Poodle Gets Surgery For Torn Knee Ligament

The cranial cruciate ligament (CCL) is one of the main stabilising structures of the stifle joint (knee). CCL rupture (torn knee ligament) is the most common orthopaedic conditions in dogs which causes hind limb pain, lameness and subsequent arthritis

Cruciate-ligament-diagram2

The cranial cruciate ligament is a fibrous tissue that connects the femur (thigh bone) with the tibia (lower leg bone). (ref: michiganveterinarysurgeons.com)

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Once the ligament ruptures, the dog will become acutely lame due to severe inflammation that occurs within the joint. (ref: highdesertvet.com)


extracapsular suture repair is the most common 
orthopaedic procedure performed for small dogs (below 20kg) with CCL disease.
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Dr Dennis Choi, Mount Pleasant Veterinary Centre (Gelenggang), performed an extracapsular repair on a poodle’s right hind limb to stabilise the stifle. An incision is made to open the joint capsule for examination.

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The cranial cruciate ligament & meniscus are examined. Any torn or damaged portion is removed & the joint capsule sutured closed.

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A tiny hole is drilled in the tibia.

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A strong sterile suture is passed around the fabella behind the knee & through the hole drilled in the tibia. The suture is tightened to stabilise the knee by mimicking the action of the cranial cruciate ligament. Over time, the suture will induce scar tissue formation which also helps to stabilise the joint.

Post-operative care at home is critical.  Premature or excessive activities must be prevented. Physical rehabilitation (such as range-of-motion exercises and massage) and weight control would also help to speed up recovery and improve the outcome of surgery.

For larger or more active dogs, other surgical techniques like cranial tibial wedge osteotomy has better outcome. Read about 50kg Dandelion’s surgery here.

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50kg Mastiff Gets Surgery For Ruptured Cruciate Ligament

Dr Tan Choon Yi, Mount Pleasant Veterinary Centre (Changi)

Dandelion is a 3-year-old English Mastiff. In September 2014, she became lame on her right hind limb and was treated with a course of anti-inflammatories. After 2 courses with no improvement, Dandelion was scheduled to have her knee examined by Dr Dennis Choi (Mount Pleasant Veterinary Centre, Gelenggang) under general anaesthesia.

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General anaesthesia allows the patient to be adequately relaxed for a proper examination of the knee, which can be difficult in a conscious large dog like 50kg Dandie!

Upon examination, there was an instability of her knee reflected by a positive cranial drawer test. This confirmed a cranial cruciate ligament rupture.

knee-comparison

In a drawer test, the vet holds the femur stable and moves the tibia. If the tibia is able to move forward (like pulling out a drawer), it is considered a positive drawer test which indicates a cranial cruciate ligament rupture. (ref: morningtonvetclinic.com.au)

Cruciate-ligament-diagram2

The cranial cruciate ligament is the primary stabiliser of the knee. Once it ruptures, the dog will become acutely lame due to severe inflammation that occurs within the joint. (ref: michiganveterinarysurgeons.com)

Lateral stifle-before surgery

Radiographs of Dandie’s knee showed an increased radio-opacity in the infrapatellar fat pad, which can occur in cruciate disease.

Dandie’s surgery, performed by Dr Choi, is called a cranial tibial wedge osteotomy. A triangular wedge of bone is cut from the tibia to change the angle of the weight bearing surface of the knee. This prevents abnormal sliding motion of the joint which occurs after the cruciate ligament has ruptured.

Lateral view of stifle

AP view of stifle

2 bone plates with pins and wires were placed to close up the wedge made in the tibia.

By the first week, Dandie was able to place weight on her right hind leg but still visibly lame. 2 weeks after surgery, she was feeling better and to my dismay, trying to run and jump. Activity had to be restricted for a full 12 weeks until bone healing was complete. Premature, uncontrolled activity can risk breakdown of the surgical implant.

Dandie post surgery

Dandie before surgery

A seroma (sterile accumulation of fluid), almost the size of a fist, had also developed at her surgical site. No specific treatment was required for the seroma and it was resorbed by her body in about three weeks.

Dandelion has since made a full recovery from surgery and is back to her mischievous self – jumping onto sofas, stealing random items from the garden and chasing birds every morning!

Baking at the printers! Find out more about our vets & their pets in our next issue of Pleasant Pet News. Pick up your copy at all our clinics this month!

Baking at the printers! Find out more about our vets & their pets in the next issue of Pleasant Pet News. Pick up your copy at all our clinics this month!