Intraoperative patellar kinematics following resection of the central one-third of the patellar tendon in the ovine stifle joint

N. Bertollo; D. J. Bell; W. R. Walsh

doi:10.3415/VCOT-10-05-0073

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2011; 24(03): 197-204
DOI: 10.3415/VCOT-10-05-0073

Original Research

Schattauer GmbH

Intraoperative patellar kinematics following resection of the central one-third of the patellar tendon in the ovine stifle joint

Authors

N. Bertollo

¹Surgical and Orthopaedic Research Laboratories, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
D. J. Bell

¹Surgical and Orthopaedic Research Laboratories, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
W. R. Walsh

¹Surgical and Orthopaedic Research Laboratories, Prince of Wales Hospital, University of New South Wales, Sydney, Australia

Abstract

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Summary

Objectives: The bone-patellar tendon-bone complex is routinely harvested for anterior cruciate ligament reconstruction in humans. Patella infera may ensue. However, the contribution from resection of the central one-third of the patellar tendon (PT) to potentially altered patellofemoral kinematics, in addition to those induced by a positional shift of the patella, are yet to be distinguished. Objectives of this study were to characterize changes in intraoperative patellar kinematics and PT length in nine sheep immediately following unilateral resection of the central one-third PT, and again at six, 12 and 24 weeks postoperatively.

Methods: Following implantation of bone-screws into the patella and tibia, electromagnetic receivers were anchored to these, and then passively-induced, unloaded patellar kinematics were captured. Patellar kinematics were referenced to the tibial coordinate frame and analysed using non-parametric tests (Wilcoxon Signed Rank Test).

Results: Resection alone did cause significant alteration in kinematics at the time of surgery (p <0.05). Postoperatively, a mean increase in PT length of 2.6 mm was detected in the operated stifles, reflected partly as a net 2.8 mm proximal patellar shift (p <0.001). This was accompanied by a mean net six degree medial shift in the patellar tilt pattern (p <0.001). Significant changes to patellar spin in the latter parts of flexion were also observed (p <0.005). Kinematic and length changes did not recover up to 24 weeks postoperatively.

Clinical significance: The data obtained in this study suggests that both the patellar height and integrity of the PT are important determinants of patellar kinematics in the ovine stifle joint.

Keywords

Anterior cruciate ligament - patella infera - ovine stifle - bone-patellar tendon-bone auto-graft - cranial cruciate ligament

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References

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