Clinique Vétérinaire Animed, Gap, France.
Université de Lyon, VetAgro Sup, Interactions Cellules Environnement (ICE), Marcy l'Etoile, France.
Open Vet J. 2023 Jul;13(7):948-954. doi: 10.5455/OVJ.2023.v13.i7.15. Epub 2023 Jul 31.
As isolated ruptures of the caudal cruciate ligament (CdCL) are rare in dogs, there is no consensus on the indications and the gold-standard surgical technique for treatment.
A 2-year-old Shepherd dog with an isolated rupture of the CdCL was treated with a new surgical technique for synthetic reconstruction. Three bone tunnels were drilled in the femur and the tibia under arthroscopic guidance to make sure the anatomical insertions of the physiological ligament were respected. An ultra-high molecular weight polyethylene (UHMWPE) implant was fixed with interference screws to reconstruct the CdCL. A synovial inflammation remained present on radiographs for 6 months after the surgery, together with a mild lameness. However, the dog fully recovered clinically and recovered a normal level of activity after 6 months. Liverpool osteoarthritis in dogs questionnaire results at 6 months and 1 year postoperatively were excellent.
The use of a UHMWPE implant fixed with interference screws to reconstruct the CdCL allowed a return to full function of the knee without complications, despite a persistent synovial inflammation and mild lameness for a 6-month period after the surgery. The success of this isolated surgical technique could lead to improvements in the surgical management of CdCL rupture, if these initial results are confirmed by a prospective study with a larger number of patients.
由于犬尾部十字韧带(CdCL)的孤立性断裂较为罕见,因此对于其治疗的适应证和金标准手术技术尚未达成共识。
一只 2 岁的牧羊犬出现孤立性 CdCL 断裂,采用一种新的合成重建手术技术进行治疗。在关节镜引导下,于股骨和胫骨上钻 3 个骨隧道,以确保尊重生理韧带的解剖附着点。使用超高分子量聚乙烯(UHMWPE)植入物和干涉螺钉固定来重建 CdCL。尽管手术后 6 个月仍存在滑膜炎症和轻度跛行,但该犬在临床上完全恢复,6 个月后恢复了正常活动水平。术后 6 个月和 1 年时,利物浦犬骨关节炎问卷(Liverpool Osteoarthritis in Dogs questionnaire, LOAD)评分结果均为优秀。
尽管手术后 6 个月存在持续的滑膜炎症和轻度跛行,但使用 UHMWPE 植入物和干涉螺钉固定来重建 CdCL 可使膝关节完全恢复功能,且无并发症。如果前瞻性研究中更多患者获得类似的初始结果,那么这种孤立性手术技术的成功可能会改善 CdCL 断裂的手术治疗。