QUESTION: My four-year-old Golden Retriever hurt his left hind leg and my vet thinks that he has torn his ACL.
I’ve done some research and found out that there are few different types of surgeries and I’m debating which one to choose.
I’m quite confused and would appreciate your opinion about the differences between the methods and which you would recommend. — Jason, Kelowna
ANSWER: The rupture of the ACL — anterior cruciate ligament — is the most common reason for hind limb lameness in dogs.
The ACL is an elastic band of tissue that connects the thigh bone (femur) and the Shin bone ( tibia) and allowing the bending and extending of the knee joint while keeping the knee joint stable.
When the ACL is torn, the knee (stifle) becomes unstable. When the dog takes weight on the limb, this instability allows the shin bone (tibia) to move forward relative to the thigh bone (femur).
The stifle feels as though it is “giving-way” and this can cause the dog to appear severely lame.
There are few different approaches for dealing with the loss of the ACL.
The main purpose of the different surgical methods is to regain the knee joint stability and prevent the excess of the free movement of the tibia against the femur.
The simple and old-fashioned way is called extracapsular repair, in which the surgeon uses a special string and passes it between particular structures of both bones and tightens the string in a manner that inhibit the free movement between the bones and provides the knee joint stability.
The advantage of this procedure is that it is fairly easy to perform and cost effective. However, the procedure is not recommended for dogs that weigh more than 100-120 pounds.
Furthermore, the results are not permanent, and the condition may occur if the string tears.
The more modern and advanced surgical methods are based on cutting the tibial bone, changing the angle of the top part of the tibia (Tibial Crest) and by changing the angle, the mechanic forces changes and inhibit the excess movement in the joint.
There are few different procedures that are based on osteotomies (bone cutting) and reattaching, such as: TTA – tibial tuberosity advancement; and TPLO – tibial plateau levelling osteotomy.
In my personal opinion and experience, the absolute best procedure, with phenomenal results is CBLO (Cora-based levelling osteotomy).
CBLO is one of the newest procedures and it’s proving itself to be a great surgical method, it’s definitely my favourite method and I highly recommend it to most of my clients.