Rupture of cranial cruciate ligament--TPLO surgery

Breed: Labrador

Gender: Female (neutered)

Weight: 32kg

Age: 6Y

This is a very lively Labrador. More than a month ago, the right hind limb had acute claudication, and the examination done in the other animal hospital found that the right cranial cruciate ligamentwas ruptured. Thepetowner did not choose surgery at the beginning, but the dog's limp has not recovered. Then the dogwas transferred from other animal hospital to our hospital for surgical treatment.

Thedog'sright hind limb was lame, the medialknee joint was swollen, the patella was not dislocated, and the anterior drawer test was positive. X-rays weretaken after anesthesia, and itshowed that there was exudation and swelling in the right knee joint, the fat pad was reduced or disappeared, the fascia surface moved back, and the medialjoint capsuleof the knee jointwas thickened. The diagnosis was a rupture of the right cranial cruciate ligament. Our diagnosis process for claudication is as follows: collecting patient information (including breed, age, gender, etc.); investigating medical history;assessing patient'sstance;assessing claudication;and orthopedic examining(including detailed limb palpation, tests for specific bone and joint diseases and precise X-ray examination).In particular, further B-scan ultrasonography, or CT, or MRI, or other examinations may be performed. We can diagnose most of the cases. Why write this? Because we have encountered too many cases that are not diagnosed strictly according to the correct diagnosis process, resulting in failure of diagnosis, missed or misdiagnosed cases. In the end, the patient missed the best time to treat.

We used the "Veterinary Orthopedic Planning Softwareof BlueSAO—iBlueVet" to make accurate preoperative planningof theTPLO surgeryfor the patient, and then reducedher knee TPA 28° to about 5° as planned. Finally, the TPLO-L11.5mm titanium alloy special locking bone platewas usedfor fixation.

Preoperative walking video

The dog's right hind limb was limp. Acute cranial cruciate ligamentrupture usually results in acute claudication and even inability to bear weight. Due to the instability of the knee joint, the joint capsule and other ligaments as well as the soft tissues around the joint will be thickened compensatively, thereby stabilizing the knee joint to a certain extent. At this time, the dog will show a little weight-bearing limp. Even if the cause of the limp is really found, many doctors and pet owners will think that the dog is getting better at this time and will not accept further treatment or referral. In fact, this is completelywrong. Because the knee joint is always unstable, the pressure on the knee joint will increase during the movement of the dog, and eventually irreversible degenerative arthritis will appear.

Drawer test video

The anteriordrawer test is positive.Theclassic cranial cruciate ligamentrupture testwas performed on the dog. It should be noted here that: First, if there is patellar luxation, the patella must be reset, otherwise,false positives will occur; Second, when palpating, the part grasped by the hand must be the bone of anatomical markers, especially in large obese dogs.Otherwise, due to the sliding of the soft tissue, it is mistakenlyregarded asthe positive indication of the anteriordrawer test, resulting in wrong judgment.