Rehabilitation after extra-articular stabilisation of cranial cruciate ligament rupture in dogs

Summary

Patients at the Blue Star Foundation animal hospital in Gothenburg, Sweden, underwent a procedure with an extracapsular suture technique for cranial cruciate ligament rupture. Two groups were compared; one of the groups received rehabilitation by the owner, and the other received professional rehabilitation by a trained physiotherapists. The dogs where reexamined at four, 12 and 24 weeks postoperatively. The results were ‘good’ in both groups but a difference was not seen between the groups. This study shows that in the dogs with a body weight of between 25 and 50 kg with cranial cruciate ligament rupture, the extracapsular suture technic gives good results, provided that the dogs are actively walked on the leash postoperativly.

Keywords

Cranial cruciate - rupture - rehabilitation - physiotherapy - dog

• References

• 1 Brinker DL. et al. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 3^rded. London: W.B. Saunders Company; 1997
• 2 Egenvall A. Canine health, disease and death – Data from a Swedish Animal Insurance Database these: Swedish University of Agricultural Sciences, 1999
• 3 Arnoczky SP. The cranial cruciate ligament: the enigma of the canine stifle. J Small Anim Pract 1998; 29: 71-90.
• 4 Arnoczky SP, Marshall JL. Pathomechanics of Cruciate and Meniscal Injuries. In Bojrabs MJ. ed. Pathophysiology in small animal surgery. Philadelphia: Lea & Febiger; 1981: 590-603.
• 5 Arnoczky SP, Marshall JL. The cruciate ligaments of the stifle: An anatomical and functional analysis. Am J Vet Res 1997; 38: 1807-1814.
• 6 Johnson JM, Johnson AL. Cranial cruciate ligament rupture. Pathogenesis, diagnosis, and postoperative rehabilitation. Vet Clin North Am Small Anim Pract 1993; 23: 691-701.
• 7 Moore KW, Read RA. Rupture of the cranial cruciate ligament in dogs part II. The Compendium of Continued Education 1996; 18: 381-391.
• 8 Paatsama S. Ligamentous injuries in the canine stifle joint. A clinical and experimental study Thesis; Helsinki: 1952
• 9 Wingfield C. et al. Comparison of biomechanical properties of rottweiler and racing greyhound cranial cruciate ligaments. J Small Anim Pract 2000; 41: 303-307.
• 10 Banfield C, Morrison WB. Magnetic resonance arthrography of the canine stifle joint; technique and applications in eleven military dogs. Vet Radiol Ultrasound 2000; 41: 200-213.
• 11 Hulse DA, Johnson AL. Stifle –cranial cruciate ligament rupture. Small animal surgery. St-Louis: Mosby; 1997: 957-966.
• 12 Hulse DA, Shires PK. The stifle joint. In: Textbook of Small Animal Surgery, Slatters DH Philadelphia: W.B.Saunders; 1985
• 13 Marshall KW, Chan AD. Arthroscopic anterior cruciate ligament transection induces canine osteoarthritis. J Rheumatol 1996; 23: 338-343.
• 14 Marshall KW, Chan AD. Bilataeral canine model of osteoarthritis. J Rheumatol 1996; 23: 344-350.
• 15 Arnoczky SP. et al. Meniscal degeneration due to knee instability. An experimental study in the dog. Trans Orthop Res Soc 1979; 4: 79
• 16 Flo GL. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975; 11: 570-577.
• 17 Flo GL. Classification of meniscal lesions in twenty six consecutive canine meniscektomies. J Am Anim Hosp Assoc 1983; 19: 335-340.
• 18 Bennett D, May C. An ‘over the top with tibial tunnel’ technique for repair of cranial cruciate ligament rupture in the dog. J Small Anim Pract 1991; 32: 103-110.
• 19 Harari J, Dupuis J. Cruciate ligament and meniscal injuries in the dogs. Comp Continued Edu Small Anim Pract 1993; 15: 215-232.
• 20 Johnson JM. et al. Rehabilitation of dogs with surgically treated cranial cruciate ligament –deficient stifle by use of electrical stimulation of muscles. Am J Vet Res 1997; 58: 1473-1478.
• 21 Vasseur PB. Clinical results following conservative management for rupture of CCL in dogs. Vet Surg 1984; 13: 243-251.
• 22 Strande A. Repair of the ruptured cranial cruciate ligament in the dog. Universitetsförlaget Oslo; Norway: 1967
• 23 Arnoczky SP. et al. The over the top procedure. A technique for anterior cruciate ligament substitution in the dog. J Bone Joint Surg 1979; 61a: 1221
• 24 De Angelis M, Lau RE. A lateral retinacular imbrication technique for surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970; 157: 79-84.
• 25 Hulse DA, Aron DN. Advances in small animal orthopedics. The Compendium of Continued Education 1994; 16: 831-832.
• 26 Payne JT, Constantinescu GM. Stifle joint anatomy and surgical approaches in the dog. Vet Clin North Am Small Anim Pract 1993; 23: 691-701.
• 27 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23: 777-795.
• 28 Smith GK, Torg JS. Fibular head transposition for repair of cruciate deficient stifle in the dog. J Am Vet Med Assoc 1985; 187: 375-383.
• 29 Olmstead ML. The use of orthopedic wire as a lateral suture for stifle stabilization. Vet Clin North Am Small Anim Pract 1993; 23: 735-753.
• 30 Sandberg R. Knee ligament injuries, a plan of action. Malmö; thesis 20 March 1987
• 31 Brandson S. Anterior cruciate ligament injury. Gothenburg University: Thesis; 2000
• 32 Moore KW, Read RA. Rupture of the cranial cruciate ligament in dogs part I. The Compendium of Continued Education 1996; 18: 223-234.
• 33 Conzemius MG. et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005; 226: 232-236.
• 34 Millis DL. et al. Variables affecting thigh circumference measurements in dogs. Proceedings from 1^st . International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine: Corvallis, OR; August 7-11. 1999
• 35 Roe SC. et al. Isometry of potential suture attachment sites for the cranial cruciate ligament deficient canine stifle. Vet Comp Orthop Traumatol 2008; 21: 215-220.
• 36 Millis DL. et al. Change in muscle mass following transection of the cranial cruciate ligament and immediate stifle stabilization; VOS 27^thAnnual Conference, 2000; Val D’Isère, France
• 37 Conzemius MG. et al. The role of postoperative physical therapy in management of cranial cruciate disease in the dog; VOS 27^thAnnual conference, 2000; Val D’ Isere, France
• 38 Day TK. et al. Comparison of intra–articular and epidural morphine for analgesia following stifle arthrotomy in dogs. Vet Surg 1995; 24: 522-530.
• 39 Sammarco JL. et al. Postoperative analgesia for stifle surgery: A comparison of intra-articular Bupivacaine-Morphine or Saline. Vet Surg 1996; 25: 59-69.
• 40 Andersson CC. et al. Biomechanical evaluation of a crimp clamp system for loop fixation of mono-filament nylon leader material used for stabilization of the canine stifle joint. Vet Surg 1998; 27: 533-539.
• 41 Innes JF, Barr ARS. Can owner’s assess outcome following treatment of canine cruciate ligament deficiency. J Small Anim Pract 1998; 39: 373-378.