engleski

Rehabilitation of surgically managed cranial cruciate ligament rupture-case report

Cranial cruciate ligament rupture (CCLR) can be an acute orthopaedic disease as a result of trauma or it can occur gradually due to ligament degeneration. The ligament rupture causes joint instability and degenerative joint disease (DJD) which leads to continuous functional decline of affected limb. Five-year old female Labrador retriever was admitted to the Clinic with the signs of lameness, diminished weight barring, and muscle atrophy of the left hind limb. Patient's history included previously diagnosed coxarthrosis and obesity. Radiographic diagnostic showed signs of osteoarthritis of the left knee joint and further orthopaedic examination provided the diagnosis of CCLR. Rehabilitation program was started immediately after the tibial tuberosity advancement (TTA) surgery using different modalities of physical therapy. Cryotherapy and NSAID were used first few days post operation in order to reduce pain and inhibit the inflammation. Electrotherapy, as a form of analgesia, was used in the first week. Gentle passive movements were performed during the first week and continued throughout rehabilitation. Massage therapy was performed twice daily on both hind limbs, affected and healthy one. Goniometric measurements of the knee joint were taken three days after the operation. The extension range of the stifle joint was 150 degrees and flexion 60 degrees. Leash walks and controlled movement were advised during the entire rehabilitation period. Since the healing time after the TTA surgery requires several weeks, hydrotherapy and active exercises were started five weeks after the operation. Underwater treadmill sessions were set at a slow pace and short duration. The treatment started with maximum immersion with the tendency of gradually reducing its level and extending the length of time each week. After three months of rehabilitation, the normal gait was restored, with minimum difference between muscle girths and significantly increased range of motion (extension 159 degrees, flexion 48 degrees). This result showed that adequate rehabilitation program applied immediately after the CCLR repair surgery shortens the recovery period and has a positive impact on the improvement of lost limb function.

cranial cruciate ligament rupture; dog; rehabilitation

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