Bilateral tibial tuberosity advancement and medial patellar luxation repair in a one-year-old mixed breed dog

A one-year-old spayed female mixed breed dog presented to the Cornell University Hospital for Animals Orthopedics service in January 2012, for left hind limb lameness. The lameness had begun suddenly one month earlier while the patient was playing with other dogs, and it recurred after exercise or long periods of rest. She also had a three-month history of medial patellar luxation in her right hind limb that had never previously been treated. On presentation, the patient was ambulatory on all four limbs with no gait abnormalities or visible lameness. Orthopedic examination revealed bilateral positive cranial drawer signs, bilateral tibial thrust, bilateral Ortolani signs, a grade 2 medial patellar luxation in her right hind limb, and a grade 1 medial patellar luxation in her left hind limb. Lateral stifle radiographs were obtained but revealed no abnormalities. However, based on physical examination, bilateral cranial cruciate ligament rupture and bilateral medial patellar luxation were presumptively diagnosed. The patient’s owner elected to pursue surgical treatment rather than attempting conservative management. Bilateral tibial tuberosity transposition advancement with lateral imbrication was performed to simultaneously correct the medial patellar luxation and presumptive cranial cruciate ligament rupture. This paper will discuss the diagnosis, surgical treatment, recovery, and prognosis of both cranial cruciate ligament rupture and medial patellar luxation