• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.285-288
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• 2019

A 5-year-old 6 kg male mongrel (case 1) and a 7-year-old 4.3 kg male yorkshire terrier (case 2) were presented to Chonbuk animal medical center (CAMC). Both animals had non-weight bearing hind limb lameness. Case 1 had complete rupture of cranial cruciate ligament with grade 3 medial patellar luxation. Case 2 had complete cranial cruciate ligament rupture with grade 4 medial patellar luxation. During surgery, in both cases, trochlear block recession was performed followed by CORA based leveling osteotomy (CBLO) and tibial tuberosity transposition (TTT). General soft tissue reconstructions for medial patellar luxation including medial releasing and lateral imbrication were also performed. Postoperatively, both animals demonstrated excellent recovery and regained normal weight bearing of the affected hind limb without any recognizable complication. CBLO followed by TTT can be a curative surgical option without complications in cases of cranial cruciate ligament rupture with high-grade medial patellar luxation in small breed dogs.

• Journal of Veterinary Clinics
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• v.20 no.2
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• pp.229-232
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• 2003

Ultrasonographic examination of the stifle joint four clinically and radiographically normal adult dogs was performed before and after inducing the cranial cruciate ligament (CrCL) rupture of the bilateral stifle surgically. At Pre- or post-surgery, the hyperechoic patella ligament and the echogenic infrapatella fat interfered the visualization of the CrCL by the plain scanning method. However when the stifle joint was imaged by the scanning method injecting normal saline within the joint capsule, the hyperechogenic ligament was visualized by the separation of the infrapatella fat and the CrCL and the contrast effect of anechoic saline. When the stifle joint was imaged by the real time scanning method after the induction of the surgical rupture, fluttering of the ligament and anechoic area between the bone and the CrCL was identified due to the lack of tonicity and continuity of the ligament. Enlargement of the ligament because of its increased diameter as well as fluttering of the CrCL and the increased joint space's thickness was visualized. Consequently, confirming fluttering of the CrCL, increased ligament diameter and anechoic region between the CrCL and the bone, ultrasonographic examination is a valuable diagnostic tool as well as cranial drawer test and radiographic examination.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.497-500
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• 1999

A 4 years old male mixed breed dog, which weighed 25.5 kg, referred to Veterinary Teaching Hospital at College of Veterinary Medicine in Chonnam National University, because of chronic hindleg lameness. Click sound by flexion and extension of stifle joint, positive reaction by cranial drawer movement, fat pad sign and tibial position in cranial drawer position on the lateral radiographic view, medial patellar luxation (grade II), and lameness score 2.5 at standing and 2 at walking in right hindleg were showed. Under general anesthesia with enflurane, after medial arthrotomy, it was performed to remove remnants of cranial cruciate ligament and torn medial menisci and joint closed. In modified retinacular imbrication technique, one lateral fabellar/tuberosity suture, one medial fabellar/tuberosity suture, and one imbrication suture adjacent to the patella were placed. At 9 days after operation, lameness score 0 was observed and general condition was excellent.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.141-144
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• 2014

Two dogs (Case 1 weighing 27 kg, Case 2 weighing 42 kg) were referred with hindlimb lameness. On physical examination, there was moderate pain on stifle joint testing and mild cranial translation on cranial drawer testing in Case 1. This translation was obvious when the patient was under general anesthesia. Case 2 showed discomfort during hyperextension of the stifle joint, but no significant cranial translation under general anesthesia. Joint effusion was detected on radiography in both cases. Based on physiologic and radiographic examinations, cranial cruciate deficiency was suspected, so exploratory arthroscopy was performed. Arthroscopy revealed partial rupture of the cranial cruciate ligament (CrCL) in both cases. Case 1 showed unstable partial CrCL rupture, while Case 2 had stable CrCL rupture. Tibial tuberosity advancement (TTA) was carried out as planned. Seroma occurred one week postoperatively in Case 2, and was removed surgically. The patients returned to satisfactory weight-bearing ambulation 5 months after initial surgery. Based on the results of these cases, TTA appears to be a useful procedure in the treatment of CrCL partial rupture.

• Journal of Veterinary Clinics
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• v.34 no.5
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• pp.366-369
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• 2017

A 30 kg, 6-year-old spayed female Samoyed dog was referred with a history of intermittent weight-bearing lameness in her right hindlimb for 3 weeks. The patient hadsurgery to correct a medial patellar luxation in the same limb 3 years prior. Based on the physical examination and radiographic findings, MPL and CCLR of the right hindlimb were diagnosed. Pre-surgical arthroscopy examination was performed, revealing a complete rupture of the cranial cruciate ligament, medial caudal meniscal tears and fibrotic cartilagechanges on the trochlear groove. An arthroscopy-assisted partial meniscectomy was used to repair themedial caudal meniscus. To correct the tibial plateau angle and medial patellar luxation, a tibial plateau leveling osteotomy (TPLO) was performed. A tibial tuberosity transposition (TTT) was performed to realignthe quadriceps mechanism with the trochlear block recession followed by soft tissue reconstruction. The post-surgical recovery was uneventful, and the patient was weight-bearing with normal ambulation on the repaired limb. There were no complications, and the implants were well positioned at the last follow-up. The clinical outcome of the caseindicates that combining TPLO with TTTis a good surgical option for treatingconcurrent CCLR and MPL.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.342-344
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• 2007

