Cranial Cruciate Ligament Injury and Tibial Tuberosity Advancement

Cranial cruciate ligament rupture is the most common orthopaedic disorder in the dog. The cranial cruciate ligament can rupture due to a number of causes. Interestingly the dramatic snapping of the ligament is not the most common cause of the rupture.  Degenerative changes of the ligament progress in severity as the dog ages and is less severe in dogs under 15kg and results in a significant weakening of the ligament.  This contributes to the high incidence of both legs being effected at some stage (50%).  

There are a range of methods of treating a ruptured cranial cruciate ligament and the advantages and disadvantages of each technique are best discussed with your veterinarian.  

One of the highly successful methods of treatment, is the tibial tuberosity advancement technique. Those dogs that have the surgery done have less pain and a slower onset of arthritis than those that do not have the leg stabilised and most return to excellent use and function of the leg. The goal of this method is not to reconstruct the broken cruciate ligament but rather change the biomechanics of the knee joint so that the large thigh muscles provide the stabilising forces for the knee. This is done by cutting the tibia (shin bone),  inserting a spacing device (or cage) and restabilising the tibia with a plate and screws.

Although most surgeries are incident free this is a complex surgery involving bones and joints and implants so there is the risk of infection, bleeding from the wound and swelling.  Implants may loosen or move.  These are uncommon and can usually be managed with an excellent outcome.   A general anaesthetic is required and this carries some risk as always.  Most dogs need to stay in hospital for 2 to 3 days following surgery and are then rechecked every 2 weeks until 8 weeks following surgery, when x-rays of the knee will be taken.

A three month post operative program follows surgery and it is essential that this is followed to ensure the best result for your dog.  If the post operative care is not done properly it can greatly effect the outcome of the surgery. If you have any other questions regarding this technique then do not hesitate to ask.

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