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November 2015Cranial Cruciate Repair: How To Help Your Clients Understand Their OptionsAt Care Center, the most common orthopedic injury our team sees is cruciate ligament disease. The disease results in a progressive degeneration of the cranial cruciate ligament (CrCL), which is analogous to the anterior cruciate ligament (ACL) of humans. It is important to note that, in contrast to ACL injury in humans, cruciate disease in dogs is not purely the result of trauma. The underlying cause of degeneration is not completely understood, but the disease can affect any dog, large or small, purebred or mixed breed, house pet or athlete.There is some debate about the best option for repair for any given dog. We have four surgeons trained in various methods of treating cruciate ligament disease, so we are able to offer not only the best surgical option for the patient, but for the owner as well. Sometimes an owner’s financial situation, lifestyle, physical abilities, or work schedule does not fit with certain methods of repair. It’s important to take the needs of both the patient and the owner into consideration when deciding the most appropriate course of surgical treatment, to ensure the best possible outcome.There are many ways to repair a torn cruciate. In this article, we’ll focus on the methods our surgeons know to be the best options available. All of the procedures below are available here at Care Center. When you are speaking with your clients about surgical options for their pet’s cruciate disease, we hope this will make the conversation easier.TIBIAL PLATEAU LEVELING OSTEOTOMY (TPLO)The TPLO is in a class of corrective surgeries known as high tibial osteotomies. These procedures alter the mechanics of the stifle joint such that the cranial cruciate ligament is no longer necessary for stability. The TPLO procedure neutralizes stifle instability by flattening the angle of the tibial plateau, the weight-bearing surface of the tibia. To accomplish this, the surgeon makes a curvilinear cut (osteotomy) through the tibia, rotating the upper segment of the bone and stabilizing the fragments with a metal plate and screws. The healing process post-surgery involves allowing the tibia to heal, which requires eight weeks of moderate exercise restriction and physical rehabilitation. PROS:(Images provided by Dr. Michael Kraun)• Oneofthetreatmentsofchoiceforlargebreedoractivedogs,aswellasathletesorservicedogs • WeightbearingsoonerthanwithlateralsutureContinued page 2


































































































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