Lateral fabella surgery, most commonly known as the lateral fabella suture (LFS) technique, lateral retinacular suture, or the DeAngelis suture, after the veterinary surgeon who developed the procedure in the 1970s, is a type of canine surgery designed to treat knee injuries to the cranial cruciate ligament. Complications of canine knee surgery are mostly tied to its invasiveness and the fact that lateral fabella surgery is extra-articular, meaning that the surgeon stabilizes the joint from the outside.
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Loosening of Sutures
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Lateral fabella surgery involves heavy nylon sutures placed around the lateral fabella and tied on the outside to replicate the function of the cranial cruciate ligament after it has been damaged. Because these sutures are tied around the joint, motion of the joint over time can loosen the sutures, particularly in dog breeds weighing over 40-45 pounds. Although all of the sutures can be expected to loosen or break eventually, broken or loose sutures too soon after surgery may require a second surgical intervention. Broken pieces of sutures or screws may also need to be removed from the joint if they interfere with normal knee function after surgery.
Swelling and Drainage
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According to James Tomlinson of the American College of Veterinary Surgeons, swelling and drainage are the two most common type of complications for LFS canine knee surgery. As many as 18 percent of cases experience swelling in the soft tissue around the joint, and 21 percent experience wound drainage, often as a result of infection of the surgical incision. Infection may be a result of normal surgical procedure or improper bandaging or wound care post-operation. Untreated swelling and drainage may also lead to further complications in canine knee surgery and other types of surgery.
Fracture
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Recent adaptations of the lateral fabella surgery require drilling of bone for tying the sutures, and this drilling can result in bone fracture during surgery. Drilling is riskier for smaller breeds of dog than for larger breeds, and veterinary surgeons will typically avoid drilling in the highest risk cases. Additionally, dogs are at risk for fracture in any of the bones involved in the knee joint following canine knee surgery because of the stress placed on the joint during recovery. Possible fractures include the tibial tuberosity fracture, delayed union fracture, fibula fracture, and patella fracture. Additional fractures may require additional types of canine knee surgery to repair and stabilize.
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