For a primary repair of an avulsed cranial cruciate ligament, place a suture through the avulsed piece of bone and ligament. Pass the free ends of the suture through parallel tunnels and tie them outside the joint.
CRANIAL CRUCIATE LIGAMENT RUPTURE/ARTHROTOMY CLOSURE
- The integrity of the cruciate ligament is tested by cranial or caudal drawer motion.
- Always inspect the contralateral limb if joint instability is questionable. You can also radiograph the affected stifle and if effusion and DJD are present, it is likely to be associated with a partial or complete tear of the CCL.
- Both intra and extra capsular repair of the cranial cruciate ligament can lead to successful resolution of clinical signs.
- If extracapsular reconstruction is the chosen surgical approach, extreme care must be used to identify and protect the peroneal nerve throughout the procedure.
MOST COMMON COMPLICATIONS AND DIFFICULTY
- Complete removal of the CCL might be difficult.
- Medial meniscus might have damaged part(s) that need to be inspected and removed.
- Use of a Wallace Stifle Retractor will improve visualization of the stifle.
CRANIAL CRUCIATE LIGAMENT RUPTURE/ARTHROTOMY CLOSURE:
SUTURE AND NEEDLE OPTIONS
|Brand||Needle Type||Needle Reference|
|Main Choice||Also Possible||Main Choice||Also Possible|
|PDS* II||Reverse Cut||X-1, CP-2||SH, CT-3, CT-2|
|Taper Point||RB-1, SH, CT-2, CT-1|
|Silk||Reverse Cut||FS-2, FS-1, FS||FSL, CP-2, CP-1, KS|
(20 lbs or less)
(20-45 lbs or less)
(50 to 75 lbs)
(75 lbs +)
|JOINT CAPSULE/RETINACULUM||3-0 or 2-0||2-0||2-0 or 0||0|
|SUBCUTANEOUS||4-0||4-0 or 3-0||3-0 or 2-0||2-0|
|SKIN CLOSURE||4-0||4-0 or 3-0 or 2-0||3-0 or 2-0||2-0|