Your dog has been limping for a while and you’ve received a diagnosis of a ruptured anterior cruciate ligament in the knee? Here’s everything you need to know
First of all, this is a common injury and many veterinarians regularly perform these surgeries, so you can breathe easy—a permanent solution exists.
If you’ve noticed your dog limping or lifting their hind leg, a very common injury can be suspected: an anterior cruciate ligament injury in the knee. This ligament keeps the knee stable, and if it ruptures (and sometimes even stretches), the knee is no longer stable and every step leads to knee dislocation, which is painful and also wears down the joint. Diagnosis is done using an MRI but also manually through the so-called “drawer test.” The veterinarian firmly holds the femur and tibia and tries to pull the tibia out of the joint. If the ligament is intact, the knee doesn’t move; with a positive test, the so-called “drawer” opens. Some dogs are tense and stiff from fear, so sedation is necessary to perform this test with 100% certainty.
dog knee surgery – methods
How the clinical picture progresses
In the first phase immediately after the injury, swelling, pain occur and the dog doesn’t put any weight on the leg at all. Usually if you go to the veterinarian, anti-inflammatory and pain medications are prescribed, and after 10 days the picture is better, the swelling decreases and the dog sometimes even puts a little weight on the leg. We think it’s better. But if there’s no ligament—it’s not better. With every walk, the dog’s knee comes out and grinds on the joint, which leads to wearing of the joint head and serious consequences in old age.
It’s important to make a 100% diagnosis so you can decide on surgery and prevent further joint damage.
There are two main surgical approaches
Veterinarians will explain everything to you, and this article is informative to help those (and I know there are many of you) who are afraid of surgery relax with information.
01
TPLO (Tibial Plateau Leveling Osteotomy) and TTA (Tibial Tuberosity Advancement)
Both techniques are based on changing the position of the knee joint, which then ensures stability. The bone is secured with a plate. Figure 01.
TPLO technique, figure 01.
02
Lateral Suture
Placement of the so-called “lateral suture” where the upper femur and lower tibia are actually secured laterally with strong floss, thus imitating the function of the ligament. Figure 02.
Lateral suture technique for knee surgery, figure 02.
It’s important to emphasize
The first option is necessary for large dogs (over 17kg) because the suture doesn’t hold greater weight.
For smaller, lighter dogs, the lateral suture can also be an excellent solution—it’s less invasive. Although everything is well tolerated with medications and proper physical therapy. The difference in surgery cost is also noticeable; the lateral suture is much cheaper. But with large dogs there’s a greater chance of repeat surgery, and that’s definitely worth avoiding.
Dog Knee Surgery
Pay attention to the importance of the following two factors
a) Timing when you decide on surgery
The closer to the injury the better, because with limping and not using the leg, muscle atrophy occurs which is much harder to restore later after surgery once we’ve regained stability (we’re talking about months)—which again means months that the dog spends on three legs and unevenly loads the shoulder girdle and the opposite uninjured leg. It’s not good for the spine and joints.
b) Physical therapy after surgery
It’s crucial (just like for us humans, everyone goes to the spa after knee surgery, right), so our dogs must also start physical therapy and very quickly
First PHASE – passive range-of-motion exercises, gently, can start on the 3rd day after surgery, light cooling to reduce swelling after exercises is important.
Second PHASE – weight-bearing on the leg, light walks, with gradual extension of walks and exercises that put more load on the leg to restore the muscle
Being informed and prepared is one-third of the work; the other two-thirds is doing everything as well as possible, and you can have a dog that continues to live without problems as if nothing happened.
CONSERVATIVE SOLUTIONS
Orthosis
If this problem has affected you, you’ve surely Googled and found orthoses that are a solution. An orthosis can minimally prevent the injured knee from sliding out of position, but it still happens (look at our knees—we stand upright; in dogs the knee is at an angle, which means that with every step dislocation occurs) (!).
An orthosis is a solution only for old dogs who aren’t ready for surgery due to other health problems.
