Cruciate ligament disease Flashcards
List the three causes of crucilate ligament rupture?
Trauma- RTA (no evidence of DJD)
Degenerative- most common, secondary to minimal trauma through ageing
Inflammation_ rheumatoid arthritis
What two tests can you use to asses the cruciate ligament disease in the dog?
Cranial draw
Tibial thrust
What investigations can you do to confirm at CCL rupture?
Radiographs mediolateral and craniocaudal
show evidence of DJD osteophyte formation
How is CCL rupture medically managed?
NSAIDs
weight loss
strict rest 6 to 8 weeks minimal lead exercise toilet only
dogs less than 15kg without meniscal tears
What two types of surgery categories are available to correct CCL rupture?
Extra-articular stabilisation
Altering limb alignment/osteotomies
What ar the principles of CCL surgery?
Confirm diagnosis explore the joint debride the CCL Check and remove torn pieces of menical tears Stabilise the joint
At what rate do dogs return to clinical function after CCL surgery?
8-12 weeks reasonable function
3-6 months full function
List the extra-articular stabilisation techniques for CCLand describe?
The lateral suture
suture is placed medial to the lateral femorofebella ligament
suture secured using a metal tube
List the types of altering limb alignment/ osteotomy techniques for the CCL
Tibila plataeu levelling osteotomy
Tibial plateu angle is reduced to 5-7 degrees the bone is stabilised TPLO plate on the medial tibia
cranial draw is still present
converts cranial tibial thrust to caudal tibial thrust
Synthes LCP plate for the TPLO
Cranial Closing wedge or Tibial Wedge Osteotomy
shortening of the cranial tibia maybe useful in large dogs who have large tibial slopes
Tibial Tuberosity Advancement
Triple Tibial Osteotomy
What instruments do you require for a TPLO?
Oscilating saw sterile marker pen Kirschener wire TPLO plate Locking screws Saline for flushing Plate bending equipment Drill Basic surgical kit Hohmann retractor Senn retractor Meniscal probe
Post operative care CCL patient
Strict rest 4-6 weeks carefully controlled and gradual increase to exercise for the following 6-10 weeks
Physio and hydro
What are the possible complications of CCL surgery?
Screw loosening Implant failure Infection Fibular head fractures Peroneal nerve damage Popliteal artery seveerance tibial tuberosity avulaion
What a menisci and what is their function?
Fibrocartilage that sits on the tibia and femur aid as shock absorbers
Medial meniscus more prone to damage due to attachment to medial collateral ligament making it less mobile
Palpable or audible click
Surgical correction of meniscal injuires?
Removal of torn or worn pieces
When do meniscal tears occur?
Usually subsequently to CCL rupture vary rare they occur on their own
