Orthopedic Repair 

Dr. Taylor has taken numerous advanced continuing education courses on repair of fractured bones, surgical correction of limb deformities and repair of ruptured cruciate ligaments, including the TPLO technique.

We are very proud that other veterinary clinics send some of their orthopedic referral cases to us - we work hard to continue to earn their trust!

 

Anterior Cruciate Ligament Rupture Repair

Dr. Taylor performs both the extracapsular repair, and the tibial plateau leveling osteotomy (TPLO) of the cruciate ligament. Below is a brief description of each.

Information regarding the injury itself can be found at Cruciate Disease at Veterinary Partner dot com.

Extracapsular Repair

This procedure is currently favored as the surgery can be performed in a relatively shorter time than the other procedures.

The knee joint is opened and inspected. The torn or partly torn cruciate ligament is removed. 

If the meniscus is torn, the damaged portion is removed.

A large, strong suture is passed around the fabella behind the knee and through a hole drilled in the front of the tibia. This tightens the joint to prevent the drawer motion, effectively taking over the job of the cruciate ligament.

 

  • Typically, the dog may carry the leg up for a good 2 weeks after surgery but will increase knee use over the next 2 months, eventually returning to normal.

  • Typically, the dog will require 8 weeks of exercise restriction after surgery (no running, only outside on a leash, including the backyard).

  • The suture placed will break 2 to 12 months after surgery and the dog's own healed tissue will hold the knee.

 

Tibial Plateau Leveling Osteotomy

 This procedure uses a fresh approach to the biomechanics of the knee joint and is meant to address the lack of long-term success seen with the above technique in larger dogs. With this surgery, the tibia is cut and rotated in such a way that the natural weight bearing of the dog actually stabilizes the knee joint. As before, the knee joint still must be opened and damaged meniscus removed. The cruciate ligament remnants may or may not be removed depending on the degree of damage.

This surgery is complex and involves special training in this specific technique. Many radiographs are necessary to calculate the angle of the osteotomy (the cut in the tibia). At this time, the TPLO is felt by many experts to be the best way to repair a cruciate ligament rupture regardless of the size of the dog and is especially appropriate for dogs over 50 lbs. This surgery usually costs more than the extracapsular method and requires a specialist.

  • Typically, most dogs are touching their toes to the ground by 10 days after surgery, although it can take up to 3 weeks.

  • As with other techniques, 8 weeks of exercise restriction are needed.

  • Full function is generally achieved 3 to 4 months after surgery and the dog may return to normal activity.

We use Synthes plates for our TPLO procedures.  They have an excellent web page that explains the procedure very well at http://www.tploanswers.com/Pages/Anatomy.aspx.