Case studies
Barry - Cranial Cruciate Ligament Rupture
Barry was presented to us with a severe limp in one of his hind legs. He was a very active dog and even took part in an energetic pastime called flyball. Flyball races involve two teams of dogs who race side-by-side over a 51 foot long course. Each dog must run in relay fashion down a set of jumps and trigger a flyball box that releases the ball. The dog has to catch or retrieve the ball, and return over the jumps. This is usually done by lightweight agile breeds such as border collies - not St Bernards!
Barry's lameness had started suddenly and he was only able to walk a few yards before he became very lame. Investigations revealed that Barry had torn his cranial cruciate ligament. This ligament is one of the main stabilisers of the stifle (knee) joint and, in people, it is an injury not uncommonly seen in sports men and women (and recreational skiers!). In dogs, this injury can be managed in a number of ways but surgery is usually necessary. Our preferred technique in most patients, particularly larger dogs, is a procedure called a TPLO (Tibial Plateau Leveling Osteotomy). In this procedure we reshape the top of the tibia (shin bone) to help the patient cope without the cruciate ligament.
These patients are usually using the leg within a few days of surgery and able to go for short very controlled lead walks - ideal for Barry not losing too much fitness!
Barry made good post operative progress and was walking well on the leg when he came back for his check x-rays 6 weeks after surgery. Unfortunately we received a telephone call a few weeks later to say Barry had now gone lame on his other back leg. Further tests showed he had done the same thing on that side! This is quite common as in many dogs the cranial cruciate ligament fails because of an underlying weakness or predisposition to it stretching or tearing and not just due to a sudden severe injury breaking the ligament. The good news is that TPLO works very well in the most of patients and enables them to return to an active lifestyle with little or no lameness. Barry did well following surgery on his other knee and has returned to an active lifestyle....including Flyball!
Images (from top):
(1) Pre operative x-rays (side view) of Barry's left knee. The pencil lines are part of the pre-operative planning.
(2) The same view immediately after surgery.
(3) A 'font to back' view of the knee after surgery showing the six screws used to attach the metal plate to the bone. The plate and screws keep the top of the bone in its new position whilst it heals.
