Cruciate Repair - Surgical versus Medical
May 15, 2013, Vol. 242, No. 10, Pages 1364-1372
Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically
Katja L. Wucherer, DVM; Michael G. Conzemius, DVM, PhD, DACVS; Richard Evans, PhD; Vicki L. Wilke, DVM, PhD, DACVS
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108. (Wucherer, Conzemius, Wilke)
Objective—To determine short- and long-term rates of successful outcomes of surgical and nonsurgical treatments for overweight dogs with cranial cruciate ligament rupture (CCLR).
Design—Prospective, randomized, clinical trial.
Animals—40 client-owned overweight dogs with unilateral CCLR.
Procedures—Dogs were randomly assigned to nonsurgical (physical therapy, weight loss, and NSAID administration) or surgical (tibial plateau leveling osteotomy) treatment groups; dogs in both groups received the same nonsurgical treatments. Dogs were evaluated immediately before and 6, 12, 24, and 52 weeks after initiation of treatments via owner questionnaires, gait analysis, and dual-energy x-ray absorptiometry. A successful outcome was defined as an affected limb net ground reaction force > 85% of the value for healthy dogs and a ≥ 10% improvement in values of questionnaire variables.
Results—Owner questionnaire responses indicated dogs in both groups improved during the study, but dogs in the surgical treatment group seemed to have greater improvement. Body fat percentages for dogs in both treatment groups significantly decreased during the study. Surgical treatment group dogs had significantly higher peak vertical force for affected limbs versus nonsurgical treatment group dogs at the 24- and 52-week evaluation times. Surgical treatment group dogs had a higher probability of a successful outcome (67.7%, 92.6%, and 75.0% for 12-, 24-, and 52-week evaluations, respectively) versus nonsurgical treatment group dogs (47.1%, 33.3%, and 63.6% for 12-, 24-, and 52-week evaluations, respectively).
Conclusions and Clinical Relevance—Overweight dogs with CCLR treated via surgical and nonsurgical methods had better outcomes than dogs treated via nonsurgical methods alone. However, almost two-thirds of the dogs in the nonsurgical treatment group had a successful outcome at the 52-week evaluation time.
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