Does My Dog Need a Meniscus?
When 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?
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
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.
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!
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.
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.
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.
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
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
I should add that my dog is only 2 years old…she’ll be 3 years old at the end of May.
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.
What is the average cost for this surgery?
Thanks,
Rick