Short- and long-term outcomes of primary Achilles tendon repair in cats: 21 Cases

Summary

Objectives: To evaluate the short- and long-term outcomes of surgically repaired Achilles tendons in cats.

Methods: Twenty-one cats that underwent surgical repair of Achilles tendon injuries were retrospectively examined. Signalment, type of injury, time from injury to surgery, the surgical repair, complications, and long-term outcomes were recorded. Statistical comparisons were made between traumatic and atraumatic injuries using Student’s paired t-tests.

Results: Both traumatic and atraumatic causes of disruption were equally represented and female cats were significantly over-represented. Type I and Type IIc injuries were found in cats, but the type did not affect short- or long-term outcome. A complication rate of 33% was identified and was always attributable to the method of external coaptation. None of the cats that were augmented with a splint developed complications, however complications did occur in those with transarticular external skeletal fixators. Long-term clinical outcome found an 84% overall success rate and a 79% success rate for cats with Type IIc injuries. A significantly shorter time from injury to surgery was identified for traumatic injuries, but not for age, weight, or long-term outcome.

Clinical significance: Surgical correction resulted in excellent functional outcome in all cases but one, and should be considered in both complete and partial disruption of the Achilles mechanism in cats. A direct comparison between surgical and conservative management of Type IIc injuries in cats should be considered to determine which method is most appropriate to manage these injuries.

Keywords

Achilles tendon - Likert scale - tenorrhaphy

• References

• 1 Hermanson J, Evans HE. The muscular system. In Miller's Anatomy of the Dog. Evans HE. editor. Philadelphia: Saunders; 1993. pgs 356-359. 369-370. 380.
• 2 Clark D. Tendon injury and repair. In Disease Mechanisms in Small Animal Surgery. Second Edition. Bojrab MJ. editor. Philadelphia: Lea and Febiger; 1993. pgs 1079-1082.
• 3 Mughannam A, Reinke JR. Avulsion of the gastrocnemius tendon in three cats. J Am Anim Hosp Assoc 1994; 30: 550-556.
• 4 Reinke J, Mughannam A, Owens J. Avulsion of the gastrocnemius tendon in 11 dogs. J Am Anim Hosp Assoc 1993; 29: 410-418.
• 5 Reinke J. Treatment of avulsion of the gastrocnemius tendon. In Current Techniques in Small Animal Surgery. Fourth Edition. Bojrab MJ, Ellison G, Slocum B. editors. Baltimore: Williams and Wilkins; 1998. pgs 1257-1260.
• 6 Sivacolundhu R, Marchevsky A, Read R. et al. Achilles mechanism reconstruction in four dogs. Vet Comp Orthop Traumatol 2001; 14: 25-31.
• 7 King M, Jerram R. Achilles tendon rupture in dogs. Compend Cont Ed Pract Vet 2003; 25: 613-621.
• 8 Gilbert T, Stewart-Akers A, Simmons-Byrd A. et al. Degradation and remodeling of small intestinal submucosa in canine Achilles tendon repair. J Bone Joint Surg Am 2007; 89: 621-630.
• 9 Guerin S, Burbridge S, Fox E. Achilles tenorrhaphy in five dogs: A modified surgical technique and evaluation of a cranial half cast. Vet Comp Orthop Traumatol 1998; 11: 205-210.
• 10 Nielson C, Pluhar G. Outcome following surgical repair of Achilles tendon rupture and comparison between postoperative tibiotarsal immobilization methods in dogs. 28 cases (1997–2004). Vet Comp Orthop Trauma-tol 2006; 19: 246-249.
• 11 Morshead D, Leeds E. Kirschner-Ehmer apparatus immobilization following Achilles tendon repair in six dogs. Vet Surg 1984; 13: 11-14.
• 12 de Haan J, Goring R, Renberg C. et al. Modified transarticular external skeletal fixation for support of Achilles tenorrhaphy in four dogs. Vet Comp Orthop Traumatol 1995; 8: 32-35.
• 13 Hudson J, Slater M, Taylor L. et al. Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. Am J Vet Res 2004; 65: 1634-1643.
• 14 Meutstege J. The classification of canine Achilles tendon lesions. Vet Comp Orthop Traumatol 1993; 6: 53-55.
• 15 Kannus P, Josza L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 1991; 73: 1507-1525.
• 16 Hossain M, Park J, Choi S. Dexamethasone induces apoptosis in proliferative canine tendon cells and chondrocytes. Vet Comp Orthop Traumatol 2008; 21: 337-342.
• 17 Lim S, Hossain M, Park J. et al. The effects of enrofloxacin on canine tendon cells and chondrocytes proliferation in vitro. Vet Res Commun 2008; 32: 243-253.
• 18 Norton J, DeCamp C, Yu J. et al. Use of a single-ring transarticular fixator construct for immobilization of the talocrural joint following common calcaneal tenor-rhaphy. Vet Comp Orthop Traumatol 2009; 22: 430-435.
• 19 Fenwick S, Hazleman B, Riley G. The vasculature and its role in the damaged and healing tendon. Arthritis Res 2002; 4: 252-260.
• 20 Tomlinson J, Moore R. Locking loop suture use in repair of five calcaneal tendons. Vet Surg 1982; 11: 105-109.
• 21 Berg R, Egger E. In vitro comparison of the three loop pulley and locking loop suture patterns for repair of canine weight bearing tendons and collateral ligaments. Vet Surg 1986; 15: 107-110.
• 22 Jann H, Stein L, Good J. Strength characteristics and failure modes of locking-loop and three-loop pulley suture patterns in equine tendons. Vet Surg 1990; 19: 28-33.
• 23 Moores A, Owen M, Tarlton J. The three-loop pulley suture versus two locking-loop sutures for the repair of canine Achilles tendons. Vet Surg 2004; 33: 131-137.
• 24 Moores A, Comerford E, Tarlton J. et al. Biomechanical and clinical evaluation of a modified 3–loop pulley suture pattern for reattachment of canine tendon to bone. Vet Surg 2004; 33: 391-397.
• 25 Worth A, Danielsson F, Bray J. et al. Ability to work and owner satisfaction following surgical repair of common calcaneal tendon injuries in working dogs in New Zealand. N Z Vet J 2004; 52: 109-116.