Técnica de interligação extracapsular femoro-fabelo-tibial na ruptura do ligamento cruzado cranial em cães – achados clínicos e radiográficos

Abstract

Cranial cruciate ligament rupture (CCLR) is a common disease in dogs that cause joint instability resulting in lameness and rapid development of degenerative joint disease (DJD). The aim of this work was evaluate the results of a new technique of restoration of joint femur-fabelo-tibial stability for the treatment of spontaneous CCLR in dogs, using for this purpose clinical and radiographic features. Sixteen joint of fifteen dogs were operated, six male and nine female, with weight between 2.3 to 53.0 kg (median 8.4 kg) and age between 1 year and 10 months to 11years (mean 6.1± 2.8 years), miscellaneous breed and that the interval between the suspect of lesion by the owners and the surgical procedures varied between 3 to 365 days (mean 123 ±131.5 days), were submitted to the surgical correction though the extracapsular femur-fabelo-tibial interconnection technique. The tibial compression radiographs and the distal displacement of the popliteal sesamóide were 100 per cent efficient and sensitive to the diagnostic of CCLR. In anyone of the sixteen operated joint were observed difficulty or intra-operative complication. In 3 dogs were observed discreet instability (until 2mm) in the cranial drawer test and the tibial compression test, until 180 days; however these dogs didn’t show any damage in the functional evaluation in this period. In another three operated joints a discreet degree of cranial drawer remains until the 30º day, disappearing completely at 90 days. After 30 days of the surgery all the animals showed a improvement (P≤0.05) in the evaluated parameters, with progressive improvement until the 90 days after the surgical. There was no more change statistically significant, although observed clinical improvement until 180 days, when all the animals showed complete functional recovery. The increase (90 and 180 days) in the thigh perimeter weren’t statistically significant. Among 20 joints evaluated (operated or non operated) radiographically between 0 and 180 day, the evolution of degenerative changes was seen in 90 per cent of joints. It was possible conclude that the extracapsular femur-fabelo-tibial interconnection technique evaluated in this experiment is efficient in the immediate stabilization of joint with CCLR, offering functional recovery for reduce the cranial displacement and internal rotation of the tibia, however it not arrest the osteoarthritis progression. Secondarily it can be conclude that: the nylon strands despite its elasticity and plastic deformation can produce a discreet clinical instability, it continue been a good option for joint stabilization because of its low cost, feasibility of sterilization, no production of fistulous tracts and disposability of different diameters with variable resistance adequate for the animal size. Thick strands of difficult management can be arrest through by crimp clamp system with relative facility. Another important conclusion is that like the radiographic tibial compression test, the orthopedic evaluation with tibial compression test and cranial drawer test is 100 per cent efficient in the diagnosis of CCLR, in dogs.