General Medicine, Surgery, Acupuncture and Chiropractic for all Companion Animals

Torn Cruciate

Has your dog ruptured it’s cruciate ligament? Does your dog need knee surgery?  Here at Scott G. Nachbar, Veterinarian we perform two stifle surgeries for torn cruciate ligaments: Extracapsular Repair and Tibial Plateau Leveling Osteotomy (TPLO).  There are many factors that go into deciding what surgery is best for your beloved pet: cost, activity level, age, weight of your pet, etc. We recommend coming in for a consultation with Dr. Nachbar so that he can discuss the options and decide together what is the best option for your pet.


What happens if I don’t do surgery?

Since the knee is unstable without an intact cruciate ligament, the wearing between bone and cartilage becomes abnormal and the joint begins to develop irreversible degenerative changes.  Pain and lameness persist, and the opposite leg becomes stressed.  Please contact your veterinarian or come in for a consultation to find out the options for your dog.

A Leveling Osteotomy (CBLO, TPLO) is often the best option for active, large dogs.  CBLO and TPLO change the biomechanical function of the knee joint to stabilize the cruciate deficient stifle joint. After exploring the joint, removing damaged ligament fragments and any torn portions of the meniscal cartilage and smoothing bone spurs, the tibial plateau is rotated to a more level position, greatly reducing the role of the missing cranial cruciate ligament and allowing the remaining ligaments and tendons to provide joint stability in its absence.  It provides the best long term function and can greatly reduce the development of arthritic, degenerative changes over time.  It is an involved surgery since the bone must be precisely cut, rotated, and stabilized with a bone plate and screws.  The CBLO is an improvement over the older TPLO surgery, providing a more secure fixation, better centering the forces of weight bearing, and avoids cutting the bone of the stifle joint.  It also allows for correction of stifles with extremely steep tibial plateau angles.  

Extracapsular Repair is a technically simpler procedure than CBLO/TPLO to treat a cruciate rupture. As in the CBLO/TPLO surgery, the damaged cruciate ligament is removed, any damaged portions of the meniscal cartilage is removed and any bone spurs are smoothed. A strong suture is then passed around the stifle joint to provide stability while the stifle heals.  Depending on several factors, this option may be sufficient for your pet, although arthritic changes do continue to progress over time and the strong suture does loosen somewhat eventually.

Rehabilitation after surgery is very important in helping your dog recover better after surgery. Your dog will be restricted to leash only and minimal activity for 8 to 12 weeks, with slowly building up activity after that. We recommend our patients go through a 6-treatment therapeutic laser series that helps speed healing and reduce swelling after the surgery. Your pet will receive 2 laser treatments after the surgery itself, one right after the surgery before they wake up from anesthesia and then the morning after surgery, having stayed in hospital overnight.

For more information on Ruptured Cruciate Ligaments please visit the link below:

Ruptured Cruciate Ligament

For more information on CBLO and TPLO specifically please visit the links below:

CBLO

TPLO

Here is a document on Post Surgical Care your pet would receive after their knee surgery:

post-surgical-care-of-bone-joint-surgeries.pdf

Here is a document on Rehabilitation care for your pet if they were to undergo TPLO surgery (note this is rehabilitation after the initial 8 weeks after surgery):

rehabilitation-regimedoc.pdf