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Does My Dog Need a Meniscus?

Surgical Repair for a Torn MeniscusWhen there is a joint injury like a cranial cruciate ligament (CCL) rupture, it is important for the vet to try to preserve the menisci to the greatest extent possible. Loss of all or part of a stifle’s meniscus has the potential to accelerate the breakdown of articular cartilage with resultant DJD (Degenerative Joint Disease). The more of the meniscus that is lost through injury or through surgical removal, the less stable the joint will be in future, and the greater the potential for DJD, i.e. arthritis. The risk of further damage to the menisci is minimized by greatly reducing activity after ligament injury while the dog’s body re-establishes stability in the joint.

Whether or not your dog has surgery to temporarily stabilize the joint after ligament rupture, long term joint health is best assured by careful restriction during a slow return to normal activity over a period of at least several months, and by avoiding unnecessary surgical removal of all or part of the meniscus. People are sometimes told that their dog’s meniscus is damaged and that the meniscus cannot heal on its own therefore surgery is always required for meniscal injury. This is not true. In fact, there are two basic methods used by the body to repair meniscal damage:

1) Extrinsic - When meniscal tear occurs, a fibrin clot forms within its margins. This fibrin clot contains factors that act as agents for reparative cells to migrate and develop. Further inflammatory response and angiogenesis result in healing of the lesion in about 10 weeks in the dog. It may take months or even years for the scar tissue to change into fibrocartilage, resembling that of the meniscus. Differences between the newly formed fibrocartilage and mature fibrocartilage are recognizable and include increased cellularity and, at times, increased vascularity in the repair tissue.

2) Intrinsic - The cells within the meniscus itself have an inherent capability to generate a healing response. The cells of the meniscus are assisted by the fibrin clot, which not only acts as a scaffold, but also provides stimuli to promote healing.

Why should I be wary of a veterinary surgeon removing my dog’s mensicus during ccl repair surgery?

There are many veterinary surgeons out there who are much too quick to carve off parts of a damaged meniscus when the dog would be far better off with the joint left alone to recover using its own resources. The menisci are now known to play an important role in the complex biomechanisms of the knee. But just a few decades ago doctors believed the menisci were functionless tissue that could be removed without consequence. Surgeons routinely removed the entire meniscus if there was any indication that it was even slightly damaged or for no reason simply as part of their standard procedure when doing any stifle surgery. This resulted in crippled dogs as Degenerative Joint Disease developed in the joints.

Eventually the more observant doctors woke up to the fact that the menisci were important joint components, and in recent years the more enlightened surgeons have become less aggressive in removing all or part of the meniscus. But there are still many vet surgeons who cut far too much of a meniscus away. Some of these guys just can’t stop themselves from getting in there and excising something. Their approach is often, “When In Doubt, Cut It Out” and is a rule of thumb often used in canine stifle surgery. They won’t usually tell clients that of course. The history of surgery in general is filled with examples like this of too-aggressive surgical intervention. Never be too trusting of a surgeon. They became surgeons to cut; not to tell you no cutting is needed.

Source:

About the Dog Meniscus – http://home.earthlink.net/~tiggerpoz/id16.html

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25 Responses to Does My Dog Need a Meniscus?

  1. Jan Manor June 26, 2008 at 5:25 pm #

    My Corgi tore her meniscus while twisting to scratch her back end. The emergency vet I took her to said surgery would be the best thing for her, but I disagree. It has been a week, now, and I’m keeping her as still as possible. I fully agree with the article I just read that she CAN heal without surgery. It’s just going to take a while to get her back to walking, again.

