title: Systematic review of surgical treatments for cranial cruciate ligament disease in dogs.
abstract: Surgery for cranial cruciate ligament disease is often recommended; however, it is unclear if one procedure is superior. The aim of this systematic review was to answer the a priori question, "Is there a surgical procedure that will allow a consistent return to normal clinical function in dogs with cranial cruciate ligament disease and is that procedure superior to others?" A systematic literature search was performed through September 2013. Peer reviewed publication in the English language and 6 mo of postoperative follow-up were required. In total, 444 manuscripts were identified and reviewed, and 34 met the inclusion criteria. Two studies provided level 1, 6 provided level 2, 6 provided level 3, and 20 provided level 4 evidence relative to the study question. The most common surgical procedures included tibial plateau leveling osteotomy (TPLO, n = 14), lateral extracapsular suture (n = 13), tibial tuberosity advancement (n = 6). The strength of the evaluated evidence most strongly supports the ability of the TPLO in the ability to return dogs to normal function. It also provided strong support that functional recovery in the intermediate postoperative time period was superior following TPLO compared with lateral extracapsular suture. There was insufficient data to adequately evaluate other surgical procedures.
authors.affiliation: Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA (M.B., C.S., J.T.); Department of Small Animal Medicine and Surgery, The University Of Georgia College of Veterinary Medicine, Athens, GA (C.F., S.B.).
authors.forename: Mary Sarah
authors.initials: MS
authors.lastname: Bergh
authors.forename: Carly
authors.initials: C
authors.lastname: Sullivan
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Ferrell
authors.forename: Jarrod
authors.initials: J
authors.lastname: Troy
authors.forename: Steven C
authors.initials: SC
authors.lastname: Budsberg
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D007592:Joint Diseases / Q000601:surgery / Q000662:veterinary*; D010027:Osteotomy / Q000662:veterinary*; D011183:Postoperative Complications / Q000662:veterinary; D020127:Recovery of Function; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome