Surgical management of cranial cruciate ligament rupture and concurrent medial patellar luxation in a small breed dog by means of a modified cranial closing wedge ostectomy and tibial tuberosity transposition.

Abstract

Medial patella luxation (MPL) is a common cause of hindlimb lameness in small breed dogs and is associated with concurrent cranial cruciate ligament (CCL) rupture in up to 40% of cases. This case report describes a surgical technique that addressed both conditions concurrently. A four-year-old castrated, male Yorkshire Terrier presented with a chronic (two months) intermittent grade 3/5 lameness of the right pelvic limb that progressed to an acute non-weight bearing grade 5/5 lameness (Impellizeri et al. 2000). A clinical diagnosis of a grade 3 MPL and a concurrent CCL rupture of the right pelvic limb was made. A modified cranial closing wedge ostectomy (mCCWO) and a tibial tuberosity transposition (TTT), with a wedge trochleoplasty, were performed. The patient recovered uneventfully, and no lameness was detected at six weeks follow-up. No lameness or other incidents were reported by the owner on telephonic contact three months postoperatively. A follow-up clinical evaluation and lameness examination were performed at 12 months, and there was, subjectively, no visible lameness, and the radiographs showed radiographic union. This surgical technique has been shown to be an effective and viable option in this small breed patient to treat both conditions in one surgical procedure, but warrants further investigation with larger case numbers.