  2. Todd M October 1, 2009 at 9:46 am #

    My 2 yr old Golden Retriever (Male-100 lbs.)developed what appeared to be a meniscus tear post CCL surgery. He had a TR procedure for a CCL on his right rear stifle. We discussed with the surgeon who recommended continued restriction, which we have been doing for the last 10 months. We have also seen our regular Vet during this period, but he would not recommend a treatment other that seeing another surgeon.
    I’m somewhat concerned that we are doing all that needs to be done by treating it only with restriction. He has improved, but very slowly. Only occasional clicking and he can walk okay, but not normal. You mention that it may take years for the tissue to regenerate and this may be what we are experiencing. Any advise or comments would be appreciated.
    Thanks!

  3. Cindy October 1, 2009 at 12:39 pm #

    Note to Todd M: If your dog underwent the Tightrope procedure & is still experiencing lameness 10 months later, I would strongly urge you to seek a second opinion from another ortho surgeon. I would also recommend you get the leg x-rayed. There have been many cases of the fibretape abrading the bone & causing the bone tunnel to expand. This is a complication the surgeons have been reluctant to talk about or admit. It could also be a case of torn meniscus due to the knee remaining unstable. In both cases, your dog could be experiencing considerable pain. A torn meniscus will not heal on its own & will need further surgical repair.

  4. Todd M October 1, 2009 at 6:44 pm #

    Cindy
    Thank you for your quick response. I will get him to an ortho surgeon a.s.a.p. Do you have any recommendations for a good Ortho Vet in So Cal? On the bright side, he doesn’t appear to be in too much pain as he is quite active…more than we would like.
    I will update this blog when I know more. I really grateful there is a site like this out there.

  5. Cindy October 2, 2009 at 9:26 am #

    Todd M: I am in Canada, so I am not overly familiar with ortho surgeons in S Cal, but one name I have seen mentioned over & over again, with nothing but positive feedback, is Dr Andrew Sams of Mill Valley, CA.

    http://www.thesamsclinic.com/index.html

    Here is a website with feedback from some of his clients.

    http://www.yelp.com/biz/the-sams-clinic-mill-valley

    I hope that helps.

  6. Max October 8, 2009 at 5:50 am #

    Hi,
    I see you have utilized a good deal of my writing here at your website. I am happy to have you do that. My purpose is to help dogs, not to be possessive of my research. Your website provides a valuable resource to people facing dogs’ stifle injury problems & I am pleased to have your website use my writing. However, I would appreciate a link to my website on yours in recognition of your use of my work product. But my main reason for writing today is to point out to you that I have added to the information on my ‘Meniscal Info’ page about the common surgical practice of Meniscal Release, and suggest that you might like to include some part of this on your website also. ‘Meniscal Release’ is seldom explained to clients as what it in fact is– a way of reducing the risk of post-op crush injury to the meniscus by altering the attachment of the meniscus, removing it from functional position to a great extent.
    Wishing you continued success with your efforts to help dogs,
    Max

  7. Jen February 4, 2010 at 4:46 pm #

    Hi. My dog had acl surgery (tightrope)on both of her hind knees last year March. She is a bullmastiff and is about 125 pounds. After surgery she went through some periods of lameness where she would seem to limp on one of the legs and then eventually get better (she still shuffled when she walked, but got along fine). She just started limping pretty badly again. The surgeon said that he wanted to give her some time to see if the problem repairs on it’s own with giving her rimadyl (anti-inflammatory) and tramadol for pain as we’ve done in the past. However, it’s been about 10 days of the limping. The surgeon said that if she does not improve in about one month, we could consider doing a laproscopy procedure again on both knees to check out the menisci and possibly tighten up the knees if need be. What is your suggestion and for how long will this help her if we do decide to go with another surgery? Thanks for your help.
    Jen

  8. Jen February 4, 2010 at 4:57 pm #

    I should add that my dog is only 2 years old…she’ll be 3 years old at the end of May.

