Anterior Cruciate Ligament Repairs
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by John Maniatty V.M.D.
here are several types of anterior cruciate ligament repairs, and more are coming out every few years. For the sake of this article, we will cover the three main repair techniques: Lateral imbrication, tibial plateau leveling osteotomy (TPLO), and tibial tuberosity advancement (TTA). They each can be effective, and there are positive and negatives associated with each. All three techniques start the same by going into the stifle joint to remove the remnants of the broken anterior cruciate ligament, any bony fragments, smooth out roughened areas, and if the meniscus is damaged remove the damaged portion. Then close the joint capsule. From here the three techniques vary. 12
Delmarva Unleashed
Lateral imbrication is the oldest of the three techniques and is being tweaked 'till this day. It replaces the anterior cruciate ligament with a monofilament nylon suture. This is accomplished by passing the nylon suture behind the lateral fabella, a small bone on the back of the stifle joint at the level of the distal femur. The nylon suture is passed just below the patella tendon and brought back through a hole that is drilled in the tibial tuberosity. The stifle is then placed in normal position for standing, and we secure the nylon suture by either tying a knot or using a crimp clamp. By doing this, we prevent internal rotation and also keep the tibia from being able to slide forward. This gives the stifle increased joint stability.
Early Summer 2017
