Ruptured Cruciate Ligament
A rupture of the cranial cruciate ligament of the knee is one of the most common causes of hind leg lameness in the dog. The symptoms are caused by a partial or complete rupture of the cranial cruciate ligament, which causes a discrete to obvious instability of the knee.
Over the years, several techniques have already been described to treat a cranial cruciate ligament rupture: in addition to the conservative treatment with inflammatory inhibitors and rest - which mainly affects small dog breeds - there is the surgical treatment that strives to prevent instability.
Older techniques focus primarily on restoring stability by reconstructing the cranial cruciate ligament or by strengthening the joint capsule. The newer techniques reorient the forces within the knee, thus eliminating instability.
In an imbrication, the joint capsule and the soft tissues are stretched around the knee joint to restore a stable joint. Over time, the sutures can loosen back and the knee may become more stable. This technique can be successfully applied to small and large dog breeds.
Over the years, more than 100 techniques have been described to treat a ruptured cranial cruciate ligament: in addition to the conservative treatment with anti-inflammatory drugs and rest - which mainly helps small dog breeds - there is the surgical treatment that strives to prevent instability.
Worldwide still the most widely used technique is placing a bracket outside the joint (the so-called "FLO-bracket"). This bracket runs in the same direction as the cranial cruciate ligament and helps to restore the knee stability.
The reason for his success is that the technique is quite easy to learn and offers pretty good results, especially in the lighter dog breeds. In larger (heavier) dogs, it has been scientifically demonstrated that osteotomy techniques are superior.
The newest way to perform a TTA is ‘TTA Rapid’. These implants were developed by R. Leibinger and the technique itself was improved by our own department
In a TTA (Tibial Tuberosity Advancement) technique, the tuberositas are cut from the tibia and fixed in a more forward position with a cage. In and around the cage a bone sample or bone paste is applied to stimulate the filling of this space. The implants were developed by R. Leibinger and the technique was further improved by our own department.
After a pilot study with ? dogs with excellent results, the technique is successfully applied to ? dogs a year.
TTA_Rapid is successfully used in large to giant breeders, but can also be performed in smaller dogs.
This technique allows us to apply the same proven principle of a classic TTA, but with less implants (less chance of failure) and faster surgery (less long anesthesia for the dog).
An illustrative video can be viewed below.
More information about the product can be found on the Official TTA-Rapid website.
In a TPLO (Tibial Plateau Leveling Osteotomy) the tibial plateau is sawn, tilted and subsequently fixed with a plate and screws. A TPLO can be applied in both large and small breed dogs.
CBLO is the abbreviation for CORA based leveling osteotomy. The CORA, center of rotation of the angulation, is based on a human surgical technique which mathematically corrects the curvature of the bone.
Therefore a CBLO has a double effect: the curvature of the tibia is corrected and a cranial displacement occurs. The latter effect is similar to the TTA technique.
CBLO is most suitable in dogs with an excessive tibial plateau angle (> 28°). In dogs with a tibial plateau angle < 28° a TTA rapid or imbrication can be performed.