Short-term outcomes of cranial cruciate ligament rupture treated surgically with tibial plateau leveling osteotomy or non-surgically in small-breed dogs weighing less than 10 kg

Irin Kwananocha, Ekkapol Akaraphutiporn, Rutaitip Upariputti, Chalermpol Lekchareonsuk, Chalika Wangdee
J Vet Med Sci. 2024 Apr 10;86(4):428-435. doi: 10.1292/jvms.23-0512.

Cranial cruciate ligament rupture (CCLR) is a common cause of stifle joint pain in dogs.

This study assessed the short-term outcomes in the management of CCLR, with or without concurrent medial patellar luxation (MPL), in small-breed dogs, comparing surgical intervention using tibial plateau leveling osteotomy (TPLO) with non-surgical approaches. 

Dogs weighing less than 10 kg and suffering from CCLR were divided into two groups: surgical and non-surgical (nine stifles per group). Both groups followed the same rehabilitation protocol. Measurements were taken on days 0, 14, 28, 42, 56, 70, and 84. These measurements included the mean difference in orthopedic assessment score (diffOAS) and thigh muscle circumference (TMC) assessed by veterinarians, as well as the Canine Brief Pain Inventory score (CBPI) evaluated by the owners. Six stifles had concurrent MPL in the surgical group and five in the non-surgical group. No significant differences were observed in diffOAS (P=0.685), TMC (P=0.557), CBPI pain severity score (P=0.062), and CBPI pain interference score (P=0.29) between the two groups. However, both groups showed a significant decrease (P<0.05) in diffOAS and CBPI. The TMC remained relatively stable in the non-surgical group (P>0.05), but it significantly increased in the surgical group (P<0.05). 

Both groups demonstrated improved clinical outcomes in the short term, with no significant differences. However, cautious consideration should be given to a conservative treatment in small-breed dogs, particularly when considering the exclusive improvement observed in TMC within the TPLO group.