This study was performed to report the signalment, history, and outcome of modified retinacular imbrication technique (MRIT) for treatment of cranial cruciate ligament rupture (CCLR) in dogs. Nine dogs (12 stifles) presented with chronic hindlimb lameness associated with CCLR. They were 7 males and 2 females. Six were Yorkshire terriers. Mean age was 8 years (range,2 to 14 years), and mean weight was 5.6kg (range, $1.8{\sim}19kg$). Three dogs had bilateral CCLR and six dogs had unilateral CCLR (2 left stifles and 4 right stifles). Nine stifles (8 dogs) had concomitant patellar medial luxation. Surgery was performed in eight stifles (5 dogs) and recovery rate of 100%. Three stifles (2 dogs) were underwent simultaneously femoral trochleoplasty. Mean time to the normal gait after surgery was 30 days. There were not postoperative complications.

• Journal of Veterinary Clinics
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• v.34 no.1
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• pp.7-12
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• 2017

Twelve dogs weighing less than 10 kg underwent unilateral TTO to stabilize the stifle joint with cranial cruciate ligament rupture. Surgical findings, intra-operative and post-operative complications were recorded. Radiographic examinations were performed for 8 weeks following surgery. Postoperative outcome was evaluated using a visual analogue lameness scoring system. Mean preoperative PTA (the angle created by the intersection of the tibial plateau extrapolation line and the patellar tendon) was 103.8 degrees. Mean tibial wedge angle was 16.6 degrees. Mean postoperative PTA was 92.1 degrees. Intraoperatively, fracture through the caudal tibial cortex occurred in all dogs, through the distal tibial crest cortex in 2 dogs, through the lateral tibial cortex in 2 dogs and through the fibula in 1 dog. Four-week postoperative radiographs demonstrated evidence of progressive bone union at osteotomy site and complete unions were identified at 8 week in 10 dogs. All dogs were healed in 11 weeks. Most of dogs revealed weak lameness in 4 weeks and normal ambulation in 8 weeks postoperatively except for only one dog returned in 11 weeks. Despite frequent minor complication, it appears that the TTO is an alternative procedure for management of cranial cruciate ligament rupture in small breed dogs.

• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.282-284
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• 2019

A 8-year-old, intact female, 2.1 kg, yorkshire terrier dog was referred to Animal Medical Center, Chonbuk National University due to right hindlimb lameness. Orthopedic examinations revealed pain during extension and flexion on stifle joint, positive cranial drawer sign, positive tibial compression test and patella luxation. Radiography showed the cranial displacement of right tibia with mildly increasing the synovial volume. The surgical procedure involved radial osteotomy of the proximal tibia and fixation by 1.2 T-locking plate. At two weeks after surgery, the patient was able to weight-bearing and gait gradually improved. This case report describes circular Tibial Tuberosity Advancement (cTTA) surgical technique and the successful surgical repair of cranial cruciate ligament rupture a dog.

• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.443-448
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• 2003

To determine whether localization of tartrate-resistant acid phosphatase (TRAP) and cathepsin K was associated with rupture of the cranial cruciate ligament (CCL) in dogs. Tissue specimens were obtained from 30 dogs with CCL rupture during surgical treatment, 8 aged normal dogs, and 9 young normal dogs that were necropsied for reasons unrelated to this study and unrelated to musculoskeletal disease. The cranial cruciate ligament was examined histologically. $TRAP^+$ cells and cathepsin $K^+$ cells were identified by histochemical staining and immunohistochemical staining respectively. TRAP and cathepsin $K^+$ were co-localized within the same cells principally located within the epiligamentous region and to a lesser extent in the core region of ruptured CCL. Localization of $TRAP^+$ cells (P < 0.05) and cathepsin $K^+$ cells (P =0.05) within CCL tissue was significantly increased in dogs with CCL rupture, compared with aged-normal dogs, and young normal dogs (P < 0.05 - TRAP, P < 0.001 - cathepsin K). Localization of $TRAP^+$ cells and cathepsin $K^+$ cells within the CCL tissue of aged-normal dogs was also increased compared with young normal dogs (P < 0.05). Small numbers of $TRAP^+$ cells and cathepsin $K^+$ cells were seen in the intact ligaments of aged-normal dogs, which were associated with ligament fasicles in which there was chondroid transformation of ligament fibroblasts and disruption of the organized hierarchical structure of the extracellular matrix. $TRAP^+$ cells and cathepsin $K^+$ cells were not seen in CCL tissue from young-normal dogs. Localization of the proteinases $TRAP^+$ and cathepsin $K^+$ in CCL tissue was significantly associated with CCL rupture. Small numbers of proteinase positive cells were also localized in the CCL of agednormal dogs without CCL rupture, but were not detected in CCL from young-normal dogs. Taken together, these findings suggest that the cell signaling pathways that regulate expression of these proteinases in CCL tissue may form part of the mechanism that leads to upregulation of collagenolytic ligament remodeling and progressive structural failure of the CCL over time.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2008.10a
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• pp.177-177
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• 2008