ACL Surgery and Information About Anterior Cruciate Surgery In The Dog
ACL surgery in a dog is commonly done in veterinary practice. Surgical repair of a torn anterior cruciate ligament (ACL) in a dog actually does nothing to the actual ligament. An artificial suture or cord is placed alongside the joint as if to “fool” the knee joint and permit it to move in a normal fashion. There are a number of methods and materials used to repair a knee after a torn ACL injury. Presented here is one such case.
This patient is an eight year old, slightly overweight retriever named Buster who began limping on a rear leg one month ago. Recently, while chasing a Frisbee, he cried out in pain and began to hold the leg up and didn’t get much better after three days. When the owners finally brought him in to be examined the doctor noted a slipping motion in the right knee. Instead of moving like a hinge, the leg just below the knee would actually slide forward and backward. This abnormal motion is typical of a torn ACL, anterior cruciate ligament. Another new procedure is called the TIBEAL PLATEAU LEVELING OSTEOTOMY or TPLO surgery. There will be more about this procedure presented here soon.
“Buster has a torn Anterior Cruciate Ligament” the doctor said. “The best way to get him back to full function would be to do a surgical procedure where we place an artificial ligament along the side of the knee joint; we don’t try to fix the torn ligament because that particular one just won’t heal properly. So we fool the knee into thinking that there is a ligament and after a few weeks of confinement your dog can begin using the leg properly.”
“And what if we didn’t do the surgery right now, Doctor, can we wait a few months?” the owner asked.
The doctor responded that the dog probably already has some arthritic changes in the joint since it had been limping for about a month. The ligament had stretched and and the joint had been unstable until finally the ligament tore completely. Any time a joint becomes unstable pathologic changes begin and can progress to the point where permanent damage is done. “I will be able to see some arthritic changes already during surgery so waiting longer to do the corrective surgery would not be in the dog’s best interest…and the results from surgery would be less rewarding” said the doctor.
Come with the doctor and view Buster’s surgery. Oh, and please don’t touch anything! The surgical area needs to be completely sterile…
Post operative care for a dog with a torn Anterior Cruciate Ligament needs to be carried out in accordance with the veterinarian’s instructions. Leash walking for up to six weeks may be a requirement in order to allow the necessary healing to be well established before the dog places any real stress in the knee joint. The suture material that the surgeon selects to take over the work of the damaged ACL needs to have a supporting deposition of fibrous tissue which will help stabilize toe knee so that no slippage (called a “drawer slip”) of the femur occurs over the tibia. Slow return to normal may take as long as six months and even longer for older, overweight or large breeds of dogs.
An incision is made in the lateral side of the knee joint. Just below the kneecap, at the top of the tibia where the patellar tendon inserts on the tibia, a hole is drilled through the bone. Heavy sutures will be passed through this hole as an anchor point for the new artificial tendon.
In this view of the opened knee joint the arrow points to the remnant of the torn anterior cruciate ligament. Another arrow points to the rough ridge of bony arthritis that has built up. The surgeon is looking for any other damage such as a torn meniscus which can create further arthritis.
Here the needle and suture material has just been passed through the hole in the front of the tibia bone. The next step is to pass the suture material behind the knee and around another anchor point. The heavy suture material will serve as a new ligament and stabilize the knee.
The large needle is being passed behind a small bone (called a fabella) behind the knee. The needle helps the surgeon pass the suture behind the fabella as an anchor point. The tibial tuberosity is the other anchor point for the suture material (which takes the place of the original cruciate ligament).
In this view we see the heavy suture material being drawn tight and a knot tied. This suture will act as a new ligament, essentially fooling the knee into thinking there is still an original ligament present. Now the knee is stable again and there is much less risk of additional arthritis.
The joint capsule is closed and the deeper tissues are sutured together. Then the skin is closed and the incision area is cleaned up. There is surprisingly little bleeding in this procedure. Sutures are removed in 8 to 10 days.
Your veterinarian may suggest in certain cases that a TPLO (Tibial Plateau Leveling Osteotomy) procedure be done where the tibial bone is precisely cut and slightly rotated downward, then held in place with screws and a special plate, until healing occurs. In large breeds and overweight dogs, the TPLO procedure may be advisable. Special training will be required for any veterinarian to be able to properly perform the TPLO procedure.
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SOURCE: ThePetCenter.com
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Jan
My 5 year old black lab is having this procedure in 5 days. What recovery tips do you have. Thanks Jan
HART (1-800-HART)
Hi Jan…
Sometimes the post operation time that can be a bigger challenge than the surgery! Aftercare is vital to the healing process. Our Maxxie had Canine Degenerative Disc Disease and it happened during XMas and didn’t get in for treatment until well after the safety period (12-36hrs after occurrence) to make any surgery useful, so we opted out.
