Cranial cruciate ligament rupture
Jet is an extremely active 5 year old Labrador retriever who had started to limp on her left hind leg. She was unable to go on her usual walks over the mountain and this was beginning to seriously affect her quality of life.
Following assessment and clinical examination by orthopaedic surgeon Tom Butler Jet was diagnosed with cranial cruciate ligament disease of her left knee. This is a very common cause of lameness in dogs, and unfortunately Labrador retrievers are very prone to this condition.
The cranial cruciate ligament is a band of tough fibrous tissue that attaches the thigh bone to the shin bone. It anchors the knee together and prevents these two bones sliding apart when the dog walks. When diseased this ligament degenerates and weakens over time (like a fraying rope) causing pain and lameness until it eventually snaps. When this happens the knee joint becomes completely unstable and intensifies the pain felt when walking, often resulting in non-weight bearing lameness.
There are a number of surgical options available to help dogs with a ruptured cranial cruciate ligament. These can be grouped into two main categories;
1/ Procedures which act to temporarily stabilise the knee whilst the body heals itself. A bandage of soft tissue forms around the knee that restricts all movements of the thigh and shin bones. These techniques rely on the dog’s ability to heal quickly before the temporary fixation fails, and as such have a less predictable outcome.
2/ Procedures which alter the geometry of the knee joint to dynamically stabilise it meaning the cranial cruciate ligament is no longer necessary. These involve cutting the shin bone to alter the way in which the knee joint articulates. An easy way to understand this is to think about parking your car without a handbrake – if you park on a sloping road your car rolls away, but park on a flat road and your car stays still. These surgeries effectively “flatten the road” within the knee joint itself. Despite being complicated, advanced surgical procedures they do offer a number of advantages over other techniques. Bone healing is much more efficient and predictable than soft tissue healing and the repair is much more robust. A major practical benefit is the majority of dogs reliably use the leg again within 1-3 days of their surgery, making for a more manageable post operative period.
Fortunately for Jet Tom is able to offer all surgical options for treating cruciate ligament rupture. So, after discussing Jet’s lifestyle and explaining her love of walking and playing, Jet’s family decided that the best option for her was to undergo the surgery that would give her the best chance of returning to her active, fun loving self and alleviate her discomfort.
Tom opted to perform a geometry altering procedure called a tibial tuberosity advancement (TTA). Jet’s surgery went very well and she was able to walk out of the practice on the day of her surgery. Her post operative radiographs are shown.
Coordinating closely with Tom, Jet was very lucky to have dedicated owners and her post-op recovery and rehabilitation went smoothly.
By ten weeks post surgery she was able to run around off her lead with no signs of any lameness.