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Prospective Randomized Clinical and Radiographic Evaluation of a Novel Bioabsorbable Biocomposite Tibial Tuberosity Advancement Cage Implant

Barnhart, Matthew D., Watson, Adam T., Thatcher, Lawrence G., Wotton, Harry, Naber, Steven J.
Veterinary surgery 2016 v.45 no.5 pp. 651-658
biocomposites, cages, cranial cruciate ligament, dogs, osteotomy, patients, radiography, randomized clinical trials, stainless steel, tibia
OBJECTIVE: To evaluate the suitability of a novel bioabsorbable biocomposite cage (BC) implant for use in tibial tuberosity advancement (TTA) surgery in dogs with cranial cruciate ligament (CrCL) disease and to compare radiographic osteotomy healing scores and complications between groups that received either a BC or stainless steel cage (SSC). STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Dogs with unilateral CrCL rupture (n=56). METHODS: TTA was performed in 60 consecutive dogs using either a BC (30 dogs) or SSC (30 dogs). Patient parameters, 6 week and 6 month postoperative radiographic osteotomy healing scores, time elapsed to postoperative rechecks, and complications were compared between groups. Osteotomy healing was graded using a 5‐point (0–4) scale. Data were analyzed using Wilcoxon Rank Sum tests and χ² tests with significance set at P<.05. RESULTS: Fifty‐six dogs (30 BC, 26 SSC) had complete medical and radiographic records at 6 months for inclusion in data analysis. Three complications occurred in the BC group (1 major, 2 minor) and 2 occurred in the SSC group (2 minor). There was no statistical difference in patient parameters, 6 week healing scores, or complications between BC and SSC groups. Healing scores at 6 months were significantly higher in the BC group (3.3 ± 0.52) compared to the SSC group (2.9 ± 0.69; P=.04). CONCLUSION: Based on improved BC osteotomy healing scores 6 months after surgery with no significant differences in complications compared to SSC, BC TTA cages are a viable alternative to SSC.