Więzadło krzyżowe przednie u psów – dlaczego dochodzi do przerwania ciągłości i jak to naprawić?

Tibial Tuberosity Advancement (TTA according to Montavon and Tepic)

The procedure presented consists in advancing the tibial tuberosity, in order to position the patellar ligament perpendicularly to the tibial plateau, thereby reducing the tibiofemoral shear force (CTT) to zero and easing the function of the deficient CrCL. The lesser invasive technique reduces operative time and perioperative morbidity. Respecting the normal range of flexion of the stifle should make a meniscal release, hence a loss of intraarticular caudal support, not necessary. Decreased retropatellar pressure could alleviate the sulcus chondromalacia present in about 30% of the cases. These advantages should improve the short and long-time results of the surgical treatment of cranial cruciate deficient stifle.

Mediolateral radiographs of the stifle in extension, avoiding the cranial drawer phenomenon in the presence of total rupture of the cranial cruciate ligament are necessary to figure out the angle necessary to bring the patellar ligament perpendicularly to the tibial plateau. The patellar ligament is represented by its cranial border, the orientation of the tibial plateau by a line passing through both tibial origins of the cranial and caudal cruciate ligaments.

Arthroscopy or medial arthrotomy is performed in case of total cranial cruciate ligament rupture to explore the stifle joint and treat eventual meniscal lesions. There is still a great debate whether to release the medial meniscus or not. According to in-vitro [...]

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