We literally kept him confined to the kennel for 14 days so the nodes can heal. It was tough the first week, we wouldn’t even let him outside and he did ‘his business’ in the kennel and we kept it clean. We couldn’t risk him running, or twisting, or jumping or anything to make his condition worse. It was probably harder for us actually 🙂 But, now he is jumping on the bed – although we do have a little footstool to help and usually lift him off just in case. We also give him a baby aspirin every morning placed in a little milk bone piece, covered with peanut butter to help him with the pain.
I would be sure to discuss this with your Vet.
Stacy
Hi Jan,
My advice would be that of course the whole recovery period is so important, but especially that first two weeks. My dog had the TPLO surgery. The first two weeks of recovery were scary and rough at times. But you hit that two week mark and things get easier! hang in there, and good luck!
Keith
Hi,
My Border Collie had ACL Surgery June 10. As he started using his repaired leg again I notice a popping sound everytime he bends his knee. My vet says it happens in about 25 percent of dogs that have this surgery. He says the noise I hear is the suture rubbing against the rough bone. He his starting to put weight on his leg and it doesn’t seem to hurt, but I am still a little concerned that this is not normal and he will need more surgery.
Anita
My dog had ACL repair on her left hind leg 7-11-2007 and is now having difficulty walking and having ovious pain in that leg again. Is this normal, and can her leg be splinted to make her rest it? I’m afraid she will need surgery again.
Shannon
Hello, I have a slighty over weight alomost 7 year old black lab (Zoey) whom is getting this surgey next tuesday, If anyone has any tips on what to do to help her with the pain now and after the surgery i would apprienated? Also Zoey has a off the chart high liver enzine count how can i control the liver count along with rehabing her leg?
Thanks for any help
Shannon
SARAH
Hello, my dog had surgery on her torn ligament on her hind left leg in July 08, all has been fine until this week and she is limping again. Think she may have slipped but didn’t see it happen. Really scared she will need another operation on it. Has this happened to anyone else’s dog?
Judy
Hi, I have a boxer/lab mix (free mutt), 5 years old, had acl repair in march on left leg, healed great. In Oct. had her right leg, healed great the first month she walked on it from the time we left the hospital. But now she walks O.K.,slight limp sometimes and holds it up almost every night.The vet thinks she is babying it, but I’m not so sure, any one out there every have anything like this with similar symtoms?
HART (1-800-HART)
@Rebecca_M http://bit.ly/LWm7P and http://bit.ly/LWwlg are some good articles of interest
RICHARD SUDDARDS
Hi, I have a heavy boxer mastif X that has just had the ACL operation. could anyone give some advice on recovery and pain management. He is crying all the time and I feel riddled with guilt for putting him through it.
Kim
My boxer (55lbs) had the ACL repair surgery Dec 08, she is still having complications with her back right leg. The first week was the hardest, she cried alot even with the pain patch on her. We had to use a towel under her back hind legs to help her squat to do her business. She was not allowed to use the stairs for the first couple of months, so we were carrying her up and down everytime she had to go. We did everything the vet told us to do and she said that by summer she would be running around again as usual. We had to take her back a couple of months after surgery because she was still limping quite a bit, and the vet said she was developing arthritus. She takes a joint supplement everyday. She got better and was playing with our other dog, running around but not over doing it. She seemed really happy to be playing again! But, now I hear the clicking again and she is limping again. I’m worried she will need another surgery 🙁
Jason
My Cocker Spaniel had this surgery about a year and a half ago, all went well, until this weekend. Took him to the vet with what I thought was some sort of infection around his scar, but found out his body is rejecting the nylon they used to stablize the joint. Now they want to go in and remove it. Anyone have any experience with this? Advice, or thoughts…?
orthopedist
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rhonda box
my 3 1/2 yr old boxer had acl surgery 6 weeks ago, still has a slight limp and sometimes wants to lifts it up when walking, almost like a skip. also has a few bumps along scar of leg. is this normal
Jeremy
I have a 2 and half year old american bulldog who has had both acls repaired with the tplo surgery about2-3 weeks ago and iv noticed a popping and clicking sound in the left leg which was done second!! She is not in any pain n seems to walk fine but what could b making the sound! Its about 3 clicks in a row everytime she bends her leg it seems! Any help would b great! She goes to the vet in a few days