Advances in the surgical treatment of canine stifle joint affections

Abstract

The canine stifle joint, anatomically analogous to the human knee, is frequently afflicted by conditions such as cranial cruciate ligament rupture (CCLR) and patellar luxation (PL), which are leading causes of lameness and degenerative joint disease. While these pathologies are well-characterized individually, their concurrent presentation poses a significant diagnostic and therapeutic challenge, often culminating in end-stage osteoarthritis. This review explores recent advances in the surgical management of these common stifle disorders. For CCLR, evolving techniques include tibial osteotomy procedures like the Tibial Plateau Leveling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA), which aim to neutralize cranial tibial thrust and are often considered superior to traditional extracapsular or intra-articular methods. Surgical correction for PL involves a combination of soft tissue reconstruction, trochleoplasty, and tibial tuberosity transposition, with corrective osteotomies reserved for cases with significant bony deformities. In end-stage disease where conservative management fails, salvage procedures are necessary. Stifle joint arthrodesis (SJA) provides a permanent, pain-free fusion at the cost of joint motion. As a limb-sparing alternative that preserves mobility, total knee replacement (TKR) is emerging as a definitive solution. This review synthesizes the indications, techniques, and outcomes for these surgical interventions, highlighting TKR as an advanced, motion-preserving option that effectively alleviates pain and restores function, thereby improving patient welfare and preventing extremity loss.