Surgical Treatment of Dog Rupture of Cranial Cruciate Ligament with Combined Surgical Technique
Ruptured cranial cruciate ligament is a frequent orthopedic complication which can successfully be cured only surgically.
Many surgical techniques have been described, most of them involve use of different materials which often can cause postoperative complications. Our technique uses resorptive materials which are absorbed in few weeks.
We use extracapsular technique. When we inspect joint surfaces and remove remains of ruptured cranial cruciate ligament, imbrication of stifle joint capsule is made. Resorptive thread is placed around lateral fabella and fixed to the tibial tuberositas. Musculus popliteus is cut at a point of sesamoid bone of popliteus muscle and distal part of its origin is sutured with resorptive thread on tissue surrounding tibial tuberositas. Then the graft from ligamentum rectum patellae is made. We cut the lateral part of distal two-thirds of ligamentum rectum patellae. Graft is sutured in laterodistal direction with few simple interrupted sutures to ensure enough strength. Surgery is finished with suturing lateral fascia, subcutaneous tissue and skin.
After two weeks of inactivity postsurgery patients were checked, sutures were removed. Second control was after two months. Limping and motion of the joint was checked (flexion, extension, rotation). No abnormalities were found.
The imbricated joint capsula, placement of the thread, tendon of m. popliteus and ligamentum rectum patellae graft ingrowth in surrounding tissue can take over the function of joint stabilization. With use of resorptive thread the potential of rejection is minimised.