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. 2019 Oct 2;61(1):44.
doi: 10.1186/s13028-019-0481-1.

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

William McCartney  1   2 , Ciprian Ober  3 , Maria Benito  4 , Bryan MacDonald  2
Affiliations

Comparison of tension band wiring and other tibial tuberosity advancement techniques for cranial cruciate ligament repair: an experimental study

William McCartney et al. Acta Vet Scand. .

Abstract

Background: Cranial cruciate ligament (CCL) rupture is one of the most common causes of limb lameness in dogs. Surgical techniques based on tibial osteotomies such as tibial plateau leveling osteotomy and tibial tuberosity advancement are used to eliminate dynamic thrust. Tibial tuberosity advancement (TTA) uses an osteotomy fixated by cage, plates, forks and screws to change the relationship of the patellar tendon and tibial plateau angle. Tension band wiring technique is one of the most common surgical methods used to treat a tension fracture and remains the gold standard for the treatment of tibial tuberosity fractures. In this study, we compared experimentally the biomechanical effect of application of tension band wiring compared to other techniques for the fixation of the TTA osteotomy. The techniques compared to are standard commercially available systems for TTA fixation.

Results: Tension band wiring (TBW) presented the higher resistance to failure compared to all the other surgical procedures, with the highest values found in the TBW group with 1.47 ± 0.07 N and the lowest in the TTA cage (0.82 ± 0.08) and TTA-2 (0.85 ± 0.06) groups with statistically significant differences in all cases (P < 0.001). TTA rapid and TTA plate groups exhibited a similar strength, and same happened between TTA-2 and TTA cage groups. All the other comparisons by pair were significantly different with P < 0.001.

Conclusions: Results suggest that fixating the osteotomy with tension band wiring increases the strength of the fixation and decrease the risk of implant failure. Further clinical studies are needed to demonstrate in vivo reliability and to test different variables such as size and weight of dogs. These results could have important clinical implications in the treatment of CCL ruptures.

Keywords: Cranial cruciate ligament rupture; Osteotomy; Stifle joint tibial tuberosity advancement; Tension band wiring.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Image of the tensile testing machine used to measure tensile strenght in the experimental samples
Fig. 2
Fig. 2
Pattern of suture used. Pictures show different surgical procedures: a TTA rapid; b TBW; c TTA cage; d TTA-2; e TTA plate
Fig. 3
Fig. 3
Dotplot representing the distribution of the samples treated with each surgical technique at failure
See this image and copyright information in PMC

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