Novel crescentic, medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy for lateral compartment stifle disease with partial cranial cruciate ligament tear in two dogs

ABSTRACT

Case history:

Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle.

Clinical findings:

No hindlimb deformities were present on physical examination or radiographic evaluation. No stifle instability was present. Arthroscopy revealed severe (grade 5/5 modified Outerbridge score) cartilage erosion in the lateral compartment (femorotibial), marked degeneration of the lateral meniscus and early cranial cruciate ligament disease in both patients.

Treatment and outcome:

Medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy (mcmtCBLO) was performed in both patients. The procedure aims to shift the pelvic limb’s mechanical axis medially to reduce pressure in the lateral compartment while also reducing craniocaudal shear forces by lowering the tibial plateau angle.

Eight weeks after surgery one patient’s lameness had resolved while the other had improved significantly. Second-look arthroscopy performed at this time revealed fibrocartilage formation in the lateral compartment without progression of cruciate disease in both cases. At long-term follow-up (approximately 3 and 5 years), favourable outcomes (no or minimal lameness, mild or moderate osteoarthritis) were identified on the long-term owner survey, lameness examination and radiographs.

Clinical relevance:

mcmtCBLO reduced or eliminated short- and long-term lameness in these two cases afflicted by concurrent lateral compartment and early cranial cruciate ligament disease.

KEYWORDS:

• Cranial cruciate ligament disease
• dog
• stifle
• tibia
• lateral compartment disease
• osteotomy

Acknowledgements

EJ Mclean contributed to the conception of the study, retrospective review of clinical records, data acquisition, and drafted the manuscript. RG Cashmore conceived and performed the described surgical procedures, conception of the study, and critically reviewed the manuscript. Both authors finally reviewed, approved and submitted the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.