patellar tendon, researchers found that delivery of contrast solution to the patellar tendon was decreased immediately after a medial arthrotomy with TPLO. The authors concluded that surgical treatment of CCL injuries decreased blood supply to the patellar tendon in canine cadavers.…”

“…The authors concluded that surgical treatment of CCL injuries decreased blood supply to the patellar tendon in canine cadavers. 11 Arthroscopy (AR), craniomedial parapatellar arthrotomy (CrMA), and caudomedial arthrotomy (CdMA) are widely accepted for intra-articular inspection and management of meniscal lesions. Controversy exists regarding the benefits and requirement of stifle joint exploration prior to TPLO, with the argument that asymptomatic meniscal damage may not require treatment in humans.…”

Radiographic evaluation of patellar tendon length following corrective surgical procedures for medial patellar luxation in dogs

“…Retrospective studies in human have demonstrated an increased prevalence of patellar tendon shortening with total knee arthroplasties and increased prevalence of patellar tendon lengthening with unicompartmental knee arthroplasty at 5 years post-surgery [13]. Previous investigators have demonstrated reduced blood flow to the patellar tendon following TPLO and patellar luxation procedures in cadaveric canine models [14]. Previous studies have established that large breed dogs with MPL have a relatively longer patellar tendon compared to dogs without stifle disease [4].…”