Avulsion fracture of the femoral attachment of the caudal cruciate ligament treated by arthroscopy in a Bernese Mountain puppy

Abstract

A five-month-old male Bernese Mountain dog weighing 27.4 kg was presented for evaluation of an acute non-weightbearing left pelvic limb lameness. Radiographs and CT revealed an avulsion fracture of the femoral attachment of the caudal cruciate ligament (CaCL). A left stifle arthroscopy was performed. Reduction and internal fixation were realised under arthroscopic guidance using a Kirschner wire (1.8 mm) and a single cortical screw (2.0 mm). Ten weeks postoperatively, the implants were removed via arthroscopy. A mild persistent intermittent weightbearing lameness was noted. Normal healing and resolution of lameness followed and the dog was clinically healthy 6 months postoperatively. As in human medicine, surgical treatment of a CaCL avulsion injury in dogs can be performed under arthroscopic guidance. Even though surgical treatment is not always required, it seemed indicated in this case and arthroscopic treatment was successful.

Long‐term outcome of a combined surgical approach for repair of femoral avulsion fracture of the caudal cruciate ligament in a dog

“…In human medicine, the current surgical approach combines arthroscopy and fluoroscopy or arthroscopic‐assisted internal fixation to facilitate joint inspection and reconstruction of the ruptured ligament and avulsed segment 17 18. Surgical repair of an avulsion fracture of the CdCL under arthroscopic guidance was reported in a dog, but complications necessitated a second arthroscopic procedure to remove screws that had migrated 19. The prognosis for CdCL rupture alone is good based on the results of a study in which a large number of dogs had a good functional outcome regardless of the surgical repair method used 20.…”

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

“…Intra-articular techniques aim to replace the damaged ligament with either an autograft from a transposition of the patellar ligament or fascia lata, or with an allograft ( Johnson and Olmstead, 1987 , Arnoczky, 1988 , Lopez et al ., 2003 , Biskup and Conzemius, 2020 ), a synthetic material (Julinder and Ödman, personal communication) ( Smith et al ., 2019 ; Soreide et al ., 2019 ), or a combination of both ( Yoshiya et al ., 1986 , Cook et al ., 2017 , Mao et al ., 2019 ). In the event of avulsion at the level of the ligament attachment, a reduction using a screw may be considered ( Knecht et al ., 1976 ; Livet and Cachon, 2017 ).…”