Injury to the cruciate ligament is the most common hind limb injury of the dog. Dogs less than 20 lbs. can often avoid surgery through conservative management, but this is an injury that typically requies surgical repair to avoid rapid arthritis. There are up to five different ways to repair a cruciate tear, but the only the most common two will be discussed here.
Using Lateral Suture Method to Stabilize the Knee
The repair I have been doing for over 20 years is called a lateral suture repair or an extracapsular repair. It entails placing a high strength suture in a way that mimics the damaged ligament. It works well in my hands, but it is not the currently recommended repair for large (over 50 lb) active dogs. The bigger, active dogs place more stress on the artificial suture often times resulting in it breaking. The preferred method of repair in large breed dogs is a Tibial Plateau Leveling Osteotomy (TPLO).
TPLO, A better Choice for the Larger Dog
A TPLO procedure changes the knee joint angles to provide stability and remove the need for the cruciate ligament. It is a sturdier repair for large, active dogs involving cutting the tibia and plating it in a new position. In most cases, many dogs will see a faster return to function when compared to the recovery from the lateral suture method. Because TPLOs require very specialized equipment and extensive training to complete succesfully, they are often done at a specialty or referal hospital. The disadvantages of the TPLO repair for many owners are added expense of the procedure compared to the lateral suture cost and travel to a surgical referal hospital.
Canine Rehabilitation, the Final Step in Recovery
Regardless of the repair, rehabilitation is very important to the successful return of function in a timely manner. Haven Lake Animal Hospital has a state of art canine rehabilitation center able to meet the needs of our orthopedic patients. Our Rehabilitaiton Center, staffed with specially trained Certified Canine Rehabilitation Practioners (CCRP), regularly manage both post operative orthopedic patients and those that are conservatively managed. Our goals of muscle strengthening and good joint health are achieved through targeted exercise and rigorous pain control. In these cases, the underwater treadmill and heated pool are great tools for comfortable, low stress exercise. Laser therapy, TENS unit application, massage, and acupuncture can manage generalized pain and muscle spasms as the surgical leg is healing. What ever the size and orthopedic needs are of your pet, there are options to fit each individual’s circumstances. The best place to start is with a consultation to discuss which treatment choice is the best one for your canine companion.
Chris Coon DVM CCRP