Investigation of Variables Associated with Surgical Site Infection following the Management of Canine Cranial Cruciate Ligament Rupture with a Lateral Fabellotibial Suture

2020 ◽  
Vol 33 (06) ◽  
pp. 409-416
Author(s):  
Thomas Cox ◽  
Thomas W. Maddox ◽  
Robert Pettitt ◽  
Brandan Wustefeld-Janssens ◽  
John Innes ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Cruciate Ligament ◽  
Site Infection ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Ordinal Logistic Regression Analysis ◽  
Cranial Cruciate Ligament Rupture

Abstract Objective This study investigated variables associated with surgical site infection (SSI) in dogs with cranial cruciate ligament rupture managed with stifle joint examination and lateral fabellotibial suture stabilization. Study Design A retrospective study of dogs that had stifle arthroscopy, stifle arthrotomy, or a combination of both, followed by lateral fabellotibial suture stabilization for cranial cruciate ligament rupture. All cases had a minimum follow-up of 90 days. Lameness grades were recorded preoperatively, and at 6-week and final follow-up. Results One hundred fifty procedures in 130 dogs met the inclusion criteria. Overall, SSI rate was 17.3% and removal of the lateral fabellotibial suture was performed in 53% of SSI. Multivariable analysis showed significant association between SSI and bodyweight (p = 0.013), and induction using propofol (p = 0.029). Multilevel ordinal logistic regression analysis showed a greater proportion of dogs had a higher lameness grade at 6-week (p = 0.021) and final follow-up (p = 0.002) assessments in the infected compared with non-infected dogs. Conclusion Our study demonstrated a higher SSI incidence than previously reported in dogs undergoing a lateral fabellotibial suture for cranial cruciate ligament rupture. Bodyweight and induction with propofol were identified as significant risk factors for postoperative SSI. Owners could be advised of an increased SSI risk in larger dogs and consideration should be given to selection of induction agent. Dogs that develop an SSI have a worse lameness grade at 6-week and final follow-up.

Effect of Suture Type on Stifle Joint Biomechanics After Extra-Articular Repair of Cranial Cruciate Ligament Transection in the Dog

1991 ◽  
Vol 4 (04) ◽  
pp. 144-149 ◽  
Author(s):  
M. S. Bauer ◽  
W. E. Blevins ◽  
W. R. Widmer ◽  
Jaqueline Davidson ◽  
S. W. Aiken ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Before And After ◽  
Joint Biomechanics ◽  
Cranial Cruciate Ligament Rupture

SummaryThe effect of two suture types, monofilament polybutester and braided polyester, on stifle joint biomechanics after extra-articular repair of cranial cruciate ligament rupture was evaluated by analysis of the instant centre of motion. The instant centres of motion and resulting velocity vectors were determined radiographically on both stifles of eight fresh canine cadavers before and after cranial cruciate ligament transection. After ligament transection, all 16 stifles were repaired with an extra-articular technique utilizing a double strand of suture placed between the lateral fabella and the tibial tuberosity. One stifle on each cadaver was repaired with each suture type. The instant centres of motion and resulting velocity vectors were re-evaluated post repair. All stifles had normal instant centres of motion prior to transection of the cranial cruciate ligament. Neither ligament transection nor extra-articular repair with either suture type resulted in an abnormal change in the instant centre of motion.

scholarly journals Proximal Tibial Epiphysiodesis in a Growing Dog

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Luciane Dos Reis Mesquita ◽  
Leonardo Augusto Lopes Muzzi ◽  
Amália Turner Giannico ◽  
Ruthnéa Aparecida Lázaro Muzzi ◽  
Juliana Fonseca Monteiro ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Growth Line ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Ligament Rupture ◽  
Tibial Plateau Slope ◽  
Cruciate Ligament Rupture ◽  
Locking Screw ◽  
Cranial Cruciate Ligament Rupture

