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Published on: May 20, 2019
[Stifle stability after lateral suture stabilisation using Ethibond Excel®: early destabilisation following cyclic
P Böttcher1, C Fischer, H Werner
1Klinik für Kleintiere, Universität Leipzig, Leipzig, Germany. boettcher@kleintierklinik.uni-leipzig.de
Objective:
1) To report cranio-caudal stifle stability (ccStab) following lateral suture stabilisation (LSS) and passive joint motion. 2) To report tension within the suture following knotting.
Material And Methods:
ccStab was measured in vitro on latero-medial radiographs in 10 stifles of orthopaedically sound dogs (> 20 kg BW). ccStab was assessed in the intact joint, after transection of the cranial cruciate ligament and following LSS using a multi strand Ethibond loop and clamped square knots, as well as after 50, 100, 250 and 350 cycles of passive joint motion. Tension within seven suture loops was measured using a material testing machine. Tension was measured after the first (FMax) and last knot (FEnd).
Results:
ccStab following LSS was 3.7 mm und was greater by 2.7 mm than with intact cruciate ligament. Already 250 passive cycles of passive joint motion induced significant destabilisation by 1.5 mm. FMax was 133 N und dropped to 6 N (FEnd) after completion of the last knot.
Conclusion:
LSS using Ethibond and clamped square knots do not allow for restoration of physiological stifle stability. Already few cycles of passive joint motion further destabilise the joint. One of the reasons for these disappointing results is the method of suture fixation as clamped square knots did not allow for conservation of initial loop tension.
Clinical Relevance:
LSS using a multi strand Ethibond loop and clamped square knots should be avoided.