January 2009 - "Tobe"

	"Tobe" is a 6 year old female labrador that has been intermittently lame on her left hind leg for some time.  The problem was slowly getting worse so we decide to get some x-rays of her stifle (knee) which was causing her pain.  The x-ray can be seen below.
Whilst under sedation we discovered that Tobe had an unstable stifle joint due to a damaged cranial (anterior) cruciate ligament, a problem similar to that seen in many sportspeople.  Surgery was recommended and a technique called a tibial wedge osteotomy was decided on.  This surgery alters the angle of the stifle joint (specifically the tibial plateau angle) rendering the cruciate ligament redundant and has a very good success rate.  During surgery, a wedge of bone (of a pre-determined specific angle according to the x-rays)was removed from her tibia (shinbone) to change the angle of the joint.  The post-operative x-rays can be seen below.
As you can see in the x-rays after the wedge of bone has been removed the 2 pieces of bone have been secured together using a stainless steel plate and screws.  This provides a very solid fixation and many dogs will walk on the operated leg almost immediately.  The initial tibial plateau angle of 26 degrees has been reduced to 6 degrees.  The next x-ray is 3 months down the track and shows full bony healing and a healthy joint.  "Tobe" has gone on to do very well and no longer limps.
	Cruciate Disease Information   Cruciate disease is the most common orthopaedic condition that we see in dogs.  The majority of dogs with a chronic hindlimb lameness have damaged their cruciate ligament.  Advances in surgical techniques have led to new procedures and excellent success in treatment.  We have been performing the Tibial Wedge Osteotomy for almost 2 years now and are very happy with the outcome and improvement over older techniques.  This technique is generally used on larger dogs and some smaller dogs with specific deformities.  For most smaller dogs we perform an "extracapsular repair" using synthetic nylon to take up the function of the damaged ligament.  In general terms the earlier we operate the better the outcome.  However, as some of our clients have found out, as many as 50% of dogs on which we operate on one leg will develop cruciate ligament disease in the other leg at some stage!