Abstract
Cranial cruciate ligament (CrCL) rupture is one of the most common orthopaedic conditions in veterinary medicine. CrCL plays a fundamental role in the stability and biomechanics of the femoral-tibio-patellar joint, and its incorrect functionality severely impacts on the quality of life of patients. In dogs, the structural weakening of this joint due to the progressive degeneration of the ligament is the most accredited etiopathogenetic hypothesis in relation to the dog signalment (breed, sex and age) and the stifle joint conformation. In humans, this injury is often traumatic and generally occurs during sporting activities. CrCL rupture can be managed conservatively or surgically, and decisions regarding treatment are due to numerous factors: the patient’s age and health, the degree of stifle instability, and cost. Physiotherapy protocols play an important role in rehabilitation, with similar goals in humans and dogs: pain management, physiological articular range of motion recovery, periarticular and core muscle strengthening, and proprioceptive deficit correction. Physiotherapy, even if often neglected in veterinary medicine, is mandatory for the recovery of the correct functionality of the injured limb and for the return to normal daily and sporting activities.
Highlights
Cranial or anterior cruciate ligament rupture is one of the most common orthopaedic diseases in veterinary and human medicine [1,2,3,4,5,6,7,8]
Cruciate ligament inefficiency has important negative consequences on the quality of life of patients because it causes stifle instability, leading to the onset and progression of severe degenerative changes that can limit normal daily activities. This injury may represent a concrete obstacle for the progression of their career: it has been shown that only 60% of dogs participating in agility competitions are able to return to compete after a Tibial Plateau Leveling Osteotomy (TPLO) surgery [14]; in human medicine, even if 80% of patients are able to return to sports, only about 60% of these patients achieve their pre-injury level of performance [15]
Studies on degenerative changes in the cranial/anterior cruciate ligament of dogs and men suggest structural changes resulting from ligament remodeling and physiological adaptation to the stress deriving from mechanical load, micro-injuries related to conformational anomalies, and hypoxic conditions due to poor blood flow, which are more evident in the central part of the ligament [3,24]
Summary
Cranial or anterior cruciate ligament rupture is one of the most common orthopaedic diseases in veterinary and human medicine [1,2,3,4,5,6,7,8]. Cruciate ligament inefficiency has important negative consequences on the quality of life of patients because it causes stifle instability, leading to the onset and progression of severe degenerative changes that can limit normal daily activities. In athletes, this injury may represent a concrete obstacle for the progression of their career: it has been shown that only 60% of dogs participating in agility competitions are able to return to compete after a Tibial Plateau Leveling Osteotomy (TPLO) surgery [14]; in human medicine, even if 80% of patients are able to return to sports, only about 60% of these patients achieve their pre-injury level of performance [15].
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