CRUCIATE LIGAMENT SURGERY AT VSS

Question 1

Q: What is the expected outcome of cruciate ligament surgery in dogs?

Answer

The usual outcome for cruciate ligament surgery in dogs is excellent, with many dogs returning to full athletic ability. High levels of comfort in everyday life are generally accomplished. On occasions, dogs may require anti-inflammatory medications to help control lameness flare-ups, which are generally a result of underlying osteoarthritis.

The best way to reduce the degree of osteoarthritis is with surgery.

Question 2

Q: What treatment options are available for dogs with cruciate ligament surgery?

Answer

Broadly speaking, the options for surgical treatment are either an osteotomy technique, an extracapsular technique or an intracapsular technique (not currently recommended).

Variations of these procedures have been available for over 50 years, however the scientific evidence has advanced and the newer literature favours osteotomy procedures over other techniques. The technique of choice, is based on discussion with owners about the pros and cons and any particular patient characteristics. There is no ‘one size fits all’ procedure and we assess each patient individually. Several procedures can be successful depending on a surgeon's experience, and the overall outcome from these surgeries is usually very positive.

Question 3

Q: What are the differences between extracapsular techniques and osteotomy for cruciate ligament surgery?

Answer

Extracapsular techniques require sutures to be passed from the outside, or lateral aspect of the knee joint to the front of the tibia. The suture is a temporary stabiliser and therefore the technique relies on fibrous tissue stabilisation for any permanent stability. This is one of the reasons why this procedure may not achieve as favourable outcomes when compared to the osteotomy techniques.

Osteotomy works differently in that it involves a bone cut (osteotomy) in the tibia. This then changes the position of the stifle joint, such that the joint is stable in the absence of a cruciate ligament. This superior stability is what allows dogs to return to athletic function and reduces the development of osteoarthritis, compared to other techniques. Common osteotomy techniques are called TPLO, which stands for tibial plateau levelling osteotomy and TTO which stands for triple tibial osteotomy. TTA, or tibial tuberosity advancement, is another osteotomy technique. Although our surgeons can perform this technique, it is not our technique of choice as the scientific evidence currently favours other techniques.

Question 4

Q: Is osteotomy or extracapsular technique better for a dog’s cruciate ligament surgery?

Answer

When making the decision between the extracapsular technique and osteotomy, a surgeon will discuss with the owner what is the best fit for the dog. This decision may depend on a dog’s size, breed, lifestyle, and age.

Smaller dogs can have positive results with extracapsular techniques, however, generally do better with osteotomy techniques. For larger breeds, an osteotomy technique is highly recommended.