Cruciate Disease the Pros and Cons of Different Treatment Options

Pathogenesis
Cranial cruciate ligament disease (CCLD) is the most common cause of hindlimb lame- ness in the dog, being associated with and eventually leading to stifle osteoarthritis. a gradual degeneration of the ligament extracellular matrix (ECM) leads to ligament rup- ture (1).

Aims of treatment
The primary aim of treatment for a dog with CCLD is to alleviate pain and lameness. the surgical techniques are designed to variably replicate the cranial cruciate ligament, reli- ably reproduce its function or negate the need for an intact cranial cruciate ligament by reducing the tibial plateau angle and eliminating tibial thrust. Secondary aims include a reduction in osteoarthritis and prevention of latent meniscal tears.

Treatment types can be categorised into four main categories - conservative manage- ment, intra-capsular, extra-capsular or tibial osteotomy.

Conservative treatment
There is little published on conservative treatment aside a publication from 1984 whereby over 80% of dogs < 15 kg did well without surgery and 80% of dogs > 15kg remained lame (2). the advantage of conservative management is the low cost and low risk to the patient. the disadvantages are associated with failure to improve, progres- sion of osteoarthritis, a partial CrCL tear becoming a complete tear and development of meniscal tears. [...]