Topics of this event
Objectives of the course
One of the most common reasons for orthopedic examination in the dog is related to the cranial cruciate ligament (CrCL)-deficient stifle disease. Since the beginning of the 20th century, CrCL rupture in the dog has been widely studied, including its pathogenesis, diagnostic protocols and potential treatments. Scientific discussion has not brought conclusive results. Why does CrCL rupture? How can the disease be positively diagnosed? What are the therapeutical options for the many clinical presentations? What are the criteria for the choice of a surgical technique among the many proposed?
There is a broad agreement on the origin of CrCL affection. The vast majority of affected patients do not show a traumatic origin. The stifle is affected by an inflammatory and degenerative process that together with micro-traumas damage the CrCL collagen ultra-structure with subsequent loss of functionality.
The diagnosis of this disease includes clinical examination followed by radiographic
examination and other diagnostic techniques (Magnetic Resonance, CT scan, ultrasound), which can usually confirm the CrCL rupture or secondary changes due to the disease.
Furthermore, some different intra-articular disease, mostly related to the CrCL rupture, like meniscal involvement, can play a role in the final clinical result of the proposed treatment.
Among other techniques, Tibial Tuberosity Advancement (TTA) has been proposed as a treatment to stabilize the CrCL-deficient stifle. Now many variations of the technique exist.
The potential pros and cons of the proposed technique (Fig. 1) are the following.
- Ease of the technique. The osteotomy line is linear and performed on a bone structure with reduced muscular coverage, making the surgical approach easy and with reduced invasiveness.
- The structure of the porous TTA wedge and its cyclic loading in the postoperative period foster osteoinduction, accelerating bone ingrowth. The healing time is relatively short, reducing the need for bone grafting of the gap area.
- The 3D structure of the porous titanium wedge provides an excellent grip on the osteotomized area, firmly stabilizing the tibial crest in its advanced position.
- Resources optimization. The surgical procedure requires very few dedicated instruments.
- The technique causes a “patella baja” condition in the stifle. Though this condition is not clearly related to any specific disease, its long term effect is not known so far.
The event will be held in Pulawy Science and Technology Park, at ul. Moscickiego 1 in Puławy 24-110 (Puławy), Poland
The event will be held on the 2019-06-14 and will be beginning at 14:30
It will end on 2019-06-15 at 13:00
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