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Tips for the surgical repair of tears in the stifle lateral collateral ligament

Lateral collateral ligament repair.

  • Drill a hole [1.5mm diameter for the Size 1 Han-de ligature] from just above the origin of the collateral ligament on the lateral femoral condyle to a point on the medial femoral cortex just proximal to the trochlea. See ‘Tips for the surgical repair of a torn cruciate’ for details of the technique.

  • Use the loop passer to place a loop of suture material up the bone tunnel.

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  • Identify the midpoint of the fibular head and drill a hole [1.5mm diameter for Size 1 Han-de ligature] through the head at an angle of 45 degrees.

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  • Make a small incision running along the cranial border of the fibular head to reflect  a small area of muscle off the fibula.

  • With a small semi-circular suture needle, thread a loop of strong suture material through the hole.

  •  Let the needle follow its natural curve to emerge from the muscle belly cranial to the incision.

  • Remove the needle from the suture loop.

  • Then with a pair of forceps placed in the incision, pick up the loop and withdraw it out through the incision.

  • Now change your surgical gloves, open the Han-de ligature and lock the ligature onto the toggle.

  • Place the ligature into the distal loop and pull the ligature through the hole in the fibular head.

  • Pull both ligature strand and tuck the toggle under the fibular head.

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  • Thread the ligature into the femoral loop and pull through to the medial femoral surface.

  • Thread the second toggle onto the ligature and place the toggle on the medial femoral cortex.

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  • Adjust the tension and tie two throws of a surgeon’s knot over the toggle.

  • Test the range of motion of the joint and the joint tension. The tension in both medial and lateral compartments of the stifle should be equal. Do not over tighten.

  • Complete the knot with multiple[4] throws.

 

 



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