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Management of the ruptured Cranial Cruciate Ligament (CrCL) - Lateral Suture System
Management of the ruptured Cranial Cruciate Ligament (CrCL) by placing a non-absorbable suture
Management of the ruptured Cranial Cruciate Ligament (CrCL) by placing a non-absorbable suture between the lateral fabella and the proximal, cranial tibia has been routine since DeAngelis first reported the technique in 1970. Today it remains the extracapsular technique of choice.
Conzemius in 2005 in the Journal of American Veterinary Medical Association, using force plate analysis, compared the outcomes of TPLO and lateral suture performed by the same surgeon. He reported no significant difference in outcomes. The ideal lateral suture would join points of isometry in the femur and tibia. This would mean that as the stifle is flexed and extended the distance between the location points and therefore the length of the suture would remain constant.
The points chosen for the lateral suture, the lateral fabella and the proximal cranial tibia, are not fully isometric but are chosen because of the ease of placing a suture. Using bone tunnels or suture anchors it is possible to place a suture isometrically but this is more technically demanding.