Ligamentum teres reconstruction using autogenous semitendinosus tendon with toggle technique in rabbits

Rebeca Bastos Abibe; Sheila Canevese Rahal; Luciane Dos Reis Mesquita; Danuta Doiche; Jeana Pereira da Silva; Maria Jaqueline Mamprim; Renata Haddad Pinho; Alexandre Battazza; Carlos Eduardo Fonseca Alves; W Brian Saunders

doi:10.7717/peerj.14777

Ligamentum teres reconstruction using autogenous semitendinosus tendon with toggle technique in rabbits

PeerJ. 2023 Mar 23:11:e14777. doi: 10.7717/peerj.14777. eCollection 2023.

Affiliations

¹ Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
² Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
³ Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, United States.

Abstract

Background: Ligamentum teres (LT) has traditionally been considered a vestigial or redundant structure in humans; however, based on new studies and the evolution of hip arthroscopy, the LT injury has been viewed as a source of hip pain. Therefore, LT reconstruction can be beneficial in some cases. Rabbits have been frequently used as a model for cranial cruciate ligament reconstruction but few studies are available for ligamentum teres reconstruction.

Objective: To evaluate the semitendinosus tendon to replace ligamentum teres with the toggle technique, using rabbits as an experimental model.

Methods: Twenty-six female Norfolk rabbits with approximately 3 months of age were divided into two equal groups after excision of ligamentum teres (LT) from the right hip joint: G1-no reconstruction of LT and capsulorrhaphy; G2-double-bundle reconstruction of the LT using semitendinosus tendon autograft. In both groups, the LT was removed from the right hip joint. In G2 the autograft was harvested from the left hind limb of the same rabbit. The rabbits were evaluated clinically at different time intervals; before surgery (M1), 48 h (M2), 15 days (M3), 30 days (M4) and 90 days (M5) after surgery.

Results: The rabbits supported their limbs on the ground in both the groups. As complications of the procedure, four hip joints showed subluxations in the radiographic evaluation of G1; three at M4 and one at M5. In G2; two luxations of hip joints at M3 and one subluxation at M4 were seen. On ultrasound, irregular articular surface was seen in 30.8% of the rabbits that had subluxation of hip joints. Gross evaluation identified tendon graft integrity in 76.92% of the rabbits. Histological analysis revealed graft adhesion to the bone in the early phase comprised of sharpey-like collagen fibers.

Conclusion: The double-bundle reconstruction of the LT using autologous semitendinosus tendon associated with the toggle rod shows an early phase of tendon graft ligamentization at 90 days post-operatively in young rabbits, but biomechanical bias suffered by the tendon during gait must be considered.

Keywords: Hip joint; Luxation; Rabbit; Surgery; Treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Anterior Cruciate Ligament / surgery
Arthroscopy / methods
Female
Hamstring Tendons*
Hip Joint / diagnostic imaging
Humans
Joint Dislocations*
Rabbits
Round Ligaments*

Grants and funding

Funding was provided by the São Paulo Research Foundation (FAPESP no. 19/14711-2), FINEP (Financiadora de Estudos e Projetos; Grant 01.12.0530.00), Capes (Coordination for the Improvement of Higher Education Personnel), and the National Council for Scientific and Technological Development (CNPq – PQ 301585/2017-2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.