Cranial Cruciate Ligament Debridement in Cats

The cranial cruciate ligament in cats is a ligament located within the knee joint. The cranial cruciate ligament is one of two cruciate ligaments that allow the knee to move in a hinge-like fashion. Because it is one of the weakest joints in the cat’s body, the ligaments in the knee joint are susceptible to tear and rupture. If left untreated, these conditions can lead to permanent complications in the joint, including osteoarthritis. The treatment of choice for these injuries will depend on their severity. Some cases of partial rupture may be treated using conservative methods, particularly medical management. Surgery is recommended for more severe cases. Debridement, or the removal of damaged tissue, is usually only part of the surgical procedure.

Debridement of the cranial cruciate ligament is typically only part of the surgical procedure used to repair cranial cruciate ligament injury. Debridement is employed when the tissue is diseased in some way. The general steps for debridement are listed below.

1. The cat will be anesthetized and prepped for surgery.
2. X-rays will be taken to visualize the injury.
3. The surgeon will make the incision into the skin and then the joint capsule.
4. The surgeon will utilize the appropriate surgical approach to repair the joint. This may involve using permanent suture to stabilize the joint.
5. Once this is complete, debridement is started. This involves removing diseased cranial cruciate ligament tissue with a specialized blade.
6. During debridement, osteophytes, or growths which occur when the cartilage of a joint degenerates, will also be removed.
7. Additional surgical approaches may be required before the site is sutured.

The efficacy of this procedure will vary depending on the severity of the injury. However, surgery is considered one of the most effective ways to manage this condition. The most common complication of cranial cruciate ligament debridement – and the overall surgery – is delayed healing. This generally occurs when the cat begins engaging in activity too soon after surgery. Even with surgery, there is a high chance that the cat will develop arthritis or other joint conditions later in life.

The recovery period for the full surgery is extensive and typically lasts from nine to twelve weeks. Cats will need to be confined to a crate or small room for the first two weeks following surgery. Analgesics, anti-inflammatories, and other medications will be prescribed as required. Owners may need to apply hot or cold packs to the injury site as instructed by the surgeon or veterinarian. Range of motion exercises may need to be performed by the owner or by a certified veterinary physical therapist. Follow-up appointments will be scheduled within eight weeks postoperatively to monitor healing. If, during this appointment, the cat is normally bearing weight on the operated leg once again, the surgeon may choose to lift any activity restrictions.

If owners observe swelling, bleeding, or drainage near the surgery site, they should contact their vet immediately. If the cat starts dragging its foot after surgery, the veterinarian should also be consulted immediately as this is a sign that serious damage to the peroneal nerve has occurred.

The cost of cranial cruciate ligament debridement will vary based on standards of living as well as additional costs incurred. The cost of cranial cruciate ligament surgery, including debridement, ranges from $500 to $2,500. The average cost of treating this condition is $1,000.

Complications can occur during any surgical procedure. Complications of cranial cruciate ligament debridement include, but are not limited to:

• Delayed healing of the joint
• Severe swelling
• Injury to the peroneal nerve
• Serious pain as a result of injury to the peroneal nerve
• Anesthetic death

Keep in mind most of these complications are associated with the entire surgical procedure rather than the debridement itself. Debridement is only one facet of joint surgery to repair cranial cruciate ligament rupture. Anesthetic death is especially rare in animals that have been evaluated for anesthetization prior to surgery.

The main cause of cranial cruciate ligament rupture is traumatic injury, particularly falling from a height. Owners should ensure their cats do not engage in activities which may result in cranial cruciate ligament rupture or stifle joint disruption.