Abstract

Background
Cranial cruciate ligament rupture (CCLR) is a leading cause of lameness in dogs, often requiring surgical stabilization. Tibial plateau leveling osteotomy (TPLO) is a widely used procedure; however, postoperative instability, including the pivot shift phenomenon, can occur. This case highlights the need for additional stabilization techniques when TPLO alone is insufficient.

Case Description
A 5 kg toy poodle presented with right hind limb CCLR. The tibial plateau angle (TPA) was 25°, and no injury was observed in the medial meniscus. TPLO was performed, but postoperative instability due to the pivot shift phenomenon was observed. To restore joint stability, a lateral fabellotibial suture (LFTS) was placed. Eight weeks later, lameness developed in the left hind limb, and orthopedic examination confirmed CCLR with a TPA of 25° and an intact medial meniscus. LFTS was applied to the left stifle joint due to recurrent instability following TPLO. Postoperatively, stifle joint stability was regained in both hind limbs.

Conclusion
While TPLO is an effective treatment for CCLR, some cases may require additional stabilization. This case suggests that LFTS can be a valuable adjunct for managing postoperative instability in small-breed dogs, improving surgical outcomes when the pivot shift phenomenon occurs.

Key words: cruciate ligament rupture; lateral fabellotibial suture; pivot shift phenomenon; tibial plateau leveling osteotomy; toy-breed dog