Evaluation of Modified Techniques for Toggle Pin Repair of Coxofemoral Luxation in Dogs: A Cadaveric StudyFunding Materials used in this study were provided by Arthrex Vet Systems, Naples, Florida, United States.
10 October 2017
09 May 2018
23 August 2018 (eFirst)
Objectives The primary objective was to assess acetabular articular cartilage damage when an acetabular tunnel is drilled by passing the drill bit through the femoral tunnel. The second objective was to assess the success rate of passing the toggle through the femoral and acetabular tunnels in a single manoeuvre using a toggle delivery device.
Methods Open bilateral coxofemoral luxations in 16 canine cadavers were repaired by toggle pin technique by a surgical resident (n = 8) and a diplomate surgeon (n = 8). In one hip of each cadaver, the acetabular tunnel was drilled through the femoral tunnel and the toggle was passed in a single manoeuvre using the delivery device. In the contralateral hip, the tunnels were drilled separately, and the toggle was passed through each tunnel separately (resident) or in a single manoeuvre (surgeon). Pelves were examined for acetabular cartilage damage and toggle placement.
Results Cartilage damage did not occur with independent drilling of the acetabulum but occurred in 6/16 hips in which the acetabulum was drilled via the femoral tunnel. Successful deployment of the toggle was obtained in 24/24 hips in which the toggle was passed through the femoral and acetabular tunnels simultaneously using the delivery device, regardless of how the acetabular tunnel was drilled.
Clinical Significance Drilling the acetabular tunnel through the femoral tunnel risks damaging the acetabular cartilage. Success was consistently obtained when passing the toggle through the femoral and acetabular tunnels simultaneously using the toggle delivery device.
Samuel P. Franklin contributed to conception of study, study design, and acquisition of data and data analysis and interpretation. Jacob I. Helmick contributed to acquisition of data and data analysis and interpretation. Suzanne E. Bugbee and Jason R. Strasberg contributed to acquisition of data. All authors drafted, revised and approved the submitted manuscript.
- 1 Knowles AT, Knowles JO, Knowles RP. An operation to preserve the continuity of the hip joint. J Am Vet Med Assoc 1953; 123 (921) 508-515
- 2 Beckham Jr HP, Smith MM, Kern DA. Use of a modified toggle pin for repair of coxofemoral luxation in dogs with multiple orthopedic injuries: 14 cases (1986-1994). J Am Vet Med Assoc 1996; 208 (01) 81-84
- 3 Demko JL, Sidaway BK, Thieman KM, Fox DB, Boyle CR, McLaughlin RM. Toggle rod stabilization for treatment of hip joint luxation in dogs: 62 cases (2000-2005). J Am Vet Med Assoc 2006; 229 (06) 984-989
- 4 Evers P, Johnston GR, Wallace LJ, Lipowitz AJ, King VL. Long-term results of treatment of traumatic coxofemoral joint dislocation in dogs: 64 cases (1973-1992). J Am Vet Med Assoc 1997; 210 (01) 59-64
- 5 Bone DL, Walker M, Cantwell HDAN. Traumatic coxofemoral luxation in dogs results of repair. Vet Surg 1984; 13 (04) 263-270
- 6 Rose ND, Goerke D, Evans RB, Conzemius MG. Mechanical testing of orthopedic suture material used for extra-articular stabilization of canine cruciate ligament-deficient stifles. Vet Surg 2012; 41 (02) 266-272
- 7 Zambrano S, Teixeira MW, Lamb JL. , et al. Comparison of three toggle suture constructs (TSCS) for craniodorsal hip luxation in dogs: an ex-vivo biomechanical study. Abstracts presented at: 43rd Annual Conference of the Veterinary Orthopedic Society; February 27–March 5, 2016; Big Sky, Montana
- 8 Jha S, Kowaleski MP. Mechanical analysis of twelve toggle suture constructs for stabilization of coxofemoral luxations. Vet Surg 2012; 41 (08) 948-953
- 9 Lee H, Heo S. Minimally invasive arthroscopic- assisted reduction with TightRope in a dog with coxofemoral luxation. Pak Vet J 2013; 34 (04) 551-553
- 10 Tamburro R, Carli F, Cinti F, Puggioni A, Venturini A. Caudal approach and Mini TightRope system (mTR) application for the treatment of craniodorsal hip luxation in a cat: a case report. Vet Med (Praha) 2013; (09) 500-504
- 11 Kieves NR, Lotsikas PJ, Schulz KS, Canapp SO. Hip toggle stabilization using the TightRope® system in 17 dogs: technique and long-term outcome. Vet Surg 2014; 43 (05) 515-522
- 12 Ash K, Rosselli D, Danielski A, Farrell M, Hamilton M, Fitzpatrick N. Correction of craniodorsal coxofemoral luxation in cats and small breed dogs using a modified Knowles technique with the braided polyblend TightRope systems. Vet Comp Orthop Traumatol 2012; 25 (01) 54-60
- 13 Wardlaw JL, Mclaughlin RM. Toggle rod stabilization. In: Johnston SA, Tobias KM. , eds. Veterinary Surgery Small Animal. Vol. 1. 2nd ed. St Louis, Missouri: Elsevier Inc.; 2018: 962-963
- 14 Serdy MG, Schulz KS, Hornof W, Koehler C, Chiu D, Vasseur PB. Closed toggle pinning for canine traumatic coxofemoral luxation. Vet Comp Orthop Traumatol 1999; 12 (02) 6-14