- The knee joint is relatively unstable because there are no interlocking bones in the joint. Instead, the two main bones, the femur and tibia, are joined with several ligaments. The cranial cruciate ligament is located inside the joint and is a major contributor to maintaining stability. One of the important functions of the ligament is to prevent forward and backward sliding of the femur on the tibia bone (draw motion).
- Cruciate ligament disease is commonly a gradual process but is occasionally due to a single traumatic injury. Most dogs have a predisposing factor such as age-related ligament degeneration, pre-existing inflammation, anatomical abnormalities and anatomical variations which cause the ligament to rupture.
- What are the treatment options? In most cases we will advise surgery to stabilise the joint. Occasionally, usually for traumatic injuries, we may suggest a “lateral suture” using a special material called “Ligafiba” which is passed from the femur to the tibia. However in most cases we feel some kind of tibial remodelling is preferable. This is usually an MMP procedure (advancing the tibial crest) or a TPLO (altering the tibial slope). Both these techniques alter the forces on the tibia to prevent the bones sliding when weight bearing.
- What does a surgery involve? The operation will require your dog to have a general anaesthetic. This will mean your dog having to be starved from 9pm the night before the surgery, free access to water should be made available until the morning.The MMP procedure involves moving the tibial crest to further tension the patellar ligament. A special titanium wedge is inserted into the gap which allows bone to grow into the void. The TPLO involves making cut in the top of the tibia bone (osteotomy). A measured wedge of bone is removed in order to level the slope. A plate and screws are used to hold the bones in place so that the bone can heal in its new position.
- What to expect after the operation. Your dog will begin weight bearing again very soon after surgery. Over 90% of dogs are expected to regain a normal, active lifestyle without the need for any pain relieving medication. The stability in the joint will slow the progression of arthritis although it will not prevent it from occurring. There are many things you can do to help this however. For example: weight control, regular controlled exercise, joint supplements, special diets, physiotherapy and medication. We will discuss this with you.
- Your dog will need to be on the lead for 3 months following the surgery, otherwise the implants can break. This includes lead exercise for toileting purposes when in the garden. They must be prevented from jumping, running, climbing stairs slipping on floors. Physiotherapy with our qualified Chartered Animal Physiotherapist, Julia Martin, is recommended, to help your dog regain its normal function as soon as possible. We will take x-rays after 4-6 weeks to check the progress of healing which will require your dog to be with us for the day and be sedated.
- What are the possible complications of these procedures? Any general anaesthetic involves a potential risk but our staff are fully trained and highly competent. We also have a range of modern monitoring equipment which helps increase the safety of the procedure. All surgical procedures carry risk of potential problems such as infection or complications following implant placement. Occasionally further surgery is required to remove the plate once healing has taken place. We have a very low complication rate and if dealt with correctly these problems are resolved swiftly. You will notice your dog's stifle may look at little different after the operation: there will be a "lump" below the joint after an MMP surgery, which is the new tibial crest position. With a TPLO, the legt may look straighter at the stifle.
- When you have your orthopaedic appointment, you will be given an estimate of likely costs, but if you have any further questions please do not hesitate to contact us 01273 737924.
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