Cranial Cruciate Repair Instructions
Click here for Crimping 101, proper crimping patterns for the SECUROS crimping device.
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The 80# or 40# monofilamet nylon suture, supplied by SECUROS, is placed extra-articular using the DeAngelis technique. Place the suture loop around the lateral fabella and through two holes in the tibial tuberosity or through one hole and the distal patella ligament.
Figure One: Shows the monofilamet nylon suture placed around the lateral fabella and through a hole drilled in the tiberal tuberosity.
Note: For very large dogs you may want to use two lateral sutures or one lateral and one medial.
Note: Remember that this is an extra-articular technique. For illustration only, the figure does not show any soft tissue.
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Slide one suture end at a time through one of the surgical crimp clamps. Once both ends have been placed through the surgical crimp clamps, pull the ends so that the loop becomes taught. Move the crimp clamp to the location illustrated in figure 2.
Note: Some surgeons like to place the crimp clamp in other locations, the location is subject to the specific surgeon’s preference.
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Slide each individual end of the suture through and additional crimp clamp (secondary crimp clamp), placing the additional crimp clamps approximately 2-3mm from the center crimp clamp (primary). Once the additional crimp clamps are at the correct distance from the center crimp clamp, use the crimping tool to firmly crimp these crimp clamps three times.
Note: Be sure that the secondary crimp clamps are firmly crimped. If they are not crimped enough they may slip during step 4. If they do slip, slide them back to their original position and crimp them a second time in a different location.
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Slide the slotted tips of the tensioning device over the suture (the suture goes into the slots) on either side of the primary crimp clamp. Each tip of the tensioning device should be between the primary crimp clamp and of the secondary crimp clamps.
Squeeze the arms of the tensioning device allowing the device to advance one click at a time. After each click, you should palpate the joint to check cranial drawer and range of motion. BE CAREFUL, you can apply a lot of tension very easily, go slow!
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Once the desired loop tension is obtained, crimp the primary crimp clamp using the crimping tool. For best results crimp the primary crimp clamp once in the middle then once on either end. When crimping on the ends be sure to split the distance beteween the center and end of the crimp clamp.
When crimping the crimp clamps, make sure that you are crimping with the oval cross section of the clamp. This tool is designed so that it is very difficult to over crimp the clamps. Because the tool is double action only one hand should be used when crimping.
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Remove the Tensioning Device and cut off the two secondary crimp clamps. Leave appoximately 3-5mm of suture beyond each side of the primary crimp clamps.
CLOSE!