 Background: It is believed that the inclined tibial plateau angle to be a major cause of cranial cruciate ligament (CCL) rupture, and the treatment of this disease is the tibial plateau leveling for decrease the cranial tibial thrust. However, there are breeds predisposed to rupture of the cranial cruciate ligament and in this patterns breed the tibial plateau is more in­clined due to the conformation of the limb. The aim of this communication was to evaluate the effectiveness of the locking screw and cauterizing the growth plate of the tibial plateau as a preventive method of cranial cruciate ligament rupture. Case: In a young dog, one stifle joint randomly chosen for placing a screw in order to block the tibial plateau growth line. There was placed a 3.5 mm x 20 mm cancellous bone screw in the dorsocranial surface of the tibial plateau of the left hindlimb. Two months after the first surgical intervention, the contralateral limb was cauterized in the tibial plateau growth line. Electrocauterization was performed with a spatula electrode set at 60 watts, performing ablation on the cra­nial third of the tibial plateau physis with access to the medial and lateral surfaces of the proximal tibia. The electrode was placed against the physis for 10 seconds at each site. Both members were followed radiographically to measure the tibial plateau angle and observed the angle reduction. After 30 and 60 days post-surgery, the tibial plateau angle in left hindlimb decreased to 11o and -4o, respectively. However, the decrease plateau tibial angle was intense and severe and the screw was removed of the bone. However, even with the proximal tibial physis still open, withdrawing the screw did not alter the tibial plateau angle, which remained at -4º until the animal reached adulthood. The right left hindlimb was used as a control until the dog was 6 months old, when the tibial plateau angle exhibited a 26°. With the electrocauterization technique the tibial plateau angle decreased to 18° and 16° at 30 and 60 days after surgery, respectively, remaining at this last value until the animal completed its growth. Discussion: In the animals with cranial cruciate ligament rupture is indicate same surgical procedures like tibial plateau leveling osteotomy. In these cases, the recommended tibial plateau angle is aproximattely 5o. This study sought to block the line of growth of the tibial plateau to be reached an angle of approximately 5o. Epiphysiodesis technique with screw was already described for treating CCL rupture in young dogs, and the tibial plateau slope was reduced in all dogs studied. The surgical technique used was effective in blocking the physis; however, we observed that the tibial plateau slope was excessively modified and the screw was removed. This fact is explained by the dog’s immaturity, since the plateau leveling occurs more intensively in very young dogs. In epiphysiodesis using the electrocauterization technique, the same surgical principle of juvenile pubic symphysiodesis for treating coxofemoral dysplasia was used. However, in the current pilot study, it was unable to achieve the desired tibial plateau slope with this technique, possibly due to performing the procedure at an age in which the proximal tibial physis would have limited functional capacity. In this study, there was a reduction in the angle of the tibial plateau in both the techniques. However, further studies should be conducted to in order to confirm the actual effectiveness of both techniques described in this report. Keywords: cranial cruciate ligament, locking screw, electrocauterization, stifle joint

Effect of doxycycline on contra lateral canine cranial cruciate ligament rupture

2015 ◽  
Vol 28 (06) ◽  
pp. 371-378
Author(s):  
J. Sung ◽  
J. Barry ◽  
K. Hayashi ◽  
M. R. Edwards ◽  
D. J. F. von Pfeil
Keyword(s):  
Cruciate Ligament ◽  
Rank Test ◽  
Controlled Clinical Trial ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Group D ◽  
Labrador Retrievers ◽  
Cranial Cruciate Ligament Rupture

SummaryObjective: To evaluate whether doxycycline administered to dogs with unilateral cranial cruciate ligament rupture (Uni-CCLR) would decrease the risk of contralateral-CCLR (CoCCLR). To evaluate predictors for Co-CCLR survival. To evaluate if a predisposition of Labrador Retrievers to Co-CCLR exists when compared to other breeds.Methods: In this prospective randomized controlled clinical trial, 69 client-owned dogs with Uni-CCLR were randomly assigned to a doxycycline (group-D: 7.5 mg/kg PO BID x 6 weeks) or non-doxycycline (group-ND: negative control). Medical and imaging data, time from Uni- to Co-CCLR and to follow-up were recorded. Statistics included chi-squared test, logistic regression, Kaplan-Meier survival analysis, log rank test, survival curves, and frailty model (p <0.05).Results: This study included 32 dogs in group-D, and 37 dogs in group-ND. Median follow-up was 54.5 and 61 months, respectively. Contralateral CCLR occurred in 53.1% and 48.6% at medians of 20 and 11 months, respectively. Doxycycline did not significantly decrease the risk of Co-CCLR (p = 0.83). This risk was decreased by 14.2% with each year of age but increased with each increasing kilogram of body weight and each increasing degree of tibial plateau angle by 5.4% and 9.7%, respectively. Labrador Retrievers were not significantly predisposed (p = 0.37).Clinical significance: At the dose regimen investigated doxycycline does not decrease the risk for Co-CCLR.

