Prospective clinical assessment of tibial tuberosity advancement for the treatment of cranial cruciate ligament rupture in dogs

Luciano Pereira De Barros,Fernando Lucas Maschio Ferreira,Luis Gustavo Gosuen Gonçalves Dias,Letícia Cordeiro De Pina Camondá Pereira,Laura Raquel Rios Ribeiro,Maria Eduarda Bastos Andrade Moutinho Da Conceição Conceição

doi:10.1590/s0102-865020180080000004

Luciano Pereira De Barros, Fernando Lucas Maschio Ferreira + Show 4 more

Open Access

https://doi.org/10.1590/s0102-865020180080000004

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Abstract

To evaluate clinically dogs that underwent tibial tuberosity advancement (TTA) six months previously. Dogs of various breeds, gender, weight, and age that had CCL rupture and underwent TTA for treatment were included in this study. Parapatellar arthrotomy was performed in all patients to assess the joint for a ruptured ligament and meniscal injury before the TTA. The appropriate cage for the TTA was chosen with planning surgery. The surgical procedure was performed according to the literature, using a modified Maquet technique. Six months after surgery, lameness during walking; muscular atrophy; crepitation, cranial drawer and tibial compression tests and quality of life based on owner's evaluation were assessed. Postoperative complications were observed in only one knee (4.76%), with a surgical site seroma. The mean lameness score at walking was 0.29 (± 0.64). The mean score regarding muscular atrophy was 0.95 (± 1.56). The mean score of the cranial drawer test, in a range from 0 to 5, was 1.52 (± 1.54). The owners rated the dog's quality of life as excellent in 44%, good in 30%, and moderate in 17%. This clinical study supports the affirmation that patients who undergo TTA for treatment of CCL rupture have an acceptable response.

Highlights

The role of the cranial cruciate ligament (CCL) is to prevent cranial movement of the tibia relative to the femur, internal rotation of the tibia, and hyperextension of the knee[1]
CCL rupture has multiple causes, involving genetics, conformation, and inflammatory changes, that combine to promote an imbalance between biomechanics applied to the CCL and its capacity to support the load
Gender, weight, and age admitted at veterinary hospital of Universidade Católica Dom Bosco, Campo Grande-MS, Brazil, that had CCL rupture and underwent tuberosity advancement (TTA) for treatment were included in this study

Summary

Introduction

The role of the cranial cruciate ligament (CCL) is to prevent cranial movement of the tibia relative to the femur, internal rotation of the tibia, and hyperextension of the knee[1]. Degeneration and rupture of the ligament can occur leading to instability of the stifle joint[2,3]. Multiple surgical techniques have been described to treat CCL rupture, none are ideal, because they all allow for progression of stifle osteoarthritis (OA)[4,5,6]. OA occurs due to the inaccuracy of the techniques, which allow for movement of the joint[7]. Proximal tibial osteotomies alter the stifle geometry and cause dynamic stability that nullifies the force of cranial translation of the tibia, which decreases the progression of OA1,8-10

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