  9. trish February 11, 2010 at 10:17 am #

    My 65 lb Lab had the ACL surgery (tightrope)1 1/2 yrs ago but he is still not “right”. He runs but afterwards he keeps his leg up and won’t put pressure on it. Even when he is not active you can see that he does not put weight on it like he does the other leg that has not had a tear. We took him to the Ortho vet today and she wants to go back in and repair his meniscus amd remove the implant from his prior surgery (she did not take xrays). I really do not want to put him through another surgery (he had the original surgery and had to have another surgery because the line came untied). Does anybody have an opinion on what I should do? I have read that there are some holistic things to try but I’m unsure of what to try. Any advice would be appreciated.

  10. Rick March 15, 2010 at 3:51 pm #

    What is the average cost for this surgery?

    Thanks,
    Rick

  11. Jack September 12, 2010 at 12:18 pm #

    Hi, I got a 10 months old pure bred Blue Merle female collie..a few month back she thorn a tandon on her back leg, while running, the vet gave her anti inflammatory and told me to keep her quiet for a while and I did and she was doing really good playing again but yesterday it happen again her back leg was hurting and there was a popping sound when she was trying to walk….Call the vet and he told me from the sound of it it would be Meniscus problem and might need sugery and to come see him on monday for exam….Now my question is: is it normal for a young healthy dog to have that much sensitive back leg, or is it a congenital defect …as my dog as a 2 years health garanty from the breeder . what should I do…I know today she is ok when she walk but the moment she try to go faster that popping noise come back…and she doesnt seen to be in pain, she is eating and chewing on her toys and look alert…and from what I see on the internet the surgury is not a good idea, better to let her heal on her own…I need advise…thank you..

  12. sherry September 25, 2010 at 8:25 pm #

    Our 2 yr.old German shepherd had surgery on the right knee for an acl in June this year, seemed to be healing well, then in August tore the left acl and meniscus, and required much more extensive surgery, and doesnt seem to be healing as fast as the first surgery on the right knee. Anyone know how long it takes for a young dog to recover from this type of surgery?

  13. Kathy October 5, 2010 at 11:13 am #

    I have a 5 year old large lab who had his ACL repaired on both legsand his meniscus done on one. Now he’s limping so bad on the one w/o meniscus repair. Took him to the vet now he needs this meniscus repaired! Is this normal?

  14. claire December 12, 2010 at 6:57 am #

    i have a 7 1/2 year old german shepherd who had a cruciate ligament repair in july and is still lame. the vet thinks he may have a meniscus tear and wants to re x ray and possibly perform a meniscus release. what are your views

  15. Lesley December 15, 2010 at 10:12 am #

    I have a 2 year old rottwieler who had cruiate surgery 5 months ago, recovered well and has been great on the leg. Two days ago he started been lame on it again and not baring much weight on it. I phoned my vet and he said may just be arthritus and to give him his pain meds do I need to worry that he has hurt the knee again? or will it just be arthritus pain and rest for a few days?

  16. Janice December 31, 2010 at 4:04 pm #

    Our rottwieler had TPLO surgery last March which involved a small part of the meniscus being removed as well. Recovery took a little longer than usual but we got there eventually. But then she became very lame on the same leg after chasing a squirrel. It didn’t settle so she went for more surgery to remove the plate as sometimes this can niggle them a bit and look at joint. Apparently the meniscus was so damaged it could be seen as soon as he opened the knee up. He took more meniscus away which leaves about 20%. She is on rimadyl and tramadol. I want to do the right things to help her to an active life but maybe no squirrels.

  17. sherry February 11, 2011 at 2:27 pm #

    Does anyone know what is done in a meniscus removal after CCL surgery?
    Wouldnt that just be bone on bone if the meniscus is removed?
    Has anyone had the meniscus removed from their dogs knee after ccl surgery, and how did your dog do, I just dont seem to understand this procedure, and if it is really necessary. He was diagnosed with a meniscus tear, because the vet heard a popping sound when examined 4 mo. after the second surgery. He doesnt seem to be in pain, limps only after lying long periods on that leg, but the limping goes away very shortly. We are not letting him outdoors off leash.

