We perform the vast majority of orthopedic surgical procedures that are commonly seen in veterinary medicine. We perform many types of fracture repair which may include the use of orthopedic plates, screws, wires and pins.
There are occasional cases that will require a Board Certified Veterinary Surgeon to perform the procedure. In these instances, Animal Care Hospital of Phoenix refers our patients to trusted Phoenix-area specialists.
Common Orthopedic Procedures
- CCL Extra-Capsular Repair
- Tibial-Plateau-Leveling Osteotomy (TPLO)
- Medial Patellar Luxation Repair
Cranial Cruciate Ligament
The cranial cruciate ligament (CCL) is a primary ligament in your pet’s knee. The ligament helps hold the knee in its proper alignment, supporting your pet’s weight and preventing hyperextension and incorrect rotation of connecting leg bones: the femur and tibia. The CCL can rupture due to ligament degeneration or traumatic injury, leaving the knee unable to bear weight and dramatically reducing your pet’s mobility. If left untreated, CCL tears can lead to osteoarthritis and meniscus damage.
There are several surgical options designed to treat CCL ruptures. Depending on the severity of the tear and patient-specific medical factors, extra-capsular repair may be the most effective method. Although this procedure can be performed on any dog, it is most often recommended for smaller breeds and senior pets.
The extra-capsular repair procedure uses a robust suture material to reform the cranial cruciate ligament, securely binding the two halves together. Over the next several months, scar tissue develops along the suture, reinforcing the repair and stabilizing the knee. While not the sturdiest repair method available, the surgery is highly effective for smaller and less active pets, and has the fewest complications compared to other CCL repair procedures.
Extra-capsular repair is a major procedure that requires a recovery period of up to 12 weeks. Painkillers, anti-inflammation and antibiotics are prescribed in the critical period following the procedure to manage discomfort and prevent infection of the surgical site
Exercise must be limited for the first few weeks. Pets should be confined to a small area in the home to restrict unnecessary movement and prevent strenuous activity. Regular veterinary checkups (including x-rays) will monitor your pet’s recovery, assessing limb and joint function, as well as general mobility. As your dog heals, exercise may be gradually increased based on individual evaluation.
Physical therapy is generally recommended after four weeks. Rehabilitation may include strength training, range of motion techniques, and aquatic therapy to help strengthen the joint and restore mobility.
Tibial-plateau-leveling osteotomy (TPLO)
A tibial-plateau-leveling osteotomy (TPLO) is an advanced surgical procedure performed on dogs to repair the cranial cruciate ligament (CCL). Similar to an ACL in humans, this ligament supports the knee by continuously bearing the dog’s body weight and preventing the femur from sliding against the tibia. This constant tension leaves the CCL highly vulnerable to injury, resulting in one of the most common orthopedic injuries in dogs, particularly in large breeds.
When the ligament is ruptured, the knee is almost completely destabilized, severely reducing mobility and leading to pain and inflammation. Dogs are unable to put weight on the affected leg and will walk with a pronounced limp. If left untreated, this injury dramatically increases the probability of arthritis and further damage to the meniscus.
How TPLO Surgery Works
A TPLO procedure works by restructuring the bone interaction within the knee to stabilize the joint. This innovative surgery alters the slope of the tibia to allow the femur to rest directly on the bone. The surgeon cuts the upper section of the tibia and rotates the bone it until the plateau is level. Upon achieving the desired angle, a steel plate is attached to the bone to hold it in place and allow the surgery to heal correctly. By leveling the tibial plateau, the femur is no longer able to slide against the bone and cause damage, creating a load bearing, stable joint without the cranial cruciate ligament.
Tibial-plateau-leveling osteotomy is a major surgical procedure that requires an initial recovery period of 12 weeks. Painkillers, anti-inflammation and antibiotics are prescribed in the critical period following the procedure to manage discomfort and prevent infection of the surgical site. Pets that are prone to licking the wound must wear a collar to prevent oral bacteria from entering the bloodstream.
Exercise must be severely limited for the first few weeks to allow the bone and soft tissues to heal. Pets should be confined to a small area in the home to restrict unnecessary movement and prevent strenuous activity. Regular veterinary checkups (including x-rays) will monitor your pet’s recovery, assessing limb and joint function, as well as general mobility. As your dog heals, exercise may be gradually increased based on individual evaluation.
Physical therapy is often recommended to maximize recovery. Rehabilitation may include strength training, range of motion techniques, and aquatic therapy to help strengthen the joint and restore mobility.
Medial Patellar Luxation Repair
A patellar luxation occurs when a dog’s kneecap slips out of its proper position and becomes unable to fully glide down the groove of the femur. A medial patellar luxation (MPL), the most common type, occurs when the kneecap slides to the inside of knee. This is normally caused by a congenital abnormality like a misshapen femur or tibia, shallow femoral groove or hip dysplasia, or as a result from knee trauma. Small breeds are especially prone to MPL, but it can occur in larger dogs as well.
If left untreated, medial patellar luxations can result in osteoarthritis, cartilage damage and ligament tears.
Medial patellar luxations are graded according to severity and frequency of displacement:
Grade I: Occasional patella displacement, but remains in the groove the majority of time. Symptoms may include skipping or kicking out of the leg.
Grade II: Frequent patella displacement characterized by a persistent skipping gait and a mild degree of lameness; patella can be manipulated back into the groove.
Grade III: Patella is always displaced, frequent lameness; patella can be manipulated into the groove but will pop out immediately.
Grade IV: Patella is always displaced and cannot be manipulated back into the groove, constant lameness, signs of physical deformity and a bow-legged appearance. The knee cannot be extended.
Diagnosis and Treatment
Patellar luxations are often discovered during annual physicals and other general examinations. If an MPL is suspected, your [PRACTICE NAME] veterinarian will examine your pet’s knee for signs of displacement and use a radiograph to confirm the diagnosis.
Surgery is recommended to treat MPL grades II, II and IV. The procedure aims to realign patella using a number of techniques including deepening the femoral groove, altering the alignment of the patellar ligament, readjusting the leg bones and fixing the joint attachments.
This is a major surgery that requires up to a 12-week recovery period. Painkillers, anti-inflammatory medication and antibiotics are prescribed to minimize discomfort and prevent infection.
Your dog’s mobility should be restricted during recovery. Exercise should be limited to short walks for the first six weeks, then gradually increased weekly until your pet back to full strength. Physical therapy is often recommended to enhance the recovery process, and maximize joint strength and mobility.