101 Ways To Fix A Cruciate
What is cruciate injury?
The cruciate ligament is located within the knee, or stifle joint. Cruciate ligament disease remains the most common orthopaedic condition we treat surgically in dogs. Research into the pathogenesis of the condition is ongoing across the globe, with multiple contributing factors likely involved.
How is it treated?
There are several surgical techniques used to treat the condition, which aim to establish stability in weight bearing. Cruciate disease is a serious problem and although surgery is beneficial, progression of arthritis to some degree is often unavoidable.
Every patient is different
No one technique serves all patients due to variability in patient conformation, muscle and body mass, lifestyle, other diseases etc. It is important to design a treatment that takes all these factors into consideration.
Extracapsular stabilisation techniques remain popular, and some advances have been recently made into establishment of new prosthetic materials and isometric anchorage points, but the inconsistency of outcome, particularly in medium and large breed dogs makes this option less desirable.
Plateau levelling treatment techniques generally gain better overall return of function in medium-large breed dogs. The tibial tuberosity advancement (TTA) technique is most commonly performed at SASH, however patient conformation will play a role in the technique used.
Each patient is preoperatively assessed for stifle conformation and an appropriate technique and implant determined. All patients, regardless of technique, have their stifle joint thoroughly examined by arthrotomy or arthroscopy.
Medial meniscal trauma is present in a large proportion of patients and should be addressed with resection of damaged meniscus. Adequate stifle distraction (using stifle distracters) and the use of Gelpi, Hohmann and Senn retractors as well as meniscal probes aid in visualisation of the meniscus and these instruments are part of our “stifle kits” at SASH.