There are two cruciate ligaments which cross inside the knee joint: the anterior (cranial) cruciate and the posterior (caudal) cruciate.
The anterior cruciate stabilizes the knee by preventing the tibia from slipping forward and out from under the femur.
There are two collateral ligaments that stabilize the knee in a side-to-side direction.
There are two c-shaped cartilage structures (meniscus) that cushion and stabilize the knee by fitting between the femur and tibia.
Anterior (Cranial) Cruciate Ligament Rupture
ACL rupture is the most common orthopedic condition that we treat. The cause is unknown, but conformation of the limbs and genetics may play a role.
All breeds of dogs, cats and ferrets can be affected, but some breeds such as Labrador Retrievers, Rottweiler, and Mastiffs are more predisposed.
Ligament rupture is usually the result of a gradual process, not due to a single traumatic injury.
Symptoms may begin after sudden stopping, twisting, or over extension of the knee during exercise.
Many animals have a predisposing factor like age-related ligament degeneration, pre-existing inflammation, anatomical abnormalities or abnormal slope of the plateau of the tibia bone.
About 33-50% of dogs that have an abnormal cruciate ligament (ACL) will develop a partial or full rupture of the opposite ACL.
Extra capsular Repair/Extra capsular Surgery
· A strong, non-absorbable suture (nylon band) is passed around a small bone on the back of the knee and then placed through a small hole made in the front of the tibia bone. The suture is then tightened with a crimping tube which serves to prevent drawer motion, effectively taking over the job of the torn cruciate ligament.
Over time, scar tissue will form around the suture which helps to stabilize the joint.
This technique is most commonly used in small dogs and cats.
About 85% of patients show a significant improvement after surgery and are able to resume pre-injury activities.
Risks and Complications
Anesthesia complications can occur, but these are minimized by our high quality surgical facility.
The nylon band can break or loosen from its attachment behind the knee. This most often occurs when pets are too active during the early healing period (4-6 weeks from surgery).
Infection at the surgical site. This is minimized by proper sterile technique, peri-operative antibiotic usage, and prevention of licking of the incision.
If meniscal cartilage was not damaged at the time of surgery, there is a small chance that it may become damaged at a later date requiring a second surgery.
Arthritis and ACL Injury
Unfortunately we cannot stop or reverse the arthritis and degeneration of the joint, but surgery can help to slow its progression.
If your pet has arthritis in any joint, you may notice stiffness in the morning, lameness after heavy exercise or during weather changes.
We recommend that you help your pet by keeping them at a healthy weight, maintaining a regular amount of mild exercise, and giving a high quality glucosamine and chondroitin product.
TTA Rapid(Tibial Tuberosity Advancement) Repair
Did you know that we now offer the TTA Rapid surgery???
What is the TTA rapid surgery??
TTA-R is the most promising surgery for rapid recovery and repair of a torn cruciate. While older techniques like TTA standard or TPLO can be quite difficult and take a long surgery time, a surgery with TTA-R is less invasive and quicker. As a major difference to other techniques, TTA-R uses the non-Maquet-Hole-Technique. This brings the advantage of reducing the number of needed instruments and auxiliary implants, which makes this technique much more stable and quicker. TTA RAPID implants are made of titanium and are a combination of a plate and a cage with an open mesh construction. This combination enables high stability and fast bone growth “through” the sponge construction. The implant is manufactured with titanium due to its known properties which minimize the risk of infections.
View the video below to see how this surgery is done!