Cruciate Ligament Surgery

Cruciate ligaments in dogs play a crucial role in stabilizing the knee joint, also known as the stifle joint.

These ligaments are essential for maintaining the stability of the knee during various movements, such as walking, running, and jumping.

Cruciate Ligament Surgery

Cruciate ligament surgery in dogs typically refers to procedures performed to address injuries or tears in the cranial cruciate ligament (CrCL).

The cranial cruciate ligament is crucial for providing stability to the knee joint, preventing abnormal movement between the femur and tibia bones.

Symptoms

Cruciate Ligament Surgery Options:

Lateral Suture Technique (LS)

This technique aims to solve the instability in the dog’s knee joint by placing a strong piece of suture outside the knee joint to act in a similar fashion to the cranial cruciate ligament.

The aim of LS surgery is to place a suture that prevents the two bones from moving too far apart so that the tibia does not shift forward during weight-bearing. After a period of healing, the soft tissues around the joint form scar tissue around the knee, which provides support in the same way as the suture. Over time, the suture itself will weaken but by this point, the scar tissue should have taken over its role.

Modified Maquet Procedure (MMP)

MMP for dogs is based on a surgical technique for human knees that an orthopedic surgeon named Dr. Maquet developed over 50 years ago.

One of the goals of the Modified Maquet Procedure is to change the angle of the tibia (one of the bones between the knees and ankles) and move it forward so that it is 90 degrees to the patellar tendon. An Orthofoam implant provides stability as well as promotes healing and accelerated bone growth.

Cranial Closing Wedge Osteotomy (CCWO)

This is a surgical procedure that involves adjusting the tibial plateau (the surface at the top of the shin bone) by cutting out a wedge of bone from the front of the shin.

Generally, surgery will start with opening the capsule surrounding the knee joint and assessing for any damage to the shock-absorbing cartilage pads which sit between the bones (menisci). If any damage is seen then these areas must be removed before the CCWO is performed. The shin bone is exposed and marked with measurements calculated from the pre-operative X-rays.

A wedge-shaped section of bone is then cut using a saw blade and the cut portion is removed. The remaining two sections are closed using a special plate and screws to hold the bone together while it heals.

Tibial Plateau levelling Osteotomy (TPLO)

TPLO surgery works to make the top of the tibia almost flat, so when the dog is weight-bearing, the femur rests on the top of the tibial plateau rather than slipping backward and pushing the tibia forwards.

Generally, surgery will start with opening the capsule surrounding the knee joint and assessing for damage to the shock-absorbing cartilage pads that sit between the bones (menisci). If damage is seen, then the damaged portion is removed before the TPLO is performed. The bone is cut with a special curved saw blade, and then the cut portion is turned to a new position. At this point, a special TPLO plate and screws are used to hold the bone in place while it heals.

We offer this surgery with a visiting veterinary surgeon.

FAQ’s

What are the symptoms of cruciate damage?

Cruciate ligament damage can cause symptoms that vary from a slight limp to being unable to put any weight on the leg at all. Symptoms often come on quite suddenly and include:

Limping (mild to severe)
Stiffness getting up and down
Back leg pain
Swelling in one or both knees
Walking in an unusual way

How is it diagnosed?

Anterior cruciate ligament failure can be diagnosed solely by history and physical examination. However, diagnostic tools such as MRI, arthroscopy (keyhole surgery), and radiography (X-rays) may also be needed to fully evaluate the joint.

What alternative treatment is there?

The knee joint needs to be stabilised to help relieve pain and try to prevent further damage to internal structures. This is usually achieved with surgery, but sometimes for small dogs and cats, we can opt for conservative (non-surgical) treatment, i.e. strict rest. This decision will depend on individual circumstances and will be discussed with the vet.

Conservative treatment will involve restricting their exercise, ensuring they stay at a lean body weight, administration of pain relief, hydrotherapy, and physiotherapy.

The majority of dogs that are affected by this condition require surgery.