ABSTRACT
Background: As isolated ruptures of the caudal cruciate ligament (CdCL) are rare in dogs, there is no consensus on the indications and the gold-standard surgical technique for treatment. Case Description: A 2-year-old Shepherd dog with an isolated rupture of the CdCL was treated with a new surgical technique for synthetic reconstruction. Three bone tunnels were drilled in the femur and the tibia under arthroscopic guidance to make sure the anatomical insertions of the physiological ligament were respected. An ultra-high molecular weight polyethylene (UHMWPE) implant was fixed with interference screws to reconstruct the CdCL. A synovial inflammation remained present on radiographs for 6 months after the surgery, together with a mild lameness. However, the dog fully recovered clinically and recovered a normal level of activity after 6 months. Liverpool osteoarthritis in dogs questionnaire results at 6 months and 1 year postoperatively were excellent. Conclusion: The use of a UHMWPE implant fixed with interference screws to reconstruct the CdCL allowed a return to full function of the knee without complications, despite a persistent synovial inflammation and mild lameness for a 6-month period after the surgery. The success of this isolated surgical technique could lead to improvements in the surgical management of CdCL rupture, if these initial results are confirmed by a prospective study with a larger number of patients.
Subject(s)
Dog Diseases , Lameness, Animal , Dogs , Animals , Prospective Studies , Ligaments , Inflammation/veterinary , Dog Diseases/surgeryABSTRACT
Background: Tibiotarsal instabilities caused by partial or complete rupture of the medial collateral tarsal ligament (MCTL) are commonly treated by arthrodesis techniques with poor functional results and significant complication rates. Case Description: This study describes a new surgical technique for synthetic reconstruction of the MCTL in an overweight dog (estimated body condition score 8/9) with an avulsion of the long head of the MCTL. Three bone tunnels were drilled in the distal tibia, the talus, and the central tarsal bone, thus respecting the anatomical insertions of the physiological ligament. An Ultra-High Molecular Weight Polyethylene (UHMWPE) implant was fixed with interference screws to reconstruct the long and short heads of the MCTL. Premature weight-bearing was reported at 2 weeks postoperatively following early removal of the flexible restraint (bivalve resin boot), which had initially been prescribed for 6 weeks. At 11 weeks postoperatively, the tibiotarsal joint showed good valgus stability and the dog's gait was subnormal. At 12 and 16 months postoperatively, the dog regained full function of the operated limb although no weight loss was initiated as recommended. Conclusion: The use of a UHMWPE implant fixed with interference screws to reconstruct the MCTL allowed a return to full function of the tibiotarsal joint, without complications despite an early return to weight-bearing without external restraint. The success of this isolated surgical technique could lead to improvements in the surgical management of MCTL rupture if these initial results are confirmed by a prospective study with a larger number of patients.
