Anterior cruciate ligament (ACL) rupture is the most common orthopedic injury in dogs and can occur in any dog at any age. For some dogs the problem is some form of genetic influence including these most commonly affected breeds such as Labrador Retrievers, Golden Retrievers, Rottweilers, Pit Bulls, and Mastiffs. Other factors for all breeds include conformation, weight and body condition.
Approximately 90% of the knee problems that occur in dogs are due to damage to the ACL. In people, it is usually an acute athletic injury that causes this ligament to rupture. In dogs, however, it is a cumulative stress problem due to the unique configuration of the dog’s knee joint. The ACL provides the most stability and is under constant stress during weight bearing. In susceptible dogs, this constant stress eventually leads to complete or partial tearing of the ligament.
Symptoms of ACL tears may include sudden lameness when your dog completely holds his or her leg off the ground, intermittent limping, or very mild limping or stiffness that progressively becomes worse.
1. Extracapsular Suture Stabilization:
There are many different variations of this procedure. Essentially the concept for the surgery is to stabilize the knee by replacing the torn ligament using a single fiber plastic line called a mono-filament or using a braided suture. These are very strong suture or line that re-establishes the stability of the joint while maintaining normal movement. This suture is essentially placed in the same orientation or plane as the original ACL ligament. During the surgery a hole is first drilled through the front part of the tibia. Following this, the suture is looped around the small bone called the fabella bone on the back side of the femur and continued alongside the knee, through the drilled hole in the tibia and the tension is adjusted and the suture is crimped together with a surgical stainless-steel clip. Generally, this surgery technique for repair of ACL surgeries is recommended for dogs less than 50 lbs. That said, thousands of dogs every year who weigh more than 50 lbs. also do extremely well with this type of surgery.
2. TTA (Tibial Tuberosity Advancement):
During the procedure an incision about 4 to 6 inches will be made along the dog’s stifle to provide the surgeon access to the knee tissues. The torn/ruptured cranial cruciate ligament, or CCL, is completely removed and the meniscus is examined. The veterinary surgeon will determine at the time of surgery the extent to which the meniscus has sustained damage and will work to remove the injured tissue. The doctor will take care to only remove meniscal tissue that is damaged, as dogs with some intact, healthy meniscus tend to do better long-term than dogs receiving a complete meniscectomy.
A transverse osteotomy is then performed just behind the tibial tuberosity (a non-weight bearing part of the knee), which creates a groove in the bone, allowing the tibia to be advanced to its new position. The tibial tuberosity is then advanced to achieve a perpendicular relationship between the tibial plateau slope and patellar tendon, resulting in a stable joint. Examination of the stifle with a-ray radiography prior to surgery will make sure the surgeon has the proper size implants available for the procedure, and the advanced tibial tuberosity is held in place with specific plates and bone screws and the incision is closed with sutures.
We are pleased to be able to offer your pet this high-tech surgical procedure in our neighborhood veterinary practice.
TPLO (Tibial Plateau Leveling Osteoplasty)
TPLO surgery is for complete, partial, or chronic ACL tears. Surgery is extremely effective on dogs of most sizes (except toy breeds). State-of-the-art reconstructive surgery; alters the biomechanics of the joint to counteract the force that caused the ligament to tear. The tibia (lower knee bone) is surgically altered: the top portion (tibial plateau) is cut and rotated and then held in place with a stainless-steel plate and screws.
Our philosophy is to offer a variety of surgical treatments for ACL tear and do our very best to work with you, the pet owner, to tailor our treatment recommendations to the unique needs of your pet and family. Variables that we consider when making our recommendations include your pet’s activity level, size, age and conformation, the degree of knee instability, and each option’s affordability in your family budget.