Have you noticed the following warning signs of cruciate disease?
Damage to the cranial cruciate ligament (CCL), a ligament referred to as the anterior cruciate ligament (ACL) in humans, is one of the most common orthopedic injuries in dogs. The resulting instability in your pet’s knee leads to pain, inflammation, and eventually arthritis. Traumatic injury can lead to a ruptured CCL, but in most dogs, we consider this problem to be a disease. This is because the ligament undergoes degeneration over time and many dogs “injure” their CCL without any real trauma. Other dogs may sustain rupture of the ACL when performing activities that you would not expect to cause injuries, such as simply jumping off the couch.
TPLO stands for tibial plateau leveling osteotomy. This procedure changes the biomechanics of the knee so that it can remain stable without the ligament. The surgeon can rotate the upper portion of the tibia, leveling it and improving stability of the knee. A bone plate is applied to keep the bone in its new position while it heals. Locking screws also maximize the overall stability of the repair and reduce complications. Most animals live and move comfortably with the plate in place, so it is usually not removed after healing is complete. In some instances, your surgeon may speak with you about other options including CBLO, TTA and other procedures if they may benefit your pet.
How can the surgeon be certain of the diagnosis?
Besides the symptoms you’ve observed, your pet’s surgeon will also look for:
If the above clinical signs are present, radiographs (X-Rays) are indicated and further evaluation of your pet under mild conscious sedation may be required.
A few other points to consider
Once cruciate disease has been diagnosed, there are several important points to understand before considering treatment options. As mentioned above, rupture of the ligament is a degenerative process in dogs, rather than an injury. The ligament deteriorates until it may rupture under normal everyday activity. The same factors that led to ligament degeneration in one knee will also be present in the other (contralateral) knee, resulting in a 40-70% chance that the CCL will now tear in the other knee. All dogs with cruciate disease also have osteoarthritis, which cannot be cured. The good news is that surgical intervention greatly limits its progression, leading to an excellent prognosis when the problem is addressed early.
At AESC, our surgeons always use arthroscopy, a minimally invasive method, to explore the joint and provide treatment. Arthroscopy utilizes a tiny camera (2.3 to 2.7mm in diameter) to confirm the diagnosis of a torn CCL and to check the joint for other injuries. Once the diagnosis is confirmed, any treatment needed inside the joint can also be performed in this minimally invasive manner.
Every surgeon must look inside the joint to confirm the diagnosis, remove any diseased ligament and identify other common injuries, including meniscal tears (torn cartilage pad).
There are two ways to inspect the joint:
Open Arthrotomy—a large incision into the joint
Arthroscopy—exploration of the joint using a tiny camera through a small portal. Compared to arthrotomy, arthroscopy provides:
We encourage you to ask questions about a surgeon’s approach to joint exploration. Some surgeons use arthroscopy only to confirm the diagnosis and then if a concurrent meniscal injury is identified, they rely on arthrotomy, making a full-length incision into the joint. This cannot be considered minimally invasive.
Completely opening the joint at any point during the procedure increases pain, exacerbates existing arthritis and prolongs the recovery in patients with CCL injury.
AESC is committed to providing our patients with the best care available. That’s why our surgeons have acquired the advanced training and high definition equipment to both identify and address meniscal tears through arthroscopy.
Only when diagnosis and treatment are addressed through the camera and a tiny incision can a procedure truly be considered “minimally invasive.”
Be sure to understand your surgeon’s approach. We believe you and your pet will be much happier with a fully arthroscopic approach.
Once arthroscopy is completed, the knee must be stabilized in some manner. There are three main approaches for stabilizing the knee:
Recovery time for all procedures is approximately 6-8 weeks, and they each have advantages and disadvantages. Clinical research has shown that the TPLO procedure provides the fastest return to function with a relatively low complication rate compared to ES and TTA techniques. However, not all techniques have been clinically evaluated together in the same study.
AESC surgeons have advanced expertise in cruciate disease, including published research on the topic. They recommend that the best outcomes with the least number of complications can be achieved for most patients by providing the following:
Circumstances may indicate that one procedure has advantages over another. The surgeons at AESC will guide you to a recommendation based on the latest available scientific evidence and your pet’s individual details.
The success rate of TPLO surgery is extremely high, with nearly all pets returning to normal or almost normal function. These results have made TPLO the treatment of choice in not only large-breed and athletic dogs, but also smaller dogs. Complications are possible, but nearly all can be avoided if post-operative directions are followed. Adequate rehabilitation also helps the patient return to normal function.
You’ll receive instructions on post-operative care when you pick up your dog after surgery. Just like with people, it’s vital that you restrict exercise to give your pet time to heal. Physical therapy also plays an essential role in the recovery process. We’re committed to helping you every step of the way and guiding you through the rehabilitation process.
