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Long-Term Fate of Decellularized Allografts used for Cranial Cruciate Ligament Reconstruction in Dogs
07 August 2019 (online)
Introduction: Use of a deep digital flexor tendon (DDFT) allograft to replace the cranial cruciate ligament (CCL) has shown promising clinical results in an initial pilot study. A limitation of this previous study was the survival of the allografts was not assessed. Therefore, the purpose of this project was to assess the survival of DDFT allografts used to replace the CCL in dogs.
Materials and Methods: Twenty client-owned dogs were enrolled. Surgery was performed as previously described by Biskup et al. 2017. Outcome was measured with the Liverpool Osteoarthritis in Dogs’ questionnaire (LOAD) and force plate analysis (FPA) at 6 and 12 months. Dogs will undergo second look arthroscopy at 12 months.
Results: At 6-month follow-up, all owners graded their dogs as improved except two owners. On exam, 10 dogs had appreciable cranial drawer (> 5 mm). FPA revealed improvement in 16/20 dogs with 3 dogs more lame then before surgery. Arthroscopy results will be available at the time of the conference.
Discussion/Conclusion: At 6 months, the cause of continued lameness was identified in 4 dogs (2 infections, 1 fracture through the tibial screw hole, and 1 meniscal tear). One dog with an infection had all implants explanted and no graft was visualized on arthroscopy. The dog with the meniscal tear was treated with a partial menisectomy and no allograft was visualized. This prospective study suggests intra-articular allograft placement for CCLR may provide a positive clinical outcome, although second look arthroscopy at 12 months will be needed to assess graft survival.
Acknowledgment: Hohn-Johnson grant, Arthrex, Veterinary Transplant Services, TATA-endowment.