Peer-reviewed veterinary case report
How graft length affects healing after dog ACL surgery
By Qi, Li et al.·Published in Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association·2011·Department of Orthopaedic Surgery, China·View original on PubMed →
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Original publication title: Effect of varying the length of soft-tissue grafts in the tibial tunnel in a canine anterior cruciate ligament reconstruction model.
- Species:
- dog
Plain-English summary
A group of 40 adult dogs underwent surgery to repair their torn anterior cruciate ligament (ACL) using a piece of their Achilles tendon. The length of the tendon graft placed in the bone tunnel varied from 5 mm to 20 mm. It was found that grafts shorter than 15 mm led to slower healing and weaker connections between the tendon and bone in the early weeks after surgery. By 12 weeks, all grafts showed similar healing, but using at least 15 mm of graft length is recommended for better recovery.
People also search for: dog ACL surgery recovery · Achilles tendon graft length in dogs · dog knee surgery healing time
Abstract
PURPOSE: To investigate the effect of graft length within the bone tunnel on tendon-bone healing at an early stage after anterior cruciate ligament (ACL) reconstruction using Achilles tendon autograft in a canine model. METHODS: We divided 40 adult dogs into 4 groups (n = 10 per group). Each dog underwent ACL reconstruction with Achilles tendon autograft in both knees. In groups I, II, III, and IV, the graft length within the tibia tunnel was 5 mm, 10 mm, 15 mm, and 20 mm, respectively. Five dogs in each group were killed 6 and 12 weeks postoperatively, with 3 knees used for histologic observation and 7 knees for mechanical testing. RESULTS: Six weeks after surgery, the histologic scores in group I were lower than those in the other groups (P < .01) and those in group II were lower than those in group III and group IV (P < .01). However, there was no difference between group III and group IV (P > .05). At 12 weeks, there were no significant differences in histologic scores between groups (P > .05). The biomechanical test at 6 weeks showed that the mean graft pullout strength improved from group I to group IV. Except between groups III and IV (P = .142), there was a significant difference in the pullout strength among other groups. At week 12, the failure points were in the midsubstance of most specimens and more tibial-side graft pullout was found in group I than in the other groups (P < .001). CONCLUSIONS: The histologic maturity and biomechanical strength of the tendon-bone junction after ACL reconstruction in dogs will be delayed at an early stage if the graft length in the bone tunnel is less than 15 mm. CLINICAL RELEVANCE: There is a minimal acceptable amount of intratunnel tendon graft to allow satisfactory early tendon-bone healing, and attempts to save tendon graft length that lower the amount of intratunnel graft below a minimum of 15 mm should be avoided.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/21624677/