Common calcaneal tendon repair in cats: outcome and complications associated with post-operative immobilization of tarso-crural joint methods.
Rizkallal C1, Currie AJ2, Meeson R*2, Compagnone K3, Alvarez R4, Kalmukov I5, Pisani G*6, Cinti F*7, Owen M*8, Vezzoni L*9, Piras LA10, Marshall W*11, Vallefuoco R*12
1University of Ghent, Merelbeke, Belgium, 2Royal Veterinary College, Hatfield, United Kingdom, 3Davies Veterinary Specialists, Hitchin, United Kingdom, 4Southern Counties Veterinary Specialists, Ringwood, United Kingdom, 5Fitzpatrick Referrals, Godalming, United Kingdom, 6Centro Veterinario, Luni Mare, Italy, 7Clinica Veterinaria San Marco, Veggiano, Italy, 8University of Cambridge, Cambridge, United Kingdom, 9Clinica Veterinaria Vezzoni, Cremona, Italy, 10Università di Torino, Turin, Italy, 11Vets Now Glasgow Hospital, Glasgow, United Kingdom, 12Pride Referrals, Derby, United Kingdom.
Introduction
Reported complications following common calcaneal tendon (CCT) injury are commonly caused by the method of immobilization, rather than the tendon repair technique. The objectives of this retrospective study were 1) to compare the complications associated with post-operative tarso-crural joint immobilization techniques, and 2) to investigate long-term outcome.
Material and methods
Medical records for cats that underwent surgical CCT repair treated at 11 referral centers were reviewed. Data included signalment, etiology, type of injury, method of tenorrhaphy, postoperative tarsocrural immobilization technique and intra-/post-operative complications. Limb function was evaluated according to Cook et al. Long-term follow-up was based on an owner telephone questionnaire.
Results
Thirty-nine cats met the inclusion criteria. Calcaneotibial screw and calcaneotibial plate were used in 11 and 4 cats respectively. Modified type I and II transarticular external skeletal fixation (TA-ESF) and external coaptation (cast) were used in 22 and 2 cats respectively. The overall complication rate was 44%. Transarticular ESF resulted in a higher occurrence of major (50%) and catastrophic complications (41.3%), such as implant failure, and pin loosening. Thirty-two cats showed full/acceptable function and 4 cats showed unsatisfactory limb function. Owner telephone long-term (844 days) follow-up was available for 10 cases and 9 cases showing good to excellent outcome.
Discussion and conclusion
Tarsocrural joint immobilization technique affects the postoperative complication rate, but not the long-term limb function. Internal fixation techniques resulted in a lower rate of postoperative complications compared to external fixation techniques.