Lundin Tobias Per Otto, Pujari-Palmer Michael, Svensson Gustaf, Höglund Odd Viking
Department of Surgery, Blå Stjärnans Djursjukhus, Gothenburg, Sweden.
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Front Vet Sci. 2023 Sep 20;10:1250147. doi: 10.3389/fvets.2023.1250147. eCollection 2023.
Arthrodesis, performed as a salvage surgical procedure to treat intractable joint conditions in dogs and cats, is associated with a high incidence of complications intra and postoperative, proving the need for improved and new techniques in arthrodesis surgery. Adding a new resorbable bone glue to the arthrodesis could potentially add fixation strength and lower complications. The objectives of this experimental biomechanical study were therefore to develop a biomechanical test model of partial tarsal arthrodesis and to determine whether the new resorbable bone glue (phosphoserine modified cement) produced measurable fixation strength in canine calcaneoquartal arthrodesis, without orthopedic implants.
Four biomechanical test models with a total of 35 canine tarsal joints were used. Soft tissues were dissected to 4 different test models with variable contributions from soft tissues. The calcaneoquartal joint was prepared as arthrodesis and the glue was applied to joint surfaces as a liquid/putty (0.4 cc). After curing for 24 h, a shear force was applied to the joint (1 mm per minute) and the failure strength was recorded.
Calcaneoquartal joints, where all soft tissues had been completely resected and fixated with glue (1-1.5 cm joint surface), withstood 2-5 mm of displacement and an average of 100 ± 58 N/cm of shear force (Model 1). Similar adhesive fixation strengths were obtained in Model 2 and 3 with increasing contributions from soft tissues (80 ± 44 and 63 ± 23 N/cm, = 0.39, ANOVA).
The developed biomechanical model was sensitive enough to measure differences in fixation strengths between different glue formulations. The average fixation strength (60-100 N/cm) should be strong enough to support short-term load bearing in medium sized canines (20 kg). The developed cadaver biomechanical test model is of potential use for other arthrodesis studies. The new resorbable glue can potentially contribute to stability at arthrodesis surgery, acting as a complement to today's standard fixation, metal implants.
关节固定术作为一种挽救性外科手术，用于治疗犬猫的顽固性关节疾病，其术中和术后并发症的发生率较高，这表明需要改进和创新关节固定术的技术。在关节固定术中添加一种新型可吸收骨胶可能会增强固定强度并降低并发症的发生率。因此，本实验性生物力学研究的目的是建立一个部分跗关节固定术的生物力学测试模型，并确定这种新型可吸收骨胶（磷酸丝氨酸改性骨水泥）在犬跟骰关节固定术中（不使用骨科植入物）是否能产生可测量的固定强度。
使用了四个生物力学测试模型，共35个犬跗关节。将软组织解剖成4种不同的测试模型，软组织的贡献程度各不相同。将跟骰关节准备好进行关节固定术，并将骨胶以液体/油灰状（0.4毫升）涂覆在关节表面。固化24小时后，以每分钟1毫米的速度对关节施加剪切力，并记录破坏强度。
在所有软组织均被完全切除并用骨胶固定（关节表面1 - 1.5厘米）的跟骰关节中，能够承受2 - 5毫米的位移和平均100 ± 58牛/厘米的剪切力（模型1）。在模型2和3中，随着软组织贡献程度的增加，获得了相似的黏附固定强度（分别为80 ± 44和63 ± 23牛/厘米，F = 0.39，方差分析）。
所建立的生物力学模型足够灵敏，能够测量不同骨胶配方之间固定强度的差异。平均固定强度（60 - 100牛/厘米）应足以支持中型犬（20千克）的短期负重。所建立的尸体生物力学测试模型可能对其他关节固定术研究有用。这种新型可吸收骨胶有可能在关节固定术中增强稳定性，作为当今标准固定方式（金属植入物）的补充。
