Triple Tibial Osteotomy
Rupturing the cranial cruciate ligament is a common injury in people and dogs. Typically dogs are medium to large breeds, middle aged, and more often than not female, but all types can be affected. Most dogs that tear this important ligament in the stifle (knee) joint have already got a degree of arthritis and joint disease; the ligament rupture comes later on. In around 10% of cases the rupture is the result of pure trauma.
This often happens when a dog leaps a fence and gets its foot caught on the top wire, resulting in a hyperextension injury to the joint.
Rupturing a cruciate ligament is a disabling injury that is best treated with surgery. There are over a hundred techniques described, but they tend now to fall into two main groups.
The first group involves placing a prosthetic ligament (usually fishing leader line) to try and replace the torn part. This can work well in many cases.
The second group involves making a variety of saw cuts to the tibia (shinbone) in an attempt to remove the need for a cranial cruciate ligament at all. These are much more involved procedures, calling for a greater degree of skill and training, and involving more potential complications.
One of the latter group is a procedure called the Triple Tibial Osteotomy (TTO). We have been performing this operation at Pukekohe clinic now for around five years, and are very happy with the results. In general, they return to using the leg faster than the nylon band technique, have less requirement for ongoing pain management, and are easier patients to do physical therapy on since they are walking so soon after surgery.
So far we have done around 70 of this procedure, and recommend it for any dog of over about 20kg that ruptures or partially ruptures a cruciate ligament.
Note that the TTO can also be used in combination with prosthetic ligament replacement for those dogs that tear multiple ligaments in on joint. This was previously a crippling injury that is now much more readily managed.
If you have a working dog that ruptures a cranial cruciate ligament, and you want the best chance of returning him or her to work again, consider investing in a TTO rather than a nylon tie procedure. It could be very worth your while.