Theory & Principles
A ruptured cranial cruciate ligament (“CrCL”, also referenced as “CCL”; the human equivalent is “ACL”) is one of the most common orthopedic injuries in dogs. NAHAH’s Multi Filament Load Sharing (MFLS) surgical services are a more natural approach to treating canine cranial cruciate ligament injuries. NAHAH’s MFLS surgical services do not change the anatomy of the canine stifle joint and restores the same stifle joint function that existed prior to injury. Restoring the natural, authentic, and evolved stifle joint function preserves bilaterally symmetrical stifle function thereby preserving balanced and symmetrical hind limb function and the overall bilateral symmetry of the canine patient’s body.
Osteotomy (bone-cutting) surgical procedures do not restore natural stifle joint function, instead, these procedures create a new and different way for the stifle joint to function (the biomechanics). Once the stifle joint anatomy has been surgically altered and the biomechanics of the joint re-engineered, a newly created dichotomy exists between the way the surgically repaired stifle joint—and limb as a whole—now function, as opposed to the way the opposite limb stifle joint—and limb as a whole—continue to function in the original, natural and evolved manner. This newly created and unnatural dichotomy in stifle function then allows for asymmetrical and discordant hind limb function with one stifle functioning in an entirely new way through human engineering and surgery, and the other stifle continuing to function in the naturally evolved way that required millions of years of evolution to develop and refine through the forces of natural selection.
The driving forces behind natural selection are genetic variation within a population, environmental pressures, and differential reproductive success. These forces take an enormous amount of time to gradually manifest their advantageous changes in a given population of living organisms, ultimately attaining a result that forever remains in progress over time. As the environment and environmental pressures are always changing, organisms with traits better suited to their environment are more likely to survive and reproduce, passing on those advantageous traits to their offspring. This leads to evolutionary change over time. As this applies to CrCL injuries in dogs, rather than creating an entirely new and different way of functioning in a matter of just a few hours, it is our opinion and conclusion that the patient will be better served by striving to duplicate and restore the natural and authentic evolved way of functioning and so preserve balanced and bilaterally symmetrical stifle and hind limb function.
The primary goal of NAHAH’s MFLS surgical services is stabilization of the injured stifle joint and restoration of the natural, authentic, and evolved stifle biomechanics in the joint. Attaining this primary goal preserves bilaterally symmetrical and balanced stifle joint and hind limb function, and in doing so, simultaneously reduces the risk of opposite limb cranial cruciate ligament (CrCL) tears – an important secondary goal of MFLS surgery. Based on our retrospective clinical cohort study of 834 MFLS surgeries, the successful restoration of the natural, authentic, and evolved stifle biomechanics—and preserving bilaterally symmetrical and balanced stifle function appears to substantially reduce the risk of opposite limb cranial cruciate ligament tears.
Surgical procedures that do not restore natural stifle biomechanics (and so fail to preserve bilaterally symmetrical and balanced stifle function) establish a dichotomy in stifle joint function that allows for asymmetrical, discordant, and unharmonious stifle and hind limb function. This dichotomy in stifle joint function prevails and is ongoing after surgery, and may contribute significantly to increased risks of opposite limb cranial cruciate ligament tears as a result.