Cuncurrent Intra-articular Fascia Lata Flap and Extracapsular Bilateral Fabellar Techniques for Repair of CCL Rupture in a Dog: A Case Report

Background: Cranial cruciate ligament rupture in dogs is a significant cause of lameness and instability in the hind limbs. It usually arises from degeneration and trauma, causing pain, inflammation, and abnormal movement of the tibia. It may progress to osteoarthritis and muscle atrophy if left untreated; thus, early diagnosis and surgical stabilization are imperative for long-term mobility and recovery. Methods: A ۱۵ kg, ۴-year-old male Golden Retriever dog with body condition score mildly overweight was presented with acute onset of lameness of the right hind limb following exercise five days earlier. The orthopedic examination revealed pain and a positive cranial drawer test, with radiographic findings of complete cranial cruciate ligament rupture. Following aseptic preparation, a lateral parapatellar skin incision was employed to expose the stifle joint. A U-shaped fascial flap was harvested from the Tensor fascia lata muscle but sparing its distal muscular attachment to preserve blood supply. The muscular portion was trimmed to facilitate passage through bone and capsular tunnels. A polyester suture was fixed to the fascial flap in the form of a Bunnell-Mayer pattern, and the loose end was passed through a pre-drilled hole from the lateral to medial aspect of the tibial tuberosity. Medial arthrotomy was done, joint space was inspected and the remaining portion of the ruptured ligament was removed by debridement, and lavaging of the joint was done thoroughly. A drill hole was made from the intercondylar area to the lateral aspect of lateral femoral condyle. The fascial flap, was subsequently passed through the joint capsule and this femoral tunnel, then anchored to the lateral joint capsule using PGA and polyester sutures. The joint capsule was closed in a routine manner. An extracapsular suture was included for stability around the bilateral fabella then passed through the tibial tunnel to limit cranial tibial translation, followed by routine closure of the balance soft tissues. Results: The dual stabilization technique successfully restored stifle function, minimized instability, and promoted accelerated functional recovery. Conclusion: This case demonstrates that combining intraarticular fascia lata grafting with extracapsular bilateral fabellar suture augmentation offers enhanced biomechanical strength by supporting both intra-articular and extra-articular structures.

کلیدواژه ها:

CCL rupture ، Intracapsular ، Fascia Lata Flap ، Extracapsular