Intra-articular replacement of the caudal cruciate ligament using an UHMWPE ligament under arthroscopic guidance in a dog: A case report

Abstract

Background: As isolated ruptures of the caudal cruciate ligament (CdCL) are rare in dogs, there is no consensus on the indications and the gold-standard surgical technique for treatment. Case Description: A 2-year-old Shepherd dog with an isolated rupture of the CdCL was treated with a new surgical technique for synthetic reconstruction. Three bone tunnels were drilled in the femur and the tibia under arthroscopic guidance to make sure the anatomical insertions of the physiological ligament were respected. An Ultra-High Molecular Weight Polyethylene (UHMWPE) implant was fixed with interference screws to reconstruct the CdCL. A synovial inflammation remained present on radiographs for six months after the surgery, together with a mild lameness. However, the dog fully recovered clinically and recovered a normal level of activity after six months. LOAD results at six months and one year postoperatively were excellent. Conclusion: The use of an UHMWPE implant fixed with interference screws to reconstruct the CdCL allowed a return to full function of the knee without complications, despite a persistent synovial inflammation and mild lameness for a 6-month period after the surgery. The success of this isolated surgical technique could lead to improvements in the surgical management of CdCL rupture, if these initial results are confirmed by a prospective study with a larger number of patients.

Long-Term Clinical Outcome of Medial Shoulder Instability in a Dog Treated with Synthetic Implant, Cortical Button, and Interference Screw

“…The choice of a UHMWPE implant was based on the biocompatibility of its fibers 22 as well as the ex vivo biomechanical strength 23 24 25 and clinical versatility it demonstrated in various applications. 16 17 In the reported case, its flat and wide shape (compared with other implants 7 ) helped to restore stability while reconstructing a single arm of the MGHL, previously shown to be sufficient for maintaining shoulder stability in young beagles. 26 Covering the joint with an implant fixed on a single point on the glenoid to stabilize MSI has previously been described with various implants and materials (spiked washers and screws, buttons and UHMWPE tape, anchors).…”

“…3 7 Treatments include, among others, the imbrication of the SM 12 and prosthetic MGHL repair using synthetic implants fixed by suture anchors, 13 screws with spiked washers, 14 toggle sutures, 4 7 or knotless anchors. 15 Although interference screws (IS) associated with synthetic implants have already been used in various ligament reconstructions, 16 17 they have never been explored to treat MSI. We thus report the surgical management and long-term outcome of traumatic MSI in a small-breed dog treated by imbrication of the SM and extra-articular stabilization using a synthetic implant and an IS.…”