We discussed medial patellar luxation, a common orthopedic injury in small dogs, earlier this week. Big dogs have their own knee or stifle injury issues. Large breeds occasionally suffer from laterally luxating patellas but by far the biggest issue with big dogs are injuries to the cranial cruciate ligament. Sometimes referred to as the anterior cruciate ligament or ACL, this ligament helps stabilize the stifle joint keeping it from moving back and forth from front to back.
This is referred to as "drawer movement." The key diagnostic manipulation involves attempting to move the tibia forwards and backwards while keeping the femur or thigh stable. If you get movement, the ligament is damaged.
I've seen this test being applied on the sidelines of football, basketball, rugby and soccer games many times. It's a very common sports injury and occurs when an athlete attempts to change direction with the foot planted on the ground. Same thing happens in big dogs, especially big dogs that are carrying around a little more weight than they should be.
I blew my own knee out in a pick up basketball game at the Seattle YMCA several years back. This injury got me started on an obsessive compulsive cycling career including a late in life bike racing fixation. The racing career, as many readers already know, has led to a hip fracture and most recently a broken arm. Ironically, I played four years of high school football and three years of college rugby and never got a scratch.
Guess I'm getting fragile (or brittle, as my wife puts it) in my dotage.
For a long time, the same surgery I had was the procedure of choice in big dogs. This procedure involves taking a piece of the fascia lata (the fibrous fascia layer on the muscle of the thigh) and making a new ligament. This new ligament is then passed through holes drilled in both ends of the femur and tibia replacing the torn ligament.
My surgery worked great and has held up well for almost 17 years now.
This procedure is still done in Veterinary medicine along with other techniques that help stabilize the stifle joint.
In really big dogs, like the biggest dog in the world, a procedure called a TPLO or tibial plateau leveling osteotomy is often performed with good success. The idea is to reduce the angle of the stifle joint by surgically lowering the articular surface of the tibia. This helps reduce the strain on the cranial cruciate ligament during normal movement. It is often done on the unaffected leg of giant breeds to prevent this type of injury. This injury often comes in pairs as more than 40% of the time the other leg ends up with the same problem.
If your dog, especially your big dog, comes up with an acute hind limb lameness, injury to this ligament should be suspected. Often the injury is the result of a spirited game of fetch. Sometimes you have no idea what caused it. You may have just let the dog out in the backyard and she came back limping.
Just ask Yvonne. That's what happened to her and Carmel.
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