Your family vet is your go-to for routine care, but for help when your dog runs into more complicated healthcare issues, including a CCL injury, you need specialized medicine from doctors with advanced training in treating these injuries.
As an emergency and specialty veterinary hospital, AESC performs advanced surgeries every day, providing the experience and equipment needed to keep your pet healthy, calm and comfortable, while achieving optimal results.
At AESC, we carefully consider every possible detail that will provide you and your pet with the most stress-free experience, with the best available outcome. That means prioritizing all the “little things” that can add up to make a big difference.
Not every hospital will offer you the following options, but the surgeons at AESC incorporate ALL the following into your surgical package:
The surgeons at AESC are board certified through academic residency training programs and ultimately through examinations by the American College of Veterinary Surgeons and/or the American College of Veterinary Sport Medicine and Rehabilitation.
Once cruciate disease has been diagnosed, there are several important points to understand before considering treatment options. As mentioned above, rupture of the ligament is a degenerative process in dogs, rather than an injury. The ligament deteriorates until it may rupture under normal everyday activity. The same factors that led to ligament degeneration in one knee will also be present in the other (contralateral) knee, resulting in a 40-70% chance that the CCL will now tear in the other knee. All dogs with cruciate disease also have osteoarthritis, which cannot be cured. The good news is that surgical intervention greatly limits its progression, leading to an excellent prognosis when the problem is addressed early.
At AESC, our surgeons always use arthroscopy, a minimally invasive method, to explore the joint and provide treatment. Arthroscopy utilizes a tiny camera (2.3 to 2.7mm in diameter) to confirm the diagnosis of a torn CCL and to check the joint for other injuries. Once the diagnosis is confirmed, any treatment needed inside the joint can also be performed in this minimally invasive manner.
Every surgeon must look inside the joint to confirm the diagnosis, remove any diseased ligament and identify other common injuries, including meniscal tears (torn cartilage pad).
There are two ways to inspect the joint:Open Arthrotomy—a large incision into the joint
Arthroscopy—exploration of the joint using a tiny camera through a small portalCompared to arthrotomy, arthroscopy provides:
We encourage you to ask questions about a surgeon’s approach to joint exploration. Some surgeons use arthroscopy only to confirm the diagnosis and then if a concurrent meniscal injury is identified, they rely on arthrotomy, making a full-length incision into the joint. This cannot be considered minimally invasive.
Completely opening the joint at any point during the procedure increases pain, exacerbates existing arthritis and prolongs the recovery in patients with CCL injury.
AESC is committed to providing our patients with the best care available. That’s why our surgeons have acquired the advanced training and high definition equipment to both identify and address meniscal tears through arthroscopy.
Only when diagnosis and treatment are addressed through the camera and a tiny incision can a procedure truly be considered “minimally invasive.”
Be sure to understand your surgeon’s approach. We believe you and your pet will be much happier with a fully arthroscopic approach.
Once arthroscopy is completed, the knee must be stabilized in some manner. There are three main approaches for stabilizing the knee:
Recovery time for all procedures is approximately 6-8 weeks, and they each have advantages and disadvantages. Clinical research has shown that the TPLO procedure provides the fastest return to function with a relatively low complication rate compared to ES and TTA techniques. However, not all techniques have been clinically evaluated together in the same study.
AESC surgeons have advanced expertise in cruciate disease, including published research on the topic. They recommend that the best outcomes with the least number of complications can be achieved for most patients by providing the following:
Circumstances may indicate that one procedure has advantages over another. The surgeons at AESC will guide you to a recommendation based on the latest available scientific evidence and your pet’s individual details.
The success rate of TPLO surgery is extremely high, with nearly all pets returning to normal or almost normal function. These results have made TPLO the treatment of choice in not only large-breed and athletic dogs, but also smaller dogs. Complications are possible, but nearly all can be avoided if post-operative directions are followed. Adequate rehabilitation also helps the patient return to normal function.
You’ll receive instructions on post-operative care when you pick up your dog after surgery. Just like with people, it’s vital that you restrict exercise to give your pet time to heal. Physical therapy also plays an essential role in the recovery process. We’re committed to helping you every step of the way and guiding you through the rehabilitation process.
The surgeons at AESC are board certified through academic residency training programs and ultimately through examinations by the American College of Veterinary Surgeons and/or the American College of Veterinary Sport Medicine and Rehabilitation.
Thank you for taking time to understand the basics of your pet’s situation and medical options. Please ask any questions you may have so you can feel comfortable with your pet’s treatment plan. Feel free to contact us at 720-842-5050 to schedule an appointment with one of the surgeons and the whole surgical team at AESC.
If you’re interested in learning more about our TPLO procedure or would like to have your pet evaluated by one of our surgeons, fill out the form below and we’ll contact you.
