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Dictionary of Terms
What is the Anterior Cruciate ligament?
The anterior cruciate ligament, or ACL, is one of the two ligaments that hold the femur and the tibia in proper alignment. See drawing to right.
How does it get injured?
These two crossed (cruciate) ligaments prevent forward slipping of the femur over the tibia. When a dog plants his foot and suddenly twists his body, the cranial cruciate ligament can tear or break. This is the same injury often suffered by athletes - such as football players. Once torn, this will cause instability in the knee. That results in pain when walking, and grating of the femur and tibia leading to arthritis and swelling. Left unrepaired, severe arthritis and chronic pain can result.
How is it fixed?
There are many ways to repair the ACL rupture. The most common repairs are are lateral fabellar suture, tight rope repair and the TPLO (tibial plateau leveling osteotomy). The procedure performed most commonly and for the longest time was a lateral fabellar suture. The tight rope technique is a modification of the lateral fabellar suture, and is more isometric and therefore stronger. In most cases, this provides plenty of stabilization and reduces the formation of arthritis. The recovery time is approximately six to twelve weeks depending on the patient.
The lateral fabellar suture is described later in this article. Notes are made where the tightrope would differ from this technique.
What is the other surgery?
The TPLO surgery is a newer procedure and can only be performed by certified veterinarians. These veterinarians are found usually at universities or referral institutions. This procedure involves cutting the tibial plateau loose and leveling it. The bone is then plated to hold it in place. Complications are common and recovery time is between twelve and sixteen weeks. Your veterinarian will be happy to discuss both of these procedures - the pros and cons, to help you choose the best procedure for your pet.
The lateral fabellar suture repair is a commonly used method of repair. The basic premise of this technique is to replace a torn ligament with a nylon suture that mimics its function. Similarly, the tight rope technique replaces the function of the cranial cruciate ligament with a fiberwire band. The fiberwire is not nylon, so it doesn't stretch as easily. It is placed through the bone in tunnels, so it can be placed in a more isometric (close to the original path of the Cranial Cruciate Ligament) path.
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