Knee Surgery

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Knee Surgery

Knee problems are the most common reason for referral in dogs, and in most instances are caused by damage to the Cranial Cruciate ligament (CCL) or from knee-cap problems (Medial Patellar Luxation or MPL).

Cranial Cruciate Ligament (CCL). The most common condition we treat.

  • CCL injury in dogs is caused via a combination of the type of dog and his/her activity level and body weight.
  • CCL is the same as ACL in people, but in dogs it’s called the CCL because they walk on all 4 limbs.
  • We perform all currently available procedures for CCL injury in dogs. These include Tibial Plateau Leveling Osteotomy (TPLO), Tibial Tuberosity Advancement (TTA) and Extracapsular Repair.
  • We have performed most, if not all of the currently available knee surgeries.
  • Currently in the USA, there is a tendency towards TPLO as a treatment option. We will discuss with you our approach to knee surgery that has worked well for years. Below are a few highlights of our approach:
  • CCL injury in dogs will cause a lameness that comes and goes and then comes more than it goes.
  • We recommend surgery when function is less than 50%. Generally we would describe that as non weightbearing for 2-3 weeks or 2-3 months of more bad days than good days.
  • Currently it is impossible to replace the CCL in dogs.
  • It is reasonable to expect 70-80 percent function within 3-6 months of surgery.
  • Our responsibility is to perform the procedure to the best level that we can.
  • Your responsibility is to stop your dog from licking the wound for the first 10-14 days and to keep your dog on a leash when outside for 8-10 weeks.
  • Confinement in the house is dependent on what your dog will tolerate. We want it to not cause your dog distress and not cause you distress. Generally a crate or a small pen is preferable. It is OK to have access to a smaller room. Be careful of stairs as well as slick/shiny floors. Avoid jumping on high furniture such as a bed.

Medial Meniscus

The medial meniscus is a shock-absorbing cartilage structure that sits between the two bones of the knee. It will become damaged after the CCL becomes damaged. We have seen medial meniscal tears develop on the first day of ligament damage and as long as 1-2 years after.   If you are hearing clicking in your dog’s knee (and surgery has not been done by us), it is highly likely that the meniscus is damaged. Surgical debridement or removal of the torn tissue has a significant impact on improving limb use, regardless of the type of treatment done to stabilize the knee.

*Click to enlarge images

Image shows a portion of the
medial meniscus with multiple tears.
Torn Meniscus
Torn Meniscus

Medial Patellar Luxation (MPL)

Medial Patellar Luxation or MPL is common in small dogs under 20 pounds of body weight, however it can occur in any dog. In MPL, the patella (knee-cap) comes out of place. MPL is second to CCL in terms of frequency and requires a high level of expertise to correct. It is necessary to deepen the groove where the knee-cap sits and provide balance via a combination of release of tissue on the inside and tightening on the outside. In addition, it is frequently necessary to move the bone where the knee-cap tendon attaches. The best outcomes with MPL surgery are achieved by using an accomplished surgeon in conjunction with a pet owner who is committed to following exercise guidelines.

Follow these steps to protect your dog's knees!:

  • Learn what BODY CONDITION SCORE is in dogs. Keep your dog in Lean Body Condition, lifelong.
  • Try to avoid high impact athletic activity such as frisbee, ball, hard play with other dogs, encouraging chasing Squirrels. The goal is active not athletic
  • Warm your dog up before anything strenuous
  • Don't teach your dog to get wound up about chasing squirrels or going to dog park etc

Why are knee problems so prevalent in dogs?

  • Pedigree papers are no predictive of Orthopedic Soundness. They are a useful tool but not 100% accurate.
  • Dogs have inherent athletic ability that pound for pound is stronger than a human.
  • Dogs walk with their ankles off the ground which causes constant stress on their knees.
  • Having 2 ligaments inside a joint is weak and the knees will be the most susceptible to injury as a result.

Examples of our Our Work

*Click to enlarge images

TPLO
TTA
An extracapsular, mono-nylon repair.
TPLO corrects Tibial Plateau Angle (TPA)
TPLO corrects Tibial Plateau Angle
MPL
MPL
MPL
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