Abstract
AbstractThis study aimed to describe surgical technique of arthroscopically guided proximal tibial epiphysiodesis screw placement in the treatment of a bilateral partial cranial cruciate ligament (CrCL) rupture in a 5.6-month-old Golden Retriever. A 19-kg, 5.6-month-old female Golden Retriever was diagnosed with bilateral partial CrCL rupture. Proximal tibial epiphysiodesis was performed bilaterally under arthroscopic guidance. Arthroscopic stifle joint inspection was performed bilaterally with a 2.7 mm arthroscope. A medial port at the level of the distal one-third of the patella was used as camera portal. A lateral instrument port was positioned at the level of the distal one-third of the patella. A 3.0 mm diameter headless cannulated self-compressive screw was placed into the centre of the tibial cranial intercondyloid area as parallel as possible to the tibial shaft axis under arthroscopic control. Screw head was buried. Arthroscopic guidance allowed good accuracy in screw placement, specifically in its insertion point. However, the screw orientation was less satisfactory. The tibial plateau angle progressively decreased in both stifles to achieve 15 degrees on the left and 16 degrees on the right at the last follow-up. A varus deformity developed on both stifles. No clinical consequences were observed. Recurrence of right pelvic lameness occurred 1 year postoperatively because of a medial meniscal lesion, which necessitated partial caudal meniscectomy. Arthroscopically guided proximal tibial epiphysiodesis is technically feasible and is a minimally invasive treatment of CrCL injury in a juvenile dog.
Highlights
Canine cranial cruciate ligament (CrCL) rupture is usually a chronic degenerative disease that leads to partial or complete midsubstance ligament rupture.[1]
This study aimed to describe surgical technique of arthroscopically guided proximal tibial epiphysiodesis screw placement in the treatment of a bilateral partial cranial cruciate ligament (CrCL) rupture in a 5.6-month-old Golden Retriever
Proximal tibial epiphysiodesis has been described as the sole treatment to level the tibial plateau angle (TPA) in skeletally immature dogs with CrCL-deficient stifle joints.[13,14,15]
Summary
Canine cranial cruciate ligament (CrCL) rupture is usually a chronic degenerative disease that leads to partial or complete midsubstance ligament rupture.[1]. Guided Proximal Tibial Epiphysiodesis Screw Placement Olive et al e113 proximal tibial growth plate.[4] Proximal tibial epiphysiodesis (PTE), which consists of fusing the craniocentral portion of the proximal tibial epiphysis while allowing the continued growth of the caudal aspect of the plateau, was developed in an attempt to progressively level the tibial slope in immature dogs.[3,5,8] This procedure should be performed prior to proximal tibial epiphyseal closure to allow for significant tibial plateau angle (TPA) changes, and dogs younger than 7 months old have been reported to be the best candidates.[5,8]. The purpose of this case report is to report the feasibility of arthroscopically guided PTE screw placement
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