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Don’t be shy… Post on our NEW Dog Knee Injury Forum!

In response to the high volume of comments a lot of the post have been getting, I’ve opened up the forums as a way for dog owners to connect and discuss their dog’s orthopedic issues with one another.

How to post on the Dog Knee Injury Forum:

1) You must register for a user name to post on the forum.

2) After you’ve registered and retrieved your password from your email, log in (I recommend changing the password to something you’ll remember) and start posting!

3) Keep the comments on topic, and be nice. If anyone encounters any issues on the forum please post in the comments on this page/use the contact form, and I will look into it.

CCL Repair Forum for Dogs is a post from: Dog Knee Injury

Ben is doing extremely well at 2 weeks.

Day 2
Ben is feeling much better. On our walk, he actually lifted his good leg and stood on his leg with the surgery to go pee. Never thought I would be excited watching a dog pee, but that was amazing..

Days 3-4
Ben starting walking more and more. I actually caught him a few times standing on his hind legs looking out the window.

Days 5-6
I believe he started walking better than the day before surgery. Also, he is walking and standing normal. It is barely noticeable he is favoring his leg.

Days 7-8
Ben is starting to get his “gait” back. If you every watch a Standard Schnauzer, they kind of glide effortlessly across the room. He is actually getting it back. It has been months since I have seen him walk like that.

Ben is having a reaction to the staples. His incision is starting to swell and become red. The Vet has us come in and she gives him some ointment that will soothe his reaction. The Vet is amazed as to how well he is walking.

Day 10
Ben has his staples removed and his incision looks good after using the ointment.

Day 14
Ben is at the 2 week mark and is doing great. For the most part, Ben is standing and walking normal. However, he does still favor his leg on occasion. Per the Post Op instructions, Ben is walking a 1/4 mile twice a day. Muscle definition in his leg is starting to come back.

As he is getting better, it is getting harder to keep him under control. He wants to play at every chance he can get. He is feeling better than he has felt in months and is showing it!!!

TTA Surgery, 2 Weeks Post Op – Ben is a post from: Dog Knee Injury

Ben’s Story:

Ben is a 4 year old Standard Schnauzer. We believe he suffered a partial tear in his Left CCL in December 2008. We didn’t give CM (Conservative Management) a chance until about July 2009, when he was diagnosed with a CCL tear. Prior to that, it only appeared to be a minor injury. Since July 2009 when we started CM, Ben would start walking and standing normally, but would often suffer set back after set back. I will be the first to admit that most of the set backs were due to my stupidity. I guess it could be argued we never gave CM a chance.

A few weeks ago, we gave up and did some more research. The Vet indicated that he could be healed through CM, but if we wanted him to be the athletic dog he used be, then he would need surgery. Ben was/is my hiking buddy and used to go on 7-8 mile hikes in the Utah Mtns all the time. He could run for hours and hours without taking a break. The Vet believed he would never be able to do that through CM without being down the rest of the day and/or next day. We scheduled him for TTA surgery with an Orthopedic surgeon that is believed to be the best in Utah, if not the best in West. From our research, the TTA surgery appears to be far superior to the TPLO. Dogs tend to be healed within 3-4 months. Also, they tend to be weight bearing on the leg within 24-48 hours. Within 2 weeks, some dogs are pain free.

Ben made it through surgery just fine today. The Orthopedic surgeon called us and indicated to our surprise that Ben had a complete tear in his CCL and the Meniscus was completely torn as well. If I knew he had that much damage, I think we would have scheduled surgery much sooner. The Orthopedic Surgeon did tell us that he does not believe Ben will suffer anymore arthritis than normal because of our delay in scheduling surgery. His joint appeared to be clean with only minor swelling. The surgeon believed his recovery will be just as good as if we scheduled him back in 7/09.

At this point it is anyone’s guess if he would be better or worse with CM. As of now, we have the peace of mind that knowing the end is near. With CM, we never knew when the road would end. I will post updates on Ben’s recovery over the next several weeks.

Day 1 (after TTA surgery)
When I picked Ben up from the Vet, he was completely opposite from what I expected. I expected a dog that looked like he had been to hell and back. Instead, Ben was dragging the Vet tech into the room. As we were talking to the Vet, he sat on his leg that just had surgery. The Vet was impressed with the very little swelling around Ben’s leg. As we walked outside, he was practically dragging me to the car. His spirits are completely high, and looked like he wanted to go play.

As we were getting into the car, I was planning on picking him up and placing him inside the car. Instead, I opened the door and he leaped into the car. He missed and gave me a complete heart attack. I caught him as he was falling to the ground. I expected him to cry out in pain, but he acted like nothing was wrong. Once inside the car, he was jumping from seat to seat like nothing was wrong. Once he was home, he immediately went for his food.

