That “Old Football Injury” Your Dog Has
Most folks and nearly all athletes are familiar with the world’s most common knee injury: the ruptured anterior cruciate ligament, also known as the ACL. Interestingly, this is also the most common orthopedic injury in dogs, except that in dogs the ligament is called the cranial cruciate ligament or CCL. Whenever a football player goes down on the field grasping his knee, odds are that he has torn this ligament. Likewise, when a dog (especially a large dog) suddenly turns up lame without having been hit by car, most often this means a torn CCL.
Once the CCL is torn or partially torn, the knee becomes wobbly or unstable. When the dog attempts to use the leg, it “gives out.” As time goes on, the abnormal wobble in the joint causes inflammation, and this inflammation leads to arthritis. As the arthritis progresses the knee becomes more painful and less flexible.
For this condition, the only solution is surgery. Middletown Animal Hospital offers orthopedic surgery and physical therapy and rehabilitation post-surgery. (We are the only veterinary hospital in the county that has an underwater treadmill.) Over the years many techniques have been developed to repair the joint and today they have boiled down to two basic choices. The first choice is called an extra-capsular imbrication and it involves placing a heavy suture around the joint and through the bone to mimic the function of the torn ligament. This suture is actually an intermediate solution because the permanent cure comes from the joint capsule thickening and tightening around the joint over the first few months following surgery. This technique has the advantages of increased simplicity, lower costs ($1200-$1600), excellent success, and more common availability.
The second choice is called Tibial Plateau Leveling Ostectomy (TPLO) and involves cutting the shin bone with a specially designed saw, and then plating the bone back together. As a result the bottom bone of the knee joint is tipped backwards, and this keeps the joint stable and in place. This technique has the advantages of a greater range of motion and a somewhat more rapid recovery. Costs tend to be about $3000-$4000 and are performed by orthopedic specialists.
Both techniques can suffer complications or failures, but these are relatively rare. Both techniques have similar success and both require following a strict program of physical therapy post operatively. All dogs will develop a greater or lesser degree of arthritis as time progresses, but this is typically not a problem or it is a manageable problem. It is important to be aware of the fact that the opposite knee can suffer the same fate, so attention to weight loss and proper exercise/rehabilitation is essential. It is also smart to be aware of other potential joint problems like hip dysplasia or spinal disc disease because these issues may alter the prognosis or the expectations after the surgery.
Like humans patients, we can repair injured joints in many cases. If your dog seems to be lame or favoring a limb, then consider having our veterinarians evaluate the problem and outline your options for you.