Vogue Vets
& Wellness Centre
Orthopaedic surgeries
Orthopaedic Surgeries including TPLOs, Patellar luxations and Fracture Repairs
Orthopaedic surgeries
Cruciate Disease in cats and dogs is a common orthopaedic issue that often requires surgical intervention. It involves the cranial cruciate ligament (CCL) in the knee, which may fray or rupture. This ligament forms an “X” within the stifle (knee) joint, crossing the caudal cruciate ligament. Its role is to prevent the tibia (shin bone) from moving forward relative to the femur (thigh bone) when weight is placed on the leg.
When the CCL tears or frays, the tibia moves forward in relation to the femur, a condition known as a positive drawer sign. This causes instability in the knee joint, resulting in pain and difficulty walking. Over time, the instability leads to damage to the cartilage and surrounding bones, which eventually causes osteoarthritis (OA).
Top 5 Symptoms of Cruciate Disease
1. Lameness:
Lameness can occur suddenly when the weakened ligament gives way during activity, causing severe discomfort. Alternatively, it may develop gradually, with intermittent lameness that worsens with increased activity and improves with rest.
2. Sitting Abnormally:
Affected pets may sit or lie with the leg sticking out to the side, as it’s painful to bend the knee.
3. Stiffness in Both Back Legs:
Although one leg is typically affected first, about 50% of animals with CCL injury will develop a similar problem in the other leg within 12 months. If both knees are affected simultaneously, the pet may appear stiff, have difficulty walking, or may not be able to get up.
4. Knee Thickening/Swelling:
Inflammation from the injury leads to swelling in the knee, which may result in visible thickening of the joint over time due to scar tissue.
5. Clicking:
When the knee is unstable, the meniscus (a cartilage structure in the joint) can tear or become injured, causing an audible “click” while walking. Meniscus injuries are painful and often accompany significant lameness.
Diagnosis and Management
If cruciate disease is suspected, a thorough examination under sedation or anaesthesia may be necessary to assess joint instability. Advanced imaging, such as x-rays, can help confirm the diagnosis and reveal early signs of cruciate disease. Our digital x-ray system allows detailed imaging of soft tissue structures, helping us to detect signs of ligament damage before a complete rupture occurs.
Surgical intervention is generally recommended for most pets to prevent irreversible joint damage and relieve pain. For dogs over 15kg, surgical procedures are designed to alter the tibial bone structure, thereby eliminating the need for the cranial cruciate ligament.
Surgical Options for CCL Repair
1. Extracapsular Cruciate Repair:
This traditional technique is highly effective for smaller dogs (under 15kg). It involves placing an artificial nylon ligament outside the joint capsule in the same orientation as the CCL. This stabilizes the knee and prevents excessive forward movement of the tibia. The procedure involves removing any damaged tissue, including portions of the CCL and meniscus, before placing the stabilizing suture.
2. TPLO Surgery (Tibial Plateau Leveling Osteotomy):
For larger dogs (over 15-20kg), an extracapsular repair is less effective due to the higher risk of the artificial ligament failing underweight. TPLO surgery involves making a curved cut in the tibia to adjust the angle between the tibia and femur, neutralizing shearing forces on the knee. A locking plate and screws are used to stabilize the bone. TPLO requires careful pre-operative planning, specialized equipment, and expertise, and is available at our clinic.
Other Considerations
Choosing the best surgical approach depends on multiple factors, including breed, size, activity level, and the expertise of the surgeon. Other considerations include the slope of the tibial plateau and any concurrent medical conditions your pet may have. Our veterinary team will provide guidance in choosing the best treatment plan for your pet, ensuring optimal recovery.
Additionally, we also offer a variety of orthopaedic surgeries for conditions such as Medial Patellar Luxation (MPL) and fracture repairs, designed to restore your pet’s mobility and quality of life. Each surgery type is carefully tailored to meet the specific needs of your pet, with comprehensive post-operative care for the best possible outcomes.