History
- A 6 years old female griffon was presented to our clinic in Cairo “DrPaws Veterinary Hospital” with sudden onset touching toes lameness.
Orthopedic Examination
- The dog was positive (+) for cranial drawer and compression test of Henderson indicating Cranial cruciate ligament rupture at the left stifle.
2. Dog was suffering from bilateral hip arthritis and Canine hip dysplasia (CHD)
3. The dog had bilateral patellar luxation (medial and lateral) which could be graded as (3rd degree) at the left stifle.
Decision
- Surgical interference for correction of CCLR by lateral extra capsular femoro-tibial fixation.
- Femoral trochleoplasty for correction of patellar luxation.
Steps of Surgery
- Approach: craniolateral parapatellar incision was performed to allow for stifle exposure for both surgeries.
- Technique: (1) For CCLR repair, three tunnels was drilled through the femur and tibia according documented isometric entry points followed by passing of CCLR band tight rope. (2) For Patellar luxation, wedge recession trochleoplasty was performed to alleviate the effect of shallow femoral ridges enhancing patellar luxation.
Closure; Stifle joint Capsule was closed in a double raw followed by muscular closure, s/c and skin closure.
Fig., (1) shows parapatellar lateral stile arthrotomy extends from lateral side of the patellar to the level of tibial tuberosity
Fig., (1) shows the lateral collateral ligament. Exposure of that ligament is crucial for identifying the isometric points for drilling and CCL band placement.
Fig., (3) shows two femoral tunnels and passing CCL band in one tunnel and drilling of the second tunnel. Isometric points for femoral drilling are proximal part of collateral ligament and proximal-caudal point to lateral collateral ligament.
Fig., (4) shows wedge recession trochleoplasty for the correction of patellar luxation
Fig., (5) shows drilling of the third tunnel (Isometric point) at the most proximal and most cranial part of the tibial tuberosity.
Fig., (6) shows stifle CCL band after placement and before tightening. Tightening is performed at stifle angle 100 degree, while capsular closure was performed at stifle flexion 130 degree.
Fig., (7) shows patellar reduction and stifle structures reduction after correction of CCLR and Patellar luxation.
Postoperative Care
-Antibiotics for 10 days postoperatively
-NSAIDs for one week following surgery
-Cage rest for up to 14 days following surgery
Three weeks postoperatively
- Mild degree lameness