At this point he is just toe touching on the leg with the surgery, but he is getting around fabulous on his 3 legs. About 5 hours later, I took him for his first walk. We walked past a few houses before we turned around. As we got close to home, I noticed he started walking on his leg. He continued to walk on it (with a limp) the rest of the evening!!!!!! It looks like my biggest challenge at this point will be keeping him under control so that he can heal properly.

TTA Surgery and CM – Ben’s Story is a post from: Dog Knee Injury

It has been 1 week since Tim’s TTA surgery, and she is now starting to get very playful. It’s going to be difficult to keep her quiet. Her surgical line from the TTA is beautiful, bruising and swelling are completely gone.

Days 8 and 9 were uneventful. Timber is enjoying the great weather, and she is putting more weight on her leg with each day.

Days 10 and 11 we had been working around the outside, so I decided to let Timber on the deck; I had both sets of stairs baby gated so she could enjoy the outside. Well… I suddenly hear my husband yelling, so I quickly run to the back of the house to find that Timber jumped over the gate!! She seemed to be fine but back in the bathroom she went.

I gave her a pain pill and her anti-inflammatory and she rested for the remainder of the day.

Day 12, Timber seems to be okay since she decided to jump the baby gate. She is definitely becoming more active…I am reminding her and myself that its only been 2 weeks, and she still has a good 4-5 weeks to go until fully healed from the TTA surgery.

Day 13-14, it’s been 2 weeks since surgery. Timber will be going in for suture removal on Thursday, and I am very pleased to say that she never once licked or bit at her incision – mommy is so proud of her!

TTA Surgery Recovery – 2 Weeks, Timber’s Story is a post from: Dog Knee Injury

Timber went in for TTA surgery on Tues March 9th, and the surgery went great. I picked her up on Wednesday, the staff said she a had a good night, she was so sweet, she was one of the quiet ones and she didn’t cry or bark. Her first day home was uneventful. She was just so happy to be home and see her brother Tucker (he is my 12 year old male shepard mix). She doesn’t seem to have much pain, her surgical line looks beautiful, and she has moderate bruising and some swelling. She is currently on anti-inflammatory meds, ABT, and pain meds (as needed). The hardest part was taking her to go potty, because she has to be on a leash (which she is not used to), so she would just stand there and stare at me!

Timber is toe touching by Day 3 following the TTA surgery. I think she sometimes forgets and actually puts weight on her leg, but then realizes that it’s still too sore. She has been eating and drinking without difficulty and chewing on her toys (she’s a great patient!!) I forgot to mention that she has taken over my powderoom, that is the only room on our first floor that we can keep her in. She has never been crated, and the other rooms have oversized doorways that we cant baby gait, so the bathroom it is…I think she really likes it!

It’s Saturday March 13, Day 4. We are in the middle of a severe rain/wind storm, so getting Timber to go potty is an obstacle. She wants nothing to do with going outside…UGH! Other than going potty she is doing very good. There is definitely a difference between the two recovery periods, even though she had a great recovery from the TPLO, she had much more discomfort, didn’t eat much, and wasn’t putting weight on her leg at this stage of the game. So far, so good!

Not much to report on Days 5 and 6. Oh yes there is – one thing, I wasn’t paying attention and I forgot to put the baby gait up and the little bugger walked up the entire flight of stairs!!! Mommy was not very happy but she seemed to be okay…thank god!

TTA Surgery Recovery – 1 Week, Timber’s Story is a post from: Dog Knee Injury

Timber is a 6 year old female shepard mix; she is my baby. In August 2006, Timber tore her left ACL and she underwent TPLO. She recovered beautifully from TPLO surgery. Nearly 4 years later, she developed an abscess over her TPLO scar. I took Tim to my local vet, and she said that it looks like it could have been a suture from her surgery that did not dissolve. In for surgery to remove the abscess she went.

After two weeks the abscess started to grow back, so I took her to the surgeons office (who did the surgery 4 years ago), to find out that the stainless steel plate she had, had become infected. He recommended to remove the plate left in after the TPLO surgery. On Feb 7, 2010, Timber went in for plate removal, and on that same day she was also diagnosed with a torn ACL in her right knee. I was told I needed to wait 1 month until she had her right knee operated on because she had 2 types of bacteria growing on the plate in her left leg; she needed a course of antibiotics.

So we waited, and mommy did her research. After plenty of reading I chose the TTA (Tibial Tuberosity Advancement) surgery, which uses a titanium plate. I felt that she was at a greater risk of rejecting the stainless steel plate with the TPLO surgery. I did my research on the two type of metals, and titanium seems to be the better of the two, so we went with TTA.

