Cruciate Surgery and Orthopaedics
At Torenbeek Vet Clinic we are proud to offer orthopaedic surgeries including fracture repairs and joint arthrodesis (joint fusions), and more specialised procedures for Cranial Cruciate Ligament Disease and Patella (kneecap) problems.
Cruciate Ligament rupture is a common injury in dogs. Just like in human medicine when a person ruptures their "ACL" or anterior cruciate ligament, dogs can suffer similar injuries which require surgical and medical intervention. Surgical treatments for cruciate disease significantly decreases the development of often debilitating arthritis in the knee joint, reduces pain and improves quality of life.
We offer two types of surgeries for cruciate disease depending mostly on the size of the animal and some other considerations often determined by taking x-rays of the leg.
Smaller dogs up to 15kg can be treated with a cost-effective procedure called the DeAngelis Technique. In this procedure, nylon suture is used to replace the ruptured cruciate ligament and form a prosthetic ligament. It has good success rates and is an appropriate method to use on some smaller breed dogs.
Larger dogs (and some smaller dogs) can be treated with a number of other surgical options including TLPOs and TTAs. The procedure that we specialise in at Torenbeek Vet Clinic is called the Modified Maquet Procedure for Tibial Tuberosity Advancement or MMP TTA. In this procedure, a titanium wedge of an appropriate size is placed into a cut made into the tibial crest. It is held in place with a titanium staple and a stainless steel bone pin. It is a highly successful procedure with rapid recovery rates, that we perform at approximately half the cost of other specialist cruciate ligament surgeries.
See a video below for an outline of the MMP TTA procedure.
Patella (Kneecap) Problems - Luxating Patella
Miniature and Small breed dogs (and some medium/large breed dogs such as Staffies and Australian Cattle Dogs) will sometimes have a genetic problem where their patella or "kneecap" will slip or dislocate from its normal position in a bony groove of the femur (trochlear groove) to the inside of the leg. It is common in breeds that have bow-legged conformations in their hind legs.
When the patella luxates it is common to see a dog hop along and not want to bear weight on that leg, then they may kick the leg to the side and relocate the patella into it's normal position. In approximately 50% of cases it is present only in one leg, and in the other 50% of dogs it is present in both hind legs.
A grading system exists to categorise minor/mild cases to severe cases on a 1 to 4 scale with 4 being the most severely affected. The general reccomendations are that patients with luxating patellas of a grade 2,3, or 4 will benefit from surgical intervention. Without surgical intervention, an increased risk of Cruciate disease is common, as is arthritis of the knee joint as the pet ages.
At Torenbeek Vet Clinic we are happy to offer two different procedures for luxating patellas and as with all of our surgeries we will tailor the surgical plan to suit the needs of the patient. The Tibial Tuberosity Transposition surgery is a common procedure performed on patients with luxating patellas and involves:
- Shifting the attachment of the patella tendon to a more anatomically correct position
- Deepening the groove of the bony groove in which the patella normally resides
In some cases an implant may be placed on the bone on the inside of the knee to prevent it from slipping out of its normal place in the bony groove of the femur. At Torenbeek Vet Clinic we are proud to offer the RidgeStop system of implants for luxating patellas. While patient considerations are important and not every surgical technique is right for every animal, we find it is a less traumatic surgery that does not require cutting into the bone and can be a good option for those animals where degenerative conditions have caused erosion of the bone.
See below for a video of the procedure.
Call us today to discuss your pet's orthopaedic condition and how we may be able to help!