Alternatives to Canine Cruciate Surgery in the Dog

There are a few alternatives to canine cruciate surgery in the dog.

An orthotic brace can be used as an alternative to canine cruciate surgery. The orthotic brace can be used instead of surgery or as a complement to surgery to support and protect the stifle joint post operatively.

orthotic brace for the stifle of a dog as an alternative to canine cruciate surgery

orthotic brace for the stifle of a dog as an alternative to canine cruciate surgery

Here is a fun video looking at alternatives to surgery

Canine cruciate disease is the most common orthopaedic disease in the dog. It is diagnosed by pain on stifle joint manipulation, joint effusion, a medial buttress, a cranial drawer and a positive sit test.

Dogs are lame raning from mild lameness to non weight bearing lameness.

There has been quite a few alternative surgeries postulated over the years as a means to fixing this orthopaedic problem. each procedure has pros and cons and varying results.

Two decades ago we took a tendon graft from the tensor fascia lata muscle for the over the top technique which is a similar technique to how peoplehave an ACL repair. The graft would often stretch or break and results were frustratingly poor.

A prosthetic ligament technique was and still is a very popular repair technique. This is the De Angelis technique. It is relatively simple compared with complex osteotomies and in the hands of an experienced surgeon, results are quite satisfactory.

Specialists are now recommending an soteotomy technique to change the angle of the tibial slope so that an cranial cruciate ligament is not required.

osteotomies have an increased complexity and an increased risk of severe complications if they do not go well. If an osteotomy procedure goes bad, it goes really bad and may require amputation in a worst case scenario.

Specialist surgeons will turn away hyper exuberant dogs for this reason. If post operative aftercare cannot be guaranteed and the dog restricted and confined to a small area to be kept quiet, suregeons will not perform an osteotomy.

The gold standard for surgery for canine cruciate disease is the TPLO. The Tibial Plateau Leveling osteotomy. This is quite a complex procedure requiring specialised bone saws that make a curved cut into the proximal tibia. After changing the angle of the stifle joint, the tibia is bone plated using a TPLO plate to maintain the angle. Healing occurs in 10-12 weeks. Strict post op confinement is necessary to insure a good outcome. This can be an expensive procedure if done at a specialist referral hospital.

The TTO is a modification of this process. The Triple Tibial osteotomy arguably creates the same change in angle as the TPLO to alter the tibial slope so that an CCL is not required.

The TTA has a few variations. This is the most simple of the osteotomies but also the osteotomy with the most complications. It arguably does not correct the caudal tibial slope as well as a TPLO or a TTO. This will be disputed by exponents of the TTA.

The gold standard however is the TPLO.

Not everybody can afford to have a TPLO performed by an orthopaedic specialist.

Not every dog owner wants to have surgery for their dogs cranial cruciate disease.

An orthotic stifle brace makes a satisfactory alternative to surgery for dog owners who would prefer a conservative approach to treating CCL disease in their dog.

Some geriatric patients may have organ disease or heart lung disease that would make a long general anaesthesia too risky. An aorthotic brace for the dog’s stifle is a satisfactory solution for pateints that cannot handle a general anaesthesia.

Other alternate therapies include platelet rich plasma therapy

Stem cell therapy can also have remarkable results

Phone Australind Veterinary Hospital on 08 97971584 for more information on canine orthotics and prosthetics and alternatives to surgery.

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