TTA Dog Knee Surgery, Timber’s Story is a post from: Dog Knee Injury

Not surprisingly, surgery is almost always advocated by surgeons . It is likely that surgery does help reduce the amount of arthritis that occurs, but in a long term study of cruciate ligament surgery in dogs in Australia, about 50% still had detectable arthritis in surgically repaired joints and about 10% of dogs were persistently lame despite attempts to surgically stabilize the joint. Tibial plateau leveling osteotomy (TPLO) has become the top choice for surgical CCL repair among many orthopedic veterinarians, and it can be done in both large and small dogs. Supporters of TPLO will say its good choice for the situation in which there is a bilateral cruciate rupture since it seems to be a strong repair procedure, but there are many instances where dogs have done equally as well with either TTA or a traditional repair.

One benefit of doing a traditional extracapsular repair, in addition to saving a few thousand dollars, is that you still have other options for repair if for some reason the traditional repair fails. If you are choosing surgery for a dog with a double CCL rupture, make sure to research each procedure carefully before blindly going along with a procedure you know nothing about. TPLO, TTA and traditional repairs are all very different procedures, and each carry their own set of risks vs. rewards. The best way to find out what is right for your pet is to do as much research as you can and find a veterinarian that is willing to discuss your many options for surgical intervention.

If surgery absolutely isn’t an option, there is a very good chance that in a few weeks, to a few months, you will find that your dog is doing OK without any type of surgical intervention -especially if you can manage the weight loss. There are a number of great resources both on this website and the web with instructions on how to succeed with CM.

CCL Injury in Both Back Legs is a post from: Dog Knee Injury

So which is better, TPLO or TTA?

Well, if your veterinary surgeon has no experience performing TTA’s, as it was only introduced to US surgeons starting in 2004 so many vets do not, you will want to opt for the procedure with which your vet can demonstrate proficiency and results. Many veterinary surgeons perform both TPLO’s and extracapsular imbrication techniques, but there are not many who perform all three. If you have the option of choosing between a surgeon that does a TPLO and a TTA, and have an active, large breed dog that would not do well with a traditonal, or extracapsular imbrication, repair, you will want to weigh all the characteristics of both procedures.

Which is less invasive?

The TTA is surgically less invasive than the TPLO. The amount of stifle angle shifting that takes place during a TTA is minimal when compared to that of a TPLO, where the tibia (the weight bearing part of the knee joint) is surgically cut and altered. In the TTA the osteotomy is made into the tibial tuberosity (not a weight bearing part of the knee joint), not the tibial plateau itself, giving dogs a greater ease in healing, recovery and overall success of the procedure.

Which has a shorter recovery time?

The TTA, because it is a surgically less invasive process, has a shorter recovery time than the TPLO. While most TTA and TPLO dogs are able to begin weight bearing within the first 24 to 48 hours postop, TTA dogs continue to improve with time, whereas TPLO dogs often demonstrate a more gradual healing process taking place over months instead of weeks.
Which has less risks of complications?

What does each procedure cost?

The least expensive method of cranial cruciate ligament (or CrCL) repair is always going to be the extra capsular imbrication method, as it does not require the use of any implants or an osteotomy procedure, and you can expect to pay between $700-$1100 to have a traditional repair done. This procedure can be a great option for many dogs, and I encourage all owners to read more about its risks and benefits when considering surgery for a CCL rupture.

When comparing the TTA and TPLO, the TTA is less expensive, and this is due to the simpler nature of the procedure as well as the fact that it does not require as much equipment, despite the fact that titanium costs more than stainless steel. A typical price for a TTA will run between $1500-$2000 vs. a TPLO ranging between $2200-$2700, which usually includes all of the pre-operative testing, postop medications and post-op visits for suture removal, bandage removal (if applicable) and radiography.

TPLO vs. TTA for Cranial Cruciate Ligament Repair is a post from: Dog Knee Injury

The osteotomy will take 6 to 8 weeks to heal, during which time your pet will need to be kept relatively quiet and only allowed outside on a leash. Your dog will most likely start to feel that they are completely healed within a week of the TTA, but it is important to not let them to do too much too soon as they risk damage, not only to the implant, but a CCL tear in the opposite knee. Many veterinarians will advise pet owners to keep their dogs sedated during this recovery process to assure they remain quiet and only go outdoors to relieve themselves.

All dogs with CCL injuries will go on to develop some level of arthritis. It is a good idea to have your dog’s knees x-rayed during your yearly veterinary visits to examine the presence of arthritis and determine what type of treatment plan would be best for your pet to make them the most comfortable.

TTA Repair Postop Recovery is a post from: Dog Knee Injury

Complications and risks associated with tibial tuberosity advancement surgery:

• Swelling around incision site – happens in about half of all dogs
• Dirrhea, nausea or loss of appetite during post operative recovery
• Incisional dehiscence – spontaneous separation of the incision site
• Severed long digital extensor tendon
• Tibial crest failure – this most often requires re-operation as the stability of the implant is compromised
• Patellar luxations – dislocation of the knee cap; this can range from moderate to severe
• Implant rejection and/or infection
• Meniscal pain and post-op tearing of the meniscus

TTA Repair Complications is a post from: Dog Knee Injury