Reconstruction of Collateral Ligaments
Collateral ligament injuries are common in small animal patients. Traumatic injuries can result in tears of the ligaments, avulsions of ligament origins/insertions, or loss of ligaments from shearing injuries. Torn collateral ligaments are often sutured for primary reconstruction; however, due to the slow healing and remodeling of collateral ligament tears, it is common to utilize sutures and anchors to support a primary repair. Placing a suture anchor at origin and insertion of the collateral ligament and spanning the two anchors with a relatively strong strand of suture material is a typical method of supporting primary ligament repair. Collateral ligament avulsions are repaired by placing a single suture anchor at the avulsion site and then reattaching the ligament to the bone via the anchor. Some surgeons will elect to include a second anchor and suture loop to create a prosthetic ligament to protect the avulsion site during the early healing phase (similar to protection of a primary repair). Injuries, such as shearing injuries, resulting in actual loss of the collateral ligament, carry a more guarded prognosis. However, suture anchors can be utilized to facilitate placement of prosthetic ligaments that serve to maintain joint stability during the formation of functional fibrous tissue, which helps maintain joint stability over time.
Stabilization of Shoulder Subluxation and Luxation
Primary, traumatic luxation of the shoulder joint is uncommon in small animal practice, but can occur. Congenital and developmental shoulder subluxation and luxation occur in small breed dogs and chronic shoulder instability occurs in large breed, athletic dogs. Surgical stabilization for these cases can include joint capsule imbrication and prosthetic suture placement to provide reduction and strength for supporting tissue healing and strengthening of the rotator cuff. Suture anchors can be utilized for attaching these periarticular sutures. Anchors can also be used for reattaching avulsed joint capsules or glenumeral ligaments to bone.