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

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.

Effect of a single intra-articular injection of bupivacaine on synovial fluid prostaglandin E2 concentrations in normal canine stifles.

OBJECTIVE: To identify if synovial fluid prostaglandin E2 increases in response to a single intra-articular dose of bupivacaine in the normal canine stifle. RESULTS: There were no significant differences in synovial fluid prostaglandin E2 (PGE2) concentrations between treatment groups or over time within bupivacaine or saline groups. Samples requiring ≥ 3 arthrocentesis attempts had significantly higher PGE2 concentrations compared to samples requiring 1 or 2 attempts. Following correction for number of arthrocentesis attempts, PGE2 concentrations were significantly higher than baseline at 24 and 48 h in the bupivacaine group; however there were no significant differences between the bupivacaine and saline groups. In normal dogs, a single bupivacaine injection did not cause significant synovial inflammation, as measured by PGE2 concentrations, compared to saline controls. Future research should minimize aspiration attempts and include evaluation of the synovial response to bupivacaine in clinical cases with joint disease.