Extra-Articular Stabilization of the Canine Cranial Cruciate Ligament Injury Using Arthrex Corkscrew and FASTak Anchors

Erin N. Kishi, Don Hulse, Matthew Raske, W. Brian Saunders, Brian S. Beale

.
Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, USA.

DOI: 10.4236/ojvm.2013.32024                

Abstract

The objective of this study was to evaluate the long-term outcome in dogs with cranial cruciate ligament injury that were repaired with an Arthrex Corkscrew or FASTak bone anchor and Fiberwire placed at near isometric points of the stifle. A retrospective study (2006-2010) was conducted by reviewing clinical records of dogs treated for cranial cruciate ligament injury with an extra-articular repair method using anchors preloaded with Fiberwire. A questionnaire was given to owners for evaluation of their dog’s performance prior to surgery and at time of follow-up with a minimum of 12 months post-operative. Owner assessment was rated using a visual analogue scale. Completed questionnaires from 34 owners were received. The mean time to follow up was 27.5 months. Owner assessment of their dog prior to surgery versus at the time of follow up were considered significant (P < 0.001) in regards to quality of life, willingness to play voluntarily, activity level, stiffness at the beginning and end of the day, lameness in the surgical limb, and pain while walking on the surgical limb. These results indicate that extra-articular stabilization with Arthrex Corkscrew and FASTak anchors placed at near isometric sites are adequate repair methods for cranial cruciate ligament rupture.

Keywords

Corkscrew; FASTak; Cranial Cruciate Ligament Rupture; Extracapsular Repair; Questionnaire

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	S. P. Arnoczky, “Pathomechanics of Ligament and Meniscal Injuries,” In: Bojrab, Ed., Disease Mechanisms in Small Animal Surgery, 2nd Edition, Lea & Febiger, Philadelphia, 1993, pp. 764-770.
[2]	S. P. Arnoczky and J. L. Marshall, “The Cruciate Ligaments of the Canine Stifle: An Anatomical and Functional Analysis,” American Journal of Veterinary Research, Vol. 38, No. 11, 1977, pp. 1807-1814.
[3]	P. B. Vasseur, “Stifle Joint,” In: D. Slatter, Ed., Textbook of Small Animal Surgery, 2nd Edition, Saunders, Philadelphia, 1993, pp. 1817-1865.
[4]	K. Hayashi, J. D. Frank, C. Dubinsky, et al., “Histologic Changes in Ruptured Canine Cranial Cruciate Ligament,” Veterinary Surgery, Vol. 32, No. 3, 2003, pp. 269-277. doi:10.1053/jvet.2003.50023
[5]	P. B. Vasseur, “Clinical Results Following Conservative Management for Rupture of the Cranial Cruciate Ligament in Dogs,” Veterinary Surgery, Vol. 13, No. 4, 1984, pp. 243-246. doi:10.1111/j.1532-950X.1984.tb00801.x
[6]	D. L. Korvick, G. J. Pijanowski and D. J. Schaeffer, “Three Dimensional Kinematics of the Intact and Cranial Cruciate Deficient Stifle of Dogs,” Journal of Biochemanics, Vol. 27, No. 1, 1994; pp. 77-87.
[7]	A. D. Elkins, K. Pechman and M. Herron, “A Retrospective Study Evaluating the Degree of Degenerative Joint Disease in the Stifle Joint of Dogs Following Surgical Repair of Anterior Cruciate Ligament Rupture,” Journal of the American Animal Hospital Association, Vol. 27, No. 5, 1991, pp. 533-540.
[8]	P. C. Gambardella, L. J. Wallace and F. Cassidy, “Lateral Suture Technique for Management of Anterior Cruciate Ligament Rupture in Dogs: A Retrospective Study,” Journal of the American Animal Hospital Association, Vol. 17, No. 1, 1981, pp. 33-38.
[9]	D. A. Hulse, “Cruciate Ligament Rupture,” In: T. Fossum, Ed., Small Animal Surgery, 2nd Edition, Mosby, St. Louis, 2002, pp. 1110-1143.
[10]	B. Slocum and T. Devine, “Cranial Tibial Wedge Osteotomy: A Technique for Eliminating Tibial Thrust in Cranial Cruciate Ligament Repair,” Journal of the American Veterinary Medical Association, Vol. 184, No. 5, 1984, pp. 564-568.
[11]	S. C. Roe, “Limitations of Cranial Cruciate Ligament Repairs: Prosthetic Ligament Substitutions,” Proceedings of the 24th Annual American College of Veterinary Surgeons Veterinary Symposium, San Francisco, 3-6 November 1996.
[12]	C. J. Choate, A. Pozzi, D. D. Lewis, et al., “Mechanical Comparison of Lateral Circumfabellar Suture, Tightrope CCL, and SwiveLock Bone Anchor for Extracapsular Stabilization of the Cranial Cruciate Ligament-deficient Stifle in Dogs,” Proceedings of the 38th Annual Veterinary Orthopedic Society Meeting, Snowmass, 5-12 March 2011.
[13]	D. Hulse, W. Hyman and B. Beale, “Determination of Isometric Points for Placement of a Lateral Suture in Treatment of the Cranial Cruciate Ligament Deficient Stifle,” Veterinary and Comparative Orthopedics and Traumatology, Vol. 23, No. 3, 2010, pp. 163-167.
[14]	J. T. Hudson, M. R. Slater, L. Taylor, et al., “Assessing Repeatability and Validity of a Visual Analogue Scale Questionnaire for use in Assessing Pain and Lameness in Dogs,” American Journal of Veterinary Research, Vol. 65, No. 12, 2004, pp. 1634-1643. doi:10.2460/ajvr.2004.65.1634
[15]	D. Hulse, B. Saunders, B. Beale, et al., “Extra-Articular Stabilization of the Cranial Cruciate Deficient Stifle with Anchor Systems,” Tieraztliche Praxis Kleintiere, Vol. 39, No. K, 2011, pp. 363-367.
[16]	K. Thieman, J. L. Tomlinson, D. B. Fox, et al., “Effect of Meniscal Release on Rate of Subsequent Meniscal Tears and Owner-Assessed Outcome in Dogs with Cruciate Disease Treated with Tibial Plateau Leveling Osteotomy,” Veterinary Surgery, Vol. 35, No. 8, 2006, pp. 705-710. doi:10.1111/j.1532-950X.2006.00214.x
[17]	M. B. Mueller, H. H. Fredrich, E. Steinhauser, et al., “Biomechanical Evaluation of Different Suture Anchors for the Stabilization of Anterior Labrum Lesions,” Arthroscopy, Vol. 21, No. 5, 2005, pp. 611-619. doi:10.1016/j.arthro.2005.01.012
[18]	D. C. Meyer, R. W. Nyffeler, S. F. Fucentese, et al., “Failure of Suture Material at Suture Anchor Eyelets,” Arthroscopy, Vol. 18, No. 9, 2002, pp. 1013-1019. doi:10.1053/jars.2002.36115
[19]	S. A. Aktay and M. P. Kowaleski, “Analysis of Suture Anchor Eyelet Position on Suture Failure Load,” Veterinary Surgery, Vol. 40, No. 4, 2010, pp. 418-422. doi:10.1111/j.1532-950X.2011.00834.x
[20]	F. A. Barbar, M. A. Herbert, R. C. Beavis, et al., “Suture Anchor Materials, Eyelets, and Designs: Update 2008,” Arthroscopy, Vol. 24, No. 8, 2008, pp. 859-867. doi:10.1016/j.arthro.2008.03.006