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Treatment of Cranial Cruciate Ligament Insufficiency
Budsberg SC.
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Introduction
Cranial cruciate ligament (CCL) disease is the most common cause of pelvic limb lameness in dogs. It may be treated medically or surgically, but there are few data comparing the two treatment paradigms. Numerous surgical treatments have been described to stabilize the stifle joint and reportedly, many of the procedures have a high success rate of improving limb function and decreasing lameness. Direct comparisons between treatments are scarce, however. A systematic review of the scientific literature describing surgical treatments for CCL disease was performed through August 2004 and at that time, there was not enough evidence to determine the superiority of one procedure over another. The aim of this contemporary systematic review of the scientific peer-reviewed literature was to answer an a priori question whether one surgical procedure for CCL disease consistently returns a dog to normal clinical function. We assumed the null hypothesis that the best available evidence does not support a surgical procedure’s ability to consistently achieve normal clinical function in dogs with CCL disease.
Materials and Methods
Prior to beginning the systematic review, the methodology was defined and a protocol was outlined. The a priori question defined for this systematic review was: “Is there a surgical procedure that will allow a consistent return to normal clinical function in dogs with CCL disease and is that procedure superior to others?” A ‘consistent return to normal clinical function’ was defined to be greater than 90% of the treated population returning to the activity level of a dog unaffected by pelvic limb disease based on the reported outcome assessments in the study. Peer-reviewed scientific studies on dogs with naturally occurring CCL disease published in the English language were included. At least six months post-operative follow- up was required. Only unilateral, single session surgical therapy was evaluated. [...]
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