Short-term evaluation of an intra-articular technique for cranial cruciate ligament rupture in dogs using nylon or polyester

Abstract

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed suture rupture after 15 days and other had suture infection after 30 days. In Group C, dogs recovered normal limb function without complications. Therefore, surgical toggle associated with polyester yarn was better than the other studied materials.

Intra-articular stabilization of a dog stifle with polyester thread: an ex vivo evaluation

“…Although, innovative materials with improved biocompatibility and excellent strength are available in the market (GOMIDE et al, 2019), several studies have reported on the use of intraarticular synthetic polyester implants to replace ruptured ligaments (ROOSTER et al, 2001;SELMI et al, 2002;PRZĄDKA et al, 2017;PRADA et al,2018), with a higher incidence of complications related to inefficient surgical technique than to material biocompatibility, according to PRADA et al (2018). The main advantages of braided multifilament surgical polyester thread include non-absorption and load capacity maintenance over time (MÜLLER et al, 2016); in contrast, due to its characteristics, it triggers moderate tissue reaction with a 3-week peak followed by reduction (ESENYEL et al, 2009).…”

Biomechanical cyclic loading test of a synthetic ligament fixation system used for intra-articular stabilization of deficient canine stifles

“…Such implants can be implanted either (i) extra-articularly as in the FLO (1975) or the TightRope (TR) ( Cook et al , 2010 ) techniques; or (ii) intra-articularly as introduced recently by Barnhart et al (2016) and several other authors ( Cook et al , 2017 ; Prada et al , 2018 ) for synthetic implants, or by Biskup and Conzemius (2020) for intra-articular allografts. Unfortunately, in human anterior cruciate ligament (ACL) surgery, synthetic intra-articular techniques have failed several times in the last quarter of the 20th century ( Legnani et al , 2010 ).…”

“…According to this recent trend, brand new intra-articular devices have been developed for passive stabilization of the stifle, composed of an ultrahigh molecular weight polyethylene (UHMWPE) artificial ligament fixed on the bones with interference screws ( Blanc et al , 2019 ; Goin et al , 2019 ; Rafael et al , 2020 ). This approach seems to be spreading among the international veterinary community ( Barnhart et al , 2016 ; Cook et al , 2017 ; Barnhart et al , 2018 ; Prada et al , 2018 ; Barnhart et al , 2019a; Biskup and Conzemius, 2020 ), although it remains marginal in the treatment of CCL rupture ( von Pfeil et al , 2018 ). The objective of this study is to evaluate the biomechanical behavior of this new artificial ligament implanted in ex vivo stifles under cyclic tensile tests.…”