Cruciate ligament repair
Berry Haven Veterinary Group Surgical Case
Unfortunately, many dogs are prone to rupturing the anterior cruciate ligament (ACL) in their knee (stifle) joint. It is the same injury that affects many a sporting person- usually a twisting falling type of injury.
For small to medium dogs with good conformation, we place a thick nylon suture through the stifle to replace the action of the ruptured ligament. The nylon suture is similar to fishing line used to catch marlin, so it is pretty tough. Large dogs and those with poor conformation are candidates for a technique called Tibial Plateau Levelling Operation (TPL/TPO).
Mack ruptured his ACL and being a medium sized dog, the owners decided to go for the De-Angelo's repair. He was placed on IV fluids and anaethetised with Alfaxan an Isoflurane.
An incision was made on the outside of his knee and the joint was opened up by incising through the joint capsule. After removing the remnants of the ruptured ACL, we inspected the joint cartilages to make sure there were no tears in them. The joint was flushed with saline and had antibiotics placed in it. The joint capsule was then closed.
We drilled a hole through the tibial crest and placed a thick nylon suture through it before looping it around and behind the fabella (a small bone located on the outside surface of the lower femur). Once a loop of nylon was made, it was tied off using a crimping technique. The joint was very stable after this loop was tied.
The outer tissues we incised on our way through to the joint capsule were closed using an overlapping technique to give additional support to the knee.
Mack was placed on antibiotics and pain killers and restricted exercise which was gradually built up over 2-3 months. He started a course of Cartrophen injections two weeks after surgery to promote cartilage and joint fluid healing.
At 3 months he was using the leg very well.