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DOI: 10.1055/s-0042-1759868
Influence of Kirschner-Wire Insertion Angle on Construct Biomechanics following Tibial Tuberosity Osteotomy Fixation in Dogs
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Abstract
Objectives The aim of this study was to evaluate the effect of Kirschner wire insertion angle on the biomechanical characteristics following tibial tuberosity osteotomy fixation in dogs.
Study Design Twelve pairs of cadaveric tibia were harvested and randomly assigned to two treatment groups. Kirschner wires were placed either transversely (0 degrees) or placed caudodistally (30 degrees) with respect to the tibial tuberosity osteotomy. Each limb acted as its own respective control. Radiographic analysis allowed for the calculation of Kirschner wire insertion angle variance. Constructs were tested to monotonic failure while evaluating yield, peak, and failure forces, construct stiffness, and failure mode.
Results Kirschner wire insertion angles were 1.1 ± 2.2 degrees and 30.5 ± 2.3 degrees, respectively, for 0-degree and 30-degree groups (p <0.0001). Yield (p = 0.0095), peak (p <0.024) and failure loads (p <0.030) were all significantly greater for Kirschner wires inserted at an angle of 0 degrees compared with 30 degrees. Construct stiffness did not differ regardless of insertion angle (p = 0.068). Failure mode did not differ (p = 0.87) with tibial tuberosity avulsion and Kirschner wire pull-out seen in the majority of constructs (67%).
Conclusion Kirschner wires placed transversely (0 degrees) for tibial tuberosity osteotomy fixation were biomechanically superior, increasing yield, peak, and failure forces by 1.6 times, 1.3 times, and 1.4 times, respectively, to those placed in a caudodistal (30 degrees) orientation. Kirschner wire insertion angle is an important consideration following tibial tuberosity osteotomy in dogs, with Kirschner wires placed at 0 degrees conferring increased resistance of the repair to construct deformation.
Keywords
tibial tuberosity osteotomy - medial patellar luxation - canine - Kirschner wire fixation - failure modeAuthors' Contributions
T.J.H. contributed towards acquisition of study data, biomechanical testing, drafting of the manuscript, and final approval of submitted manuscript. D.J.D. contributed towards design of study, construct repair, data acquisition and analysis, interpretation of the data, writing and drafting of final manuscript, revision of the work, and final approval of submitted manuscript. Y-J.C contributed towards specimen collection and dissection, assistance during biomechanics testing, interpretation of data and final approval of the submitted manuscript. G.E.M. contributed towards statistical analysis of data, interpretation of data, and final approval of the submitted manuscript.
Publikationsverlauf
Eingereicht: 10. März 2022
Angenommen: 27. August 2022
Artikel online veröffentlicht:
23. Januar 2023
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References
- 1 Kowaleski MP, Bourdrieau RJ, Pozzi A. Stifle joint. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd ed.. St. Louis, Missouri: Elsevier Saunders; 2018: 1071-1176
- 2 Roush JK. Canine patellar luxation. Vet Clin North Am Small Anim Pract 1993; 23 (04) 855-868
- 3 Perry KL, Déjardin LM. Canine medial patellar luxation. J Small Anim Pract 2021; 62 (05) 315-335
- 4 Harasen G. Patellar luxation: pathogenesis and surgical correction. Can Vet J 2006; 47 (10) 1037-1039
- 5 Stanke NJ, Stephenson N, Hayashi K. Retrospective risk factor assessment for complication following tibial tuberosity transposition in 137 canine stifles with medial patellar luxation. Can Vet J 2014; 55 (04) 349-356
- 6 DeAngelis M, Hohn RB. Evaluation of surgical correction of canine patellar luxation in 142 cases. J Am Vet Med Assoc 1970; 156 (05) 587-594
- 7 Richards CD. Surgical correction of medial patellar luxation: tibial crest transplantation and trochlear arthroplasty. Vet Med Small Anim Clin 1975; 70 (03) 322-325
- 8 Zide AN, Jones SC, Litsky AS, Kieves NR. A cadaveric evaluation of pin and tension band configuration strength for tibial tuberosity osteotomy fixation. Vet Comp Orthop Traumatol 2020; 33 (01) 9-14
- 9 Cashmore RG, Havlicek M, Perkins NR. et al. Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. Vet Comp Orthop Traumatol 2014; 27 (04) 263-270
- 10 Eskelinen EV, Suhonen AP, Virolainen JV, Liska WD. Tibial tuberosity transposition fixation with a locking plate during medial patellar luxation surgery: an ex vivo mechanical study. Vet Comp Orthop Traumatol 2022; 35 (02) 96-104
- 11 Brower BE, Kowaleski MP, Peruski AM. et al. Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2017; 30 (01) 20-27
- 12 Gibbons SE, Macias C, Tonzing MA, Pinchbeck GL, McKee WM. Patellar luxation in 70 large breed dogs. J Small Anim Pract 2006; 47 (01) 3-9
- 13 Arthurs GI, Langley-Hobbs SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 2006; 35 (06) 559-566
- 14 von Pfeil DJF, Megliolia S, Malek S, Rochat M, Glassman M. Tibial apophyseal percutaneous pinning in skeletally immature dogs: 25 cases (2006–2019). Vet Comp Orthop Traumatol 2021; 34 (02) 144-152
- 15 Cashmore RG, Havlicek M, Dabirrahmani D. et al. Mechanical evaluation of K-wire orientation, alignment and tension band wire fixation in a tibial tuberosity osteotomy model. Paper presented at: Proceedings of the 4th World Veterinary Orthopedic Congress; March 1–8; CO: Breckenridge; 2014: 59
- 16 Verpaalen VD, Lewis DD, Billings GA. Biomechanical comparisons of three stabilization methods for tibial tuberosity fractures in dogs: a cadaveric study. Vet Comp Orthop Traumatol 2021; 34 (04) 279-286
- 17 Mosier SM, Stanitski CL. Acute tibial tubercle avulsion fractures. J Pediatr Orthop 2004; 24 (02) 181-184
- 18 Shahar R, Banks-Sills L. Biomechanical analysis of the canine hind limb: calculation of forces during three-legged stance. Vet J 2002; 163 (03) 240-250
- 19 Hayes AG, Boudrieau RJ, Hungerford LL. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982-1992). J Am Vet Med Assoc 1994; 205 (05) 716-720
- 20 Alam MR, Lee JI, Kang HS. et al. Frequency and distribution of patellar luxation in dogs. 134 cases (2000 to 2005). Vet Comp Orthop Traumatol 2007; 20 (01) 59-64