Aim

To compare the outcome of cases that underwent two different surgical techniques to treat cranial cruciate ligament rupture.

Methods

A retrospective case control study was performed. Medical records were searched at a single first-opinion veterinary practice to identify animals that underwent either extracapsular lateral suture (ECLS) or tibial tuberosity advancement (TTA) for management of cranial cruciate ligament rupture between January 2009 and September 2011. The signalment, clinical history and initial examination findings were recorded for each case and the following outcome data were extracted: lameness (present or absent) as assessed on examination by a veterinary surgeon two months after surgery, time period over which the animal received post-operative non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics and occurrence of post-operative complications.

Categorical data relating to each group were compared using Chi squared or Fisher's exact tests. Numerical data were compared using Mann-Whitney U tests with significance defined as p < 0.05.

Results

Both groups were found to have comparable age, weight and sex distributions and these were similar to those described previously. The proportions of dogs with partial or complete ligament ruptures and meniscal lesions at surgery were also comparable between groups. 17 of 23 (74%) dogs that underwent TTA and 23 of 70 (33%) of those that underwent ECLS were sound when assessed two months after the procedure. The difference in the proportion of sound animals in each group was statistically significant (p = 0.0006).

A significantly greater proportion of dogs that underwent TTA also showed evidence of subcutaneous oedema around and discharge from the surgical wound (p < 0.0001 and p = 0.0073, respectively). There were no significant differences between the groups in the occurrence of other complications (seroma or haematoma formation, wound breakdown, meniscal tears, tibial fracture or implant failure). There was no significant difference in the mean length of time over which animals in either group received NSAIDs or antibiotics.

Conclusions

A greater proportion of the dogs in this study that underwent TTA demonstrated good mobility at a single timepoint compared to those that underwent ECLS but a greater proportion of these animals also suffered post-operative complications. The success rate and occurrence of complications for dogs undergoing TTA at a first-opinion centre were comparable to those reported at referral institutes. These findings may be valuable when selecting a procedure for use in individual animals or for implementation within veterinary practices.