A Resorbable Bone Glue for Tarsal Arthrodesis. Pujari-Palmer M1, Svensson G2, Lundin T2, Östman M1, Höglund O1. 1Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden; 2Blå Stjärnans Djursjukhus, Gothenburg, Sweden.
Partial tarsal arthrodesis is a salvage procedure used to treat a range of tarsal diseases and is associated with a high risk of complications (10%–70%). The procedure involves removing cartilage and fixation with metal implants (plates), during joint fusion. At present, no tissue glue has ever been evaluated for improving tarsal arthrodesis. The aim of this study was to: develop a cadaver biomechanical test model for partial tarsal arthrodesis with an adhesive, and to determine whether a resorbable bone adhesive (phosphoserine modified cement, PMC) produced measurable, immediate fixation strength (24 hours), without metal hardware. Canine hind limbs were disarticulated in the tarsocrural joint and all soft tissues were dissected from the intertarsal and tarsometatarsal joints. A high-speed 2 mm burr was used to remove cartilage from individual joints. The glue was applied as a liquid/putty (0.4 cc) at the calcaneus-IV joint surfaces. After curing for 24 hours, a shear force was applied to the joint (AGS-X, Shimadzu, 1 mm per minute) and the failure strength was recorded. Use of adhesive was simple, and manual fixation was only required for the first 2–5 minutes. After 24 hours, the force needed to break the adhesive (1–1.5 cm2 joint surface, 2–5 mm displacement) ranged from 15–40 N in six joints. The present cadaver model produced clear data using physiologically relevant loading (shear, 0.3 MPa), where no other model exists. Since the adhesive transforms into bone in live animals, future preclinical studies will evaluate higher strength glue formulations with metal hardware, prior to clinical evaluation.