We use two main surgeries to treat cruciate tears:
1. Lateral Stabilising Suture
This involves replacing the ruptured ligament with a loop of hard nylon wire. The wire passes around a small bone at the back of the knee (lateral fabella) then through two bone tunnels drilled in the tibia.
Over 90% of dogs with this surgery show considerable improvement. Unfortunately 40-50% will still exhibit some form of lameness albeit intermittent.
This was until recently the main stay of our surgical treatment of cruciate ruptures and still remains a valuable option. However some patients, particularly larger dogs, may remain stiff and a full return to athletic potential is not achieved.
The inadequacy of this technique is that firstly we don’t have a ligament replacement that is stronger than the original ligament but retains the elasticity. Secondly it does not address one of the causes of the rupture i.e. the slope of the tibia.
2. Tibial Tuberosity Advancement
This is technically more demanding and requires specialised instruments and implants. The tibial tuberosity (the top part of the shin) is cut and moved forward then reattached to the tibia with custom made titanium implants.
Effectively this changes the position of the patellar ligament relative to the tibial table thus removing the effect of the backward slope of the tibia, so now there is no need for the anchoring of the cruciate ligament.
We have been performing TTAs for several years and the results are very exciting. Many dogs both working and pets make a full recovery to athletic ability often with little or no long term painkillers.
The other huge benefit from a TTA is there is significantly less degenerative joint disease and arthritis as these dogs get older compared to other treatments. This is the most important feature of TTAs.
Cranial cruciate tears are a common, debilitating condition of the dog's knee. It will produce arthritis, pain and lameness all of which will progressively worsen with time. However with correct treatment and care we can now expect all our patients to exercise happily and enjoy a good quality of life.