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Vet Comp Orthop Traumatol 2019; 32(03): 192-199
DOI: 10.1055/s-0039-1683398
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Biomechanical Comparison of Three Crural Fascia Repair Techniques for Tibial Tuberosity Advancement Surgery

Jenna E. Giangarra
1   Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, United States
,
Otto I. Lanz
1   Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, United States
,
Joseph C. Glennon
2   Capital Dist Veterinary Surgical Assoc, Pattersonville, New York, United States
,
Takayuki Kobayashi
3   Animal Clinic Kobayashi, Saitama, Japan
,
Michael Tarkanian
4   Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
,
Slobodan Tepic
5   Kyon, Zurich, Switzerland
,
Stephen R. Werre
6   Laboratory for Study Design and Statistical Analysis, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, United States
› Author Affiliations Funding The authors received no external funding for this project.
Further Information

Publication History

30 November 2017

23 December 2018

Publication Date:
17 May 2019 (online)

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Abstract

Objectives The aim of this study was to compare the strength of three described techniques for repair of the medial crural fascia to the strength of the intact fascia of the paired limbs. We hypothesized that intact controls would have higher peak loads at failure than repair groups and that the modified Mason–Allen suture pattern would have the highest peak load at failure of the repair groups.

Materials and Methods Canine cadavers (n = 22) were randomly assorted into three groups. Group A: a continuous suture pattern. Group B: five equally spaced simple interrupted cruciate sutures over a simple continuous suture pattern. Group C: an interrupted modified Mason–Allen suture pattern. The mid-portion of the crural fascia was incised in Groups A and C, while Group B used a cranial incision. Contralateral limbs were utilized as paired controls. Tibiae were mounted to a biomaterial testing machine and the medial crural fascia loaded at 10 mm/min.

Results Mean peak load to failure for Group A: 201.0N, Group B: 261.0N, Group C: 306.1N and Intact limbs: 799.5N. Between repair groups, there was no significant difference between peak loads to failure identified. Significant differences were identified between all repairs and intact limbs. All repairs approached a mean of 33.5% (267.8N) of intact medial crural fascia strength.

Clinical Significance All repair techniques met no more than 1/3 intact medial crural fascia strength. Further research is required to continue to evaluate the most clinically appropriate technique to repair the medial tibial crural fascia.

Keywords

repair - crural fascia - biomechanical comparison - tibial tuberosity advancement - canine

Author Contribution

Jenna E. Giangarra, Otto I. Lanz, Slobodan Tepic and Stephen R. Werre contributed to data analysis and interpretation. Otto I. Lanz, Joseph C. Glennon, Takayuki Kobayashi, Michael Tarkanian and Slobodan Tepic contributed to conception of study, study design and acquisition of data. All authors drafted, revised and approved the submitted manuscript.


 

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