Castle Rock, CO
Pet Orthopedic Surgeries
Cranial Cruciate Ligament Rupture
Another important stabilizer in the stifle are the menisci. These also function as “shock-absorbers” in the stifle and are often torn or damaged at the time of the cruciate ligament tear.
Cranial cruciate ligament disease often refers to the process that causes the cruciate ligament to tear or rupture. The underlying reason is not completely understood but is a multimodal disease process that can include anatomic variations and the slope of the tibial tuberosity. Other contributing factors include; ligament degeneration, obesity, poor physical condition, genetics, conformation, and breed. Cruciate disease is often thought of as a disease of large breed dogs. While it is true that large breed dogs are more prevalent, small and medium-breed dogs are often affected as well.
Because this is a degenerative condition, approximately 40-60% of dogs that tear one cruciate ligament, may tear the other side. This occurs, on average, within 2 years.
Cruciate tears can be diagnosed with a combination of physical exam findings as well as radiographs (x-rays) of the knee. The diagnosis is confirmed with a surgical evaluation of the ligament. This can be performed via arthrotomy or arthroscopy.
There are several surgical treatment options for dogs with cruciate tears. The one that has shown to have the best short and long-term outcome is the Tibial Plateau Leveling Osteotomy (TPLO). This is a procedure that decreases the tibial slope to a point that eliminates the abnormal motion in the knee caused by the cruciate tear.
Medial Patellar Luxation (MPL)
Patellar luxation is a common finding in young small breed dogs but can also be found in large breed dogs. Even though your pet may have patellar luxation it may or may not require surgery.
We recommend correction of patellar luxation in patients that are experiencing consistent pain and lameness secondary to the luxation. You may notice that your dog skips on the affected leg or holds it up when running or walking. They may also stretch the leg backwards in order to replace the patella back in its normal location.
There are 4 procedures that are most often required to correct the luxation.
- The normal groove that contains the patella often has to be deepened (trochleoplasty) to maintain the patella in the proper location.
- The attachment of the patellar tendon (tibial tuberosity) may need to be realigned with the remainder of the limb by cutting the bone and moving the tuberosity to a more normal location.
- When the patellar luxation occurs toward the medial (inward) of the knee this tissue must be released (retinacular release) to allow the patella to return to its normal location and
- The tissue on the lateral (outward) side of the knee must be tightened (fascial imbrication) to keep the patella in place.
Hip dysplasia is a common problem diagnosed in mainly large breed dogs. It is a developmental disorder that starts with increased laxity in the hip joints which leads to abnormal articulation and wear of the joint surfaces. This leads to the formation of arthritis as the dog ages which can cause it to be painful and difficult for the dog to rise, run, jump, and play as they did before.
There are surgical options for hip dysplasia depending on the age of the dog.
- Juvenile Pubic Symphysiodesis (JPS) is a procedure that is designed for dogs between 16 weeks and 20 weeks of age. It causes a portion of the pelvis to be fused in a growing dog which causes the pelvis to grow in a way that actually increases the “tightness” of the joint. This decreases the wear of the joint and decreases the risk of arthritis in the future.
- Double Pelvic Osteotomy (DPO) is a procedure that is performed in young dogs (<1yr) that have laxity but no evidence of arthritis and relatively normal hip conformation. Two cuts are made in the pelvic bone that allow the acetabulum (cup) to be rotated over the femoral head, increasing the coverage and decreasing the progression of arthritis in the future.
- The best option for dogs with hip arthritis is a total hip replacement (THR). This procedure replaces the acetabulum (cup) as well as the femoral head (ball) to eliminate the pain associated with the cartilage damage and arthritis that has developed. A total hip replacement is as close to a normal hip as possible and can allow dogs to return to normal function after the post-operative recovery period.
- The second option for dogs with severe hip arthritis is a Femoral Head and Neck Ostectomy (FHO). This is a procedure where the femoral head and neck are removed from the socket joint. Scar tissue forms a “false joint” that eliminates the bone-on-bone contact associated with severe arthritis. This procedure is better tolerated in cats and small dogs (<20 pounds). Hip luxations can also be treated with an FHO or total hip replacement. More commonly we treat hip luxations with a Toggle Pin repair technique that allows your dog to maintain their own hip joint.
Dogs can be affected by one or multiple components of this condition. In most cases, it can be treated arthroscopically which minimizes surgical trauma associated with a large incision into the joint and decreases postoperative pain and recovery time.
The elbow is a very tight and congruent joint and any abnormality present can lead to the progression of arthritis. Some dogs diagnosed with this condition will require treatment of arthritis as the dog ages. This may be as simple as giving fish oil and joint supplements or as complex as requiring joint injections and rehab therapy.
This condition is treated by removing the fragment and debriding the underlying bone to allow fibrocartilage formation. This procedure is most often performed arthroscopically which decreases surgical time, postoperative pain, and recovery time.
Most patients can be discharged the same day as surgery.
There is a very good prognosis for patients treated for shoulder OCD.
Biceps tenosynovitis is also a painful condition of the shoulder that can be diagnosed and treated arthroscopically. It may result from trauma to the joint or from a soft tissue injury after strenuous activity. It is typically painful on palpation over the biceps tendon and can often be diagnosed on physical examination.
Some fractures in young animals can be treated with a cast or splint for several weeks. More complex fractures in adults often require surgical stabilization. This can be accomplished by numerous methods including plate/screw fixation, pins, wire, interlocking nail, and linear or circular external fixation. The method of repair will be determined by the location and severity of the fracture as well as patient and owner factors.
Healing time for most fractures ranges from 4-6 weeks in young animals to 8-10 weeks in adult animals.
Veterinary Arthroscopy utilizes a camera in joints with small portals for the placement of instruments. Arthroscopy can be used to assist in the treatment of cruciate ligament and meniscal tears in the knee as well as most other joints in dogs.