    • Max February 11, 2011 at 4:01 pm #

      Sherry,
      It is very common for vets to recommend these surgeries based on clicking & popping sounds, but the truth is that the surgery is not only unnecessary in most instances but harmful in that removing all or part of the meniscus unavoidably increases arthritic changes in the joint over time. Please see my website for more info.
      //www.tiggerpoz.com/id11.html

      • Frankie February 11, 2011 at 4:13 pm #

        Max – Are you a veterinarian or animal rehabilitation specialist?

  18. Michael February 11, 2011 at 3:23 pm #

    Regarding Meniscus removal…My 5 year old Golden Retriever has had CCL Tightrope procedure in both back legs. Before and after both surgeries, he displayed the “clicking” sound of a torn meniscus, but the surgeon recommended that the “meniscus be left alone”, saying that it would eventually heal on it’s own. The surgeon did not remove meniscus tissue even though there was damage, and it does appear to have repaired itself. It did take several months with no walks, running or jumping and restricted activity. My dog’s case may be different than yours, so I would get a 2nd professional opinion.

  19. Jack February 13, 2011 at 6:40 am #

    well, I guess it was false alarm for my blue Merle collie( see comment in september)..in September she had what we tough was a meniscus problem, all the symptom point to it, the vet recommend some anti-inflammatory to start with, use it for 3 weeks, a some point she could walk without the popping sound…but one day everything went away..no more problem, the vet was very puzzle by that..my breeder think cause she was still growing up, maybe something went out of whack and then some day pop right back at the right place… I am so relief, she is such a great dog..:)

  20. Mike May 8, 2011 at 10:26 am #

    My dog Recently had a tibial plateau leveling performed and is still experiencing lameness. The vet suggests a menisectomy because of a problem with the meniscus on the knee that had the prior surgery. Any comments would be appreciated and a referral for ortho-vet on Central Coast, California. I am leary of rushing into more surgery

  21. janice Wilbourne May 9, 2011 at 6:50 am #

    Our rottie had TPLO in March 2010 which involved some meniscus removal and after five months seemed to be back to normal. Then she went lame on it again and had further surgery as some of the remaining meniscus had become damaged and was apparently visibly sticking out when the surgeon went into the knee. I know its important to save as much of this as possible. We have gone over things a hundred times thinking we did something wrong but the surgeon said we hadnt and it was just the way the leg was working. She has 20% meniscus left now on the inside knee and is doing ok with the help of some tablets (which I’m going to ask if she can come off) and joint aid. But no more chasing squirrels.

  22. Maine September 13, 2013 at 6:23 pm #

    So our Golden (BOO) just was diagnosed and the recommendation is surgery on both knees. I am confused that he showed NO issues until a month ago. He has a younger sister that plays with him A LOT. BOO is 11 and sister is 3. My wife wants to look for the the 3rd perfect member to our family now. 40 years of having goldens?. she always want to make sure the pack is intact.
    so i guess this will sound cruel but I have 5 kids going through college (blended family for me). I LOVE BOO BUT WHAT TO I DO WHEN IT IMPACTS THE KIDS GOING TO COLLEGE! I am getting quotes of $6000.00 dollars for both knee”s. That means ALOT to college and I am sorry if it so not sensitive but I need to help kids with school. All of the dogs that we have raised have a life expectancy of 12 years. SIGNED OFF CONFUSED IN MAINE

    • Patty January 3, 2014 at 6:46 pm #

      MAINE:

      Sounds like you went to the same Maine vet surgeon we did – $3K for one knee surgery. I don’t mind paying for expertise, but I DO mind paying $120 for two paper gowns (seriously). We are facing a possible second surgery for the other hind leg of our pittie mix and will be shopping around. This website raises some questions in our mind though. She won’t stand on her leg, but she eats and plays with gusto, and I can see no issue other than her sudden desire to travel on three legs. We know she has arthritis, and who would not be hurting in this prolonged cold spell.

      Your comments and others would be welcomed.

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