Evaluation of Tendon Plate Augmentation in Addition to a Primary Three-Loop Pulley Repair on the Biomechanical Characteristics and Gap Formation in Canine Gastrocnemius Tendons

Introduction: Repair site protection is often recommended following surgical repair of canine gastrocnemius tendons (GT) because of the large strains generated by the gastrocnemius muscle. Advantages of tendon plate augmentation include higher tensile strength and resistance to gap formation compared with sutured repairs alone. Our objective was to evaluate the effect of tendon plate augmentation and effect of tendon plate length in addition to a three loop-pulley (3LP) repair in a canine GT model.

Materials and Methods: GT were randomly assigned to four groups (n = 12/group) and repaired by 3LP alone or augmented with a 3-, 5-, or 7-hole tendon plate (3VCP, 5VCP, 7VCP). Biomechanical loads, gap formation, and failure modes were analysed.

Results: Loads were all significantly increased using a 5VCP (p <0.001) and 7VCP (p <0.0001) compared with 3LP alone. Increasing tendon plate length from 3VCP to 5VCP and 7VCP increased construct tensile strength (p <0.0001). No difference was found between 3LP and 3VCP regarding yield and peak, but failure loads were increased (p = 0.039). Loads to create a 1- and 3-mm gap were significantly greater for 5VCP (p = 0.0002; p = 0.001) and 7VCP (p <0.0001; p <0.0001), but not different between 3LP and 3VCP (p = 0.06; p = 0.053), respectively. Failure mode differed among tendon plate groups (p <0.001).

Discussion/Conclusion: Application of a tendon plate increased construct strength and loads required to create a gap in GT. Increasing the length of the tendon plate to 7VCP significantly increased the biomechanical properties of the repair while increasing its resistance to gap formation.

Acknowledgement: No proprietary interest or funding existed for this study.

Publication History

Article published online:
26 October 2022