Intraoperative Measurement of Soft Tissue Tension in Canine Uncemented Total Hip Arthroplasty

This study aimed to quantify the incremental tension forces encountered during trial and final reductions during total hip arthroplasty surgery; determine the contribution to final soft tissue tension of the tenorrhaphy of the partial tenotomy of the deep gluteal tendon during closure; develop an intraoperative protocol of soft tissue tension evaluation, describing the Shuck, Kick and External Rotator tests as subjective tools for assessing tension; and correlate this with short-term clinical outcome.

Prospective case series including client-owned dogs presented for total hip arthroplasty. Collected data included signalment, intraoperative tension measurements during sequential trial head use and trial reductions, and short-term clinical outcome.

Twenty hips (19 dogs) were included. The final soft tissue tension ranged from 70.6 to 182.4 N, with an average of 124.5 N. The Shuck test was repeatable and consistent. Tenorrhaphy of the deep gluteal tendon partial tenotomy using a continuous pattern suture of metric 3.5 polydioxanone produced a significant increase in the tension of the periprosthetic soft tissue envelope.

The Shuck test was a reliable measurement of overall soft tissue tension across the prosthetic hip joint. Tenorrhaphy of the deep gluteal tendon significantly increases the final soft tissue tension. A systematic, intraoperative approach to tension measurement and evaluation during total hip replacement is suggested.