The effect of polydioxanone hemicerclage suture on the occurrence of fracture during tibial tuberosity advancement with an elongated bi‐directional hinged osteotomy

Bleakley, Seth; Palmer, Ross H.; Bresina, Stephen; Roca, Sy Ping; Tepic, S.

doi:10.1111/vsu.12642

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The occurrence of intraoperative fracture during advancement of an elongated bi-directional hinged osteotomy for TTA in dogs of the tibial tuberosity is less when a hemicerclage suture is placed [44]. The tendency to failure is because the traditional fixation methods rely on mediolateral fixation [22] whereas the TBW is situated on the cranial plane, and therefore in line with the pull of the quadriceps.…”

Section: Discussionmentioning

confidence: 99%

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

McCartney¹,

Ober²,

Benito³

et al. 2019

Acta Vet Scand

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Background Cranial cruciate ligament (CCL) rupture is one of the most common causes of limb lameness in dogs. Surgical techniques based on tibial osteotomies such as tibial plateau leveling osteotomy and tibial tuberosity advancement are used to eliminate dynamic thrust. Tibial tuberosity advancement (TTA) uses an osteotomy fixated by cage, plates, forks and screws to change the relationship of the patellar tendon and tibial plateau angle. Tension band wiring technique is one of the most common surgical methods used to treat a tension fracture and remains the gold standard for the treatment of tibial tuberosity fractures. In this study, we compared experimentally the biomechanical effect of application of tension band wiring compared to other techniques for the fixation of the TTA osteotomy. The techniques compared to are standard commercially available systems for TTA fixation. Results Tension band wiring (TBW) presented the higher resistance to failure compared to all the other surgical procedures, with the highest values found in the TBW group with 1.47 ± 0.07 N and the lowest in the TTA cage (0.82 ± 0.08) and TTA-2 (0.85 ± 0.06) groups with statistically significant differences in all cases (P < 0.001). TTA rapid and TTA plate groups exhibited a similar strength, and same happened between TTA-2 and TTA cage groups. All the other comparisons by pair were significantly different with P < 0.001. Conclusions Results suggest that fixating the osteotomy with tension band wiring increases the strength of the fixation and decrease the risk of implant failure. Further clinical studies are needed to demonstrate in vivo reliability and to test different variables such as size and weight of dogs. These results could have important clinical implications in the treatment of CCL ruptures.

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Section: Discussionmentioning

confidence: 99%

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

McCartney¹,

Ober²,

Benito³

et al. 2019

Acta Vet Scand

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“…More recently, TTA modifications using various stabilization techniques have been developed, including the replacement of complete osteotomy by distal incomplete osteotomy. 31 32 33 34 35…”

Section: Introductionmentioning

confidence: 99%

“…More recently, TTA modifications using various stabilization techniques have been developed, including the replacement of complete osteotomy by distal incomplete osteotomy. [31][32][33][34][35] The objective of this study was to experimentally determine kinetic and kinematic differences of the medial and lateral menisci after modified TTA with 9 and 12 mm cranialization of the tibial tuberosity at different standing posi-tions (135 and 145 degrees caudal stifle angle). We hypothesized that stifle kinetics and kinematics would change significantly after transection of the CCL and 9 mm TTA treatment.…”

Section: Introductionmentioning

confidence: 99%

Meniscal Load and Load Distribution in the Canine Stifle after Modified Tibial Tuberosity Advancement with 9 mm and 12 mm Cranialization of the Tibial Tuberosity in Different Standing Angles

Schmutterer

Augat

Greinwald

et al. 2023

Vet Comp Orthop Traumatol

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Objectives The aim of this study was to investigate the kinetic and kinematic changes in the stifle after a modified tibial tuberosity advancement (TTA) with 9 and 12 mm cranialization of the tibial tuberosity in different standing angles. Study Design Biomechanical ex vivo study using seven unpaired canine cadaver hindlimbs. Sham TTA surgery was performed. Motion sensors were fixed to the tibia and the femur for kinematic data acquisition. Pressure mapping sensors were placed between femur and both menisci. Thirty percent body weight was applied to the limbs with the stifle in 135 or 145 degrees of extension. Each knee was tested in 135 degrees with intact cranial cruciate ligament (CCL) and deficient CCL with 12 mm cranialization of the tibial tuberosity in 135 and 145 degrees of extension. The last two tests were repeated with 9 mm. Results Transection of the CCL altered kinematics and kinetics. Tibial tuberosity advancement with 12 mm cranialization sufficiently restored stifle kinematics in 135 and 145 degrees but 9 mm TTA failed to do so in 135 degrees. The same effects were seen for internal rotation of the tibia. After TTA, a significant reduction in the force acting on both menisci was detected. Conclusions Tibial tuberosity advancement could restore stifle kinematics and meniscal kinetics after transection of the CCL ex vivo in the present study. Tibial tuberosity advancement reduced the contact force ratio on both menisci significantly. No changes of peak pressure and peak pressure location occurred following TTA under any of the tested experimental settings. Increased stifle extension (145 degrees) might lead to more stability, contradictory to biomechanical theory.

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Computed tomography-guided additive manufacturing of Personalized Absorbable Gastrointestinal Stents for intestinal fistulae and perforations

et al. 2020

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The effect of polydioxanone hemicerclage suture on the occurrence of fracture during tibial tuberosity advancement with an elongated bi‐directional hinged osteotomy

Abstract: The occurrence of immediate intraoperative fracture during advancement of an EBHO of the tibial tuberosity is less when a hemicerclage suture is placed.

Cited by 3 publications

References 27 publications

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

Meniscal Load and Load Distribution in the Canine Stifle after Modified Tibial Tuberosity Advancement with 9 mm and 12 mm Cranialization of the Tibial Tuberosity in Different Standing Angles

Computed tomography-guided additive manufacturing of Personalized Absorbable Gastrointestinal Stents for intestinal fistulae and perforations

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