Franklin Vets
Franklin Vets - excellence in veterinary care for dairy, farming, lifestyle, equine and household pets. BESTPRACTICE ACCREDITED NZ.
Most dogs that rupture this ligament do so because of degenerative disease in the joint.
Almost all animals with injured cruciate ligaments are better managed with surgery than without. The ligament never heals once it starts degenerating; it just degenerates further until it finally snaps. Snapped cruciate ligaments never heal.
There is a wide range of operations available for treating cruciate injury. The more basic technique involves placing a restrictive band of some form that attempts to replace the function of the lost ligament. The more complex but generally more effective techniques involve changing the structure of the bones to alter the forces acting on the joint.
TPLO (Tibial Plateau Levelling Osteotomy)
This involves changing the anatomy of part of the tibia and then securing it with a bone plate and screws. This neutralises the forces previously resisted by the cruciate ligament.
Return to normal function after surgery can be dramatically faster than with the traditional nylon band technique.
This is the most successful technique for normalising forces around the joint and has statistically the best long-term outcomes. We can now offer this surgery for dogs of almost any size, including small breeds.
TPLO is an operation with a long history of success in many countries. This is the “gold standard” surgery in specialist practices worldwide for cruciate ligament injury. If the joint is suitable for this procedure and finances permit, this would be our recommended first-choice surgery, where possible.
Extracapsular surgery
This was traditionally the most popular surgery, where a single or double strand of nylon or Fiberwire is inserted to try to replace the function of the original cruciate ligament. This can result in good function, but the results can be very unpredictable. Recovery times from surgery can be prolonged. This is a fair option for small dogs, not very good for medium dogs, and not recommended for large dogs.
This technique is simple to perform and avoids the risk associated with cutting bone for the TPLO. However, the nylon will stretch over time, and ongoing support depends on periarticular fibrosis rather than removing abnormal movement, which the TPLO achieves. Ironically, while this technique is most commonly performed on small breeds of dogs, these breeds frequently have microscopic anatomy that makes them poor candidates for extracapsular surgery, and they will normally do much better with a TPLO.
Our recommendation for managing cruciate injury in dogs is:
• TPLO is the best surgery available and should be the first option if the bone shape permits and if finances are available
• Extracapsular surgery is a cheaper option for small breed dogs, but is significantly less successful than the TPLO
• Dogs with previous extracapsular nylon surgery with unsatisfactory results can have a TPLO as a revisional procedure.
• For dogs with very abnormal tibial anatomy, or that have a dislocating patella as well, there are modifications to these techniques that can be done to manage the condition better.
Many dogs now have had both knees operated on and returned to running and working. A dog who ruptures both cruciate ligaments can have the joints operated on relatively close together, which dramatically reduces recovery time.
The rest period after cruciate ligament surgery can be quite lengthy, lasting up to 12 weeks. It is critically important that the instructions are followed closely to get the best results. We have a rehabilitation programme for you to follow during this period.
The price range for TPLO surgery is from $5000 to $6500, depending on patient size. The only additional charge for revisits is for extra dressings or medications used, as well as sedation and x-rays at 6 weeks. Just so you know, usually, no additional dressings or medications are required. The 6-week x-ray costs $330-380, depending on patient size. If needed, we can guide you on what to look for in post-op revisits for those having the checkups done locally.
Call Customer Services on 09 238 7486 or email referralsurgery@fvs.co.nz to discuss the transfer of your patient to our clinic for assessment and treatment. When you come, you may be asked to bring any clinical notes, X-ray images, and medications.
Dr Paul Eason BVM&S MANZCVS (Surgery; Emergency & Critical Care Medicine)
Franklin Vets - excellence in veterinary care for dairy, farming, lifestyle, equine and household pets. BESTPRACTICE ACCREDITED NZ.
