Canine Cruciate Surgery

Canine Cruciate Surgery

Dr Rob Hill Bunbury veterinarian professional development

This is the most common orthopeadic injury in the dog. We are able to help with surgical and non surgical treatments.

As well as canine cruciate surgery, we offer a non surgical option such as a stifle orthotic brace which many people prefer over having invasive surgery on their pet.

We also offer laser treatment to reduce pain and accelerate healing for acute injuries or for post operative pain or for osteoarthritis that may develop later in life following cruciate rupture and joint pathology.

We also offer platelet rich plasma therapy.

We are one of the few hospitals in Australia that can offer your pet stem cell therapy putting new life into old bones.

Read on for more detail about canine cruciate surgery.

TPLO cruciate surgery Treendale Pet Medical Veterinary Hospital Bunbury

What are the alternatives to surgery for a dog with canine cruciate disease? Surgery is usually the best option due to instability in the stifle following damage to the CCL. Instability causes shearing forces between the tibia and femur to slide across the menisci. The shearing forces can cause the meniscus to split causing a bucket handle tear. A torn meniscus is a disaster for the knee causing the rapid onset of degenerative joint disease and osteoarthritis and chronic pain. We advocate early intervention with TPLO surgery.

If you just don't want your dog to have surgery, it is possible to get an orthotic brace.

orthotic brace cruciate disease dog Treendale Pet Medical Veterinary Hospital Bunbury
                 Orthotic Stifle Brace

Alternatives to canine cruciate surgery involve stability using an orthotic brace, K-Laser therapy to stimulate healing and reduce inflammation, chondroprotective neutroceuticals such as 4Cyte joint supplements, monthly cartrophen injections and anti-inflammatory drugs such as Previcox. We can also offer Platelet Rich Plasma PRP therapy and even stem cell therapy. We do it all. Surgery or alternatives to surgery. We have it all covered to suit everybodies expectations.

Should I get a CWO, TTO, TTA, TPLO, CBLO cruciate surgery for my dog with canine cruciate disease?

It sure is confusing!

Cranial Wedge Osteotomy went out with the dark ages. It causes the patella tendon to be pulled down causing patella tendonitis, pain and even bone bruising under the patella that can lead to DJD and osteoarthritis. A frequent complication of CWO is also avulsion fracture of the patella.

Triple Tibial Osteotomy TTO is an Australian/NZ modification of the TPLO. It is a satisfactory procedure but there are three cuts of the tibia leading to more chance for complication.

Tibial Tuberosity Advancement TTA is a very poor technique. Recent papers suggest it is no better than an extracapsular repair. This procedure is fraught with complications. The thin piece of tibia often breaks. The implants are notorious for failing. This procedure has a high complication rate for very little benefit.

Cora Based Leveling Osteotomy CBLO is a recent technique that is being pushed as the best way to do canine cruciate surgery. It is essentially an upside down TPLO. The curved cut slides the tibial tubercle distally to lift the caudal tibia and reduce the tibial plateau angle. Unfortunately, this technique also creates severe strain on the patella tendon by pulling it down leading to all the same complications of the CWO - patella tendonitis, pain under the patella and a high risk for patella fracture and patella tendon alvulsion. It is our opinion that this is not a good technique.

Tibial Plateau Leveling Osteotomy is still the gold standard in canine cruciate surgery. It reduces the tibial plateau angle without changing the location of the tibial tuberosity where the patella tendon attaches. It therefore does not change the dynamics of the patella function at all. Reducing the tibial plateau to 5 degrees takes away the need to have a cranial cruciate ligament.

At Treendale Pet Medical we now perform TPLO with state of the art implants - the KYON ALPS plates - Advanced Locking Plate System which can be used on all sized dogs from Toy Breeds to Giant Breeds

   ALPS TPLO plate cruciate surgery dog Treendale Pet Medical Veterinary Hospital Bunbury

The image above shows correction of the tibial plateau angle using a TPLO saw blade to make a curved cut and the osteotomy is immobilised using a TPLO plate.

  radiographs TPLO surgery dog Treendale Pet Medical Veterinary Hospital Bunbury

... The image above shows what a TPLO looks like radiographically.

TPLO canine cruciate surgery


This is what a torn meniscus looks like in a dog (image below). We are looking inside the canine stifle. The knee cap (patella) is pulled out of the wayand we are looking at the space between the femur and the tibia. The shiny part is the trochlear groove of the femur which is where the patella tracks. The frayed rope looking material in the middle is the torn cranial cruciate ligament CCL.

cruciate ligament dog Treendale Pet Medical Bunbury vet

The image above shows a damaged cranial cruciate ligament in the dog. The white frayed material in the centre of the joint is the ruptured CCL.

If your dog does not have surgery for canine cruciate disease, there is a high probability of meniscal injury. A torn meniscus is a disaster for the stifle (knee) in your dog. Meniscal injury is very painful but it also causes rapid and severe osteoarthritis to develop.

meniscal injury dog Treendale Pet Medical Bunbury Vet

The image above shows a ruptured cranial cruciate ligament in the dog and the meniscal probe is pulling forward a bucket handle tear in the caudal horn of the medial meniscus in this dog. Meniscal injury resulted from instability caused by a complete rupture of the CCL in this dog.

This dog had a meniscectomy (image below)
meniscectomy dog Treendale Pet Medical Bunbury Vet
The image shows a partial meniscectomy and the caudal horn of the meniscus has been removed. This piece of cartilage had become separated from the rest of the meniscus and had lots it's blood supply. See the pearly white colour of the femur in the stifle arthrotomy above. This is what a healthy meniscus should look like. Contrast the piece of dead cartilage in the image above. Note how it has changed from a vital and healthy pearly white colour to a devitalised yellow colour because the torn fragment of the meniscus is separated from ocygen and nutrients carried in the blood. This cartilage would have degenerated and broken away causing a joint mouse that floats around in the stifle joint causing terrible pain and causing the stifle to "lock" when it gets lodged between the femur and tibia. This is extremely painful. Dog's do much better when a damaged meniscus with diseased cartilage is removed.

After your pet has cruciate surgery at Treendale Pet Medical we use laser therapy to reduce pain and inflammation and halve the healing time of the wound to reduce wound licking and the risk of post operative infection.
laser therapy dog Treendale Bunbury Vet

Ask us about laser therapy for post operative analgesia, reduction of inflammation, reduction of pain and wound licking, faster wound healing, faster rehabilitation and treatment of osteoarthritis and post op pain.

Ask us about PRP Platelet Rich Plasma Therapy for your dog having cruciate surgery

Ask us about stem cell therapy for you pet
 
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