scholarly journals Tibial tuberosity transposition advancement for treatment of concomitant cranial cruciate ligament rupture and medial patellar luxation in four feline stifles

2021 ◽  
Vol 7 (2) ◽  
pp. 205511692110446
Author(s):  
Edyta Bula ◽  
Karen L Perry
Keyword(s):  
Cruciate Ligament ◽  
Case Series ◽  
Tibial Tuberosity ◽  
Osteotomy Site ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Medial Meniscectomy ◽  
Cranial Cruciate Ligament Rupture

Case series summary Three cats (four stifles) were diagnosed with varying grades of medial patellar luxation and stifle instability in cranial tibial thrust. Radiographs showed periarticular osteophytosis, intra-articular mineralization and opacification encroachment of the infrapatellar fat pad. Stifle exploration revealed either partial (n = 2) or complete (n = 2) cranial cruciate ligament tear and medial meniscal injury in all cases. Medial meniscectomy, partial parasagittal patellectomy, femoral trochleoplasty and tibial tuberosity transposition advancement using a 6 mm cage, two-fork plate and 4 mm spacer were performed in four stifles. Screws (2.0 mm) and washers were used in the cranial cage ears rather than conventional 2.4 mm screws. By the 2-week recheck, lameness was minimal and stifles were stable. Radiographic follow-up at 8 weeks showed appropriate progression of osseous union in all cases. One cat experienced a major complication, suffering tibial fracture following a lapse in exercise restriction, and revision surgery was performed successfully with subsequent osseus union of the osteotomy site. At the mid-term follow-up, all cats had a return to previous level of function, as assessed by both owner questionnaire and clinical evaluation. Relevance and novel information Tibial tuberosity transposition and advancement has been shown to be successful in dogs for the treatment of concomitant medial patellar luxation and cranial cruciate ligament rupture. To date, there have been no reports of tibial tuberosity transposition and advancement in cats. A benefit of this approach is concomitant alignment of the extensor mechanism and neutralization of the femorotibial shear force. Our case series describes successful use of tibial tuberosity transposition advancement in cats.

Modified Triple Tibial Osteotomy for Combined Cranial Cruciate Ligament Rupture, Tibial Deformities, or Patellar Luxation

2019 ◽  
Vol 55 (6) ◽  
pp. 291-300
Author(s):  
Véronique Livet ◽  
Mathieu Taroni ◽  
François-Xavier Ferrand ◽  
Claude Carozzo ◽  
Eric Viguier ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Radiographic Evaluation ◽  
Tibial Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
The Mean ◽  
Owner Satisfaction ◽  
Cranial Cruciate Ligament Rupture

ABSTRACT Proximal tibial deformities or patellar luxation may occur concurrently with cranial cruciate ligament rupture. The objective of this study was to describe the management of those conditions with a modified triple tibial osteotomy (TTO) in nine dogs. Medical records of dogs who underwent a modified TTO were reviewed. The mean pre- and postoperative patellar tendon angles were 104.2° and 92.9°, respectively. The mean pre- and postoperative mechanical medial proximal tibial angles were 99.5° and 91.5°, respectively. Medial patellar luxation was present in five dogs (55.6%) and treated in all five dogs with a tibial crest transposition. Tibial torsion was grossly resolved in two dogs (22.2%). Perioperative distal tibial crest fracture was treated by pins and a figure-of-eight tension-band wire in five dogs (55.6%). One major (surgical site infection) and three minor postoperative complications were observed. At the last follow-up, seven dogs (77.8%) had no lameness, one dog (11.1%) had mild lameness, and one dog (11.1%) had moderate lameness. Radiographic evaluation showed good (2/9; 22.2%) to excellent (7/9; 77.8%) bone healing. The visual analog scale evaluation revealed good-to-excellent owner satisfaction. Cranial cruciate ligament rupture, tibial deformities, and medial patellar luxation are difficult to treat together. A modified TTO may be used to treat these conditions.

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