Small Animal Orthopaedics and Arthroscopy

Telephone: 07884 436 493

"What the Papers say"

Cruciate Case Study

A case of cruciate ligament injury and meniscal tearing in a Boxer.

Savanah presented with a typical history of cranial cruciate ligament disease (CCLD), her lameness had slowly worsened over a period of weeks and had then suddenly progressed to the point where she was almost non weight bearing on her leg. Clinical and orthopaedic examination revealed a mild heart murmur which was shown not to be significant and a very swollen and relatively unstable left stifle (knee) joint.

Under a general anaesthetic, x rays confirmed that there were osteoarthritic (OA) changes present and confirmed the cruciate ligament damage. The stifle joint was then examined in detail with a 2.4mm arthroscope and this demonstrated damage to the medial meniscus. In most cases of meniscal injury all that can be done is to trim out the damaged portion and for some of the tears present this was the case, however what made Savanah different was an additional tear of the meniscus that could be sutured together, which was performed arthroscopically. The instability caused by the cruciate ligament rupture was then addressed with a lateral “Tightrope” suture and the wounds closed. Savanah was rested strictly for 6 weeks after which time the hindlimb lameness had resolved and further exercise was slowly re-introduced.

What is particularly interesting in Savanah’s case was the demonstration that although she had the most common cause of hindlimb lameness (CCLD), the actual individual variation of meniscal injury was very rare. Because we could save the majority of the meniscus by repairing it arthroscopically we hope that the long term prognosis will be improved.

Feline Carpal Arthrodesis Case Study

Carpal arthrodesis in a cat to treat a carpal flexure as a result of flexor tendon myopathy.

Tate was referred to me whilst I was still working in Swindon. He had developed a profound left carpal flexure as a result of a flexor muscle myopathy and fibrosis and had also started to show some subtle signs of carpal flexure in the right fore as well.

After ruling out all possible medical causes, including FeLV and FIV, fresh muscle biopsies were taken which were sent by special delivery to Diane Shelton at UC Davis through Torrance Diamond Diagnostic Services (TDDS).

These confirmed fibrosis as a result of a myopathy of unknown cause which had also started to affect the other side to a lesser extent.

Tate was admitted and the flexor tendons of the less affected side were sectioned to release them completely, the grossly affected side was also released and a carpal arthrodesis performed using a trans carpal external fixator to provide rigid fixation.

The fixator was removed after 5 months at which time Tate was walking well albeit with a fixed carpus.