Extracapsular Repair with Swivel Lock System – Josie

I have have a 2 1/2 year old Cane Corso Mastiff and about 4 weeks ago she tore her left ACL and I was devastated. She is so young and I knew recovery post surgery was gonna be hard because she is still a puppy!

I’m not sure exactly how it happened, but I know she has very bad hips and the right hip is the worse so my vet thinks that she was over compensating on the left leg because of her bad right hip. She is doing well, but I have major concerns about re-injury and also injury to the other leg.

The Swivel Lock is a fairly new procedure, but it is available where I live in Florida. The Swivel Lock system is a extracapsular repair that is very similar to the tight rope procedure. We chose to use this system seeing as she was such and big dog, and with this system, all parts if the implant are buried so it does not disturb the muscle as much as some of the other systems.

Right after surgery she was toe touching with the leg and within one week she was using the leg but only putting about 25% of her weight on it. We have been doing a lot of physical therapy with her since surgery.

Week two we started going on short walks and using physical therapy tools to help her use the affected leg. We are now on week four and she is already weight bearing about 80% on the affected leg. We are doing water physical therapy with a under water treadmill weekly. She does have some muscle atrophy that we are working on rebuilding. I had major concerns about the high probability or her tearing the other ACL so we are working hard on getting her repaired knee back to 100% working order and I must say she is doing great!!! I must say with a dog her age the hardest part of after care is keeping her quiet and making sur ethat she does not re-injure her leg.

Josie is now about four weeks post surgery and is doing great!!! I feel that the extracapsular repair was a great choice for Josie and I. I love that it is a less invasive surgery and with the correct post operative care, correct joint support supplements to help prevent arthritis and physical therapy it can have excellent results. Our recovery has gone very smooth.

I was looking into getting her the A-trac brace but wanted to do a little more research. I don’t mind spending the money if it will help and hopefully prevent the other ligament from tearing as well because I know the statistics of injury to the opposite leg. I would lover to know how people felt about it and if any one has any suggestion before I order. I just would love her to have that extra support to help her recover and learn how to use that injured leg properly again. I would love to hear the pros and cons. Any insight would be greatly appreciated!

13 Weeks Post Op

We are about 13 weeks post op and are doing AWESOME. Josie is 100% back to normal.

I could not be more happy with her surgery and recovery! TTA was a great choice for her! I am super happy. She is doing so well that we are adding another addition to our family in the end of Feb. I am very happy! It was a long haul but we finally made it! Yay!

34 thoughts on “Extracapsular Repair with Swivel Lock System – Josie

  1. Sorry about Josie’s injury.

    Yes, unfortunately if one part of the body has problems, the rest is paying for it and makes injury that much more likely. So bad hips can definitely contribute to crucial ligament injury.

    Wow, never heard of Swivel lock technique yet, is there more information about it somewhere?

    Jasmine had extracapsular repair on both knees, but it was a traditional double-suture one. We combined the surgery with stem cell therapy, she’s doing great.

    At one point we were considering brace as well. Personally, the products that I think are really great are by http://www.orthopets.com

    Those guys really seem to know what they’re doing.

    Would I add brace at this stage? Of course it is up to you and your vet/surgeon. You might want to discuss that with him though, particularly for the knee that had the surgery. The brace supports the joint differently and I think it might interfere with the way the knee would heal/stabilize itself with fibrous tissue.

    Would I put a brace on the other knee? Again I think it’s a judgement call. Preventing the ligament rupture is a logical idea. Would you be better off to let things take their own direction and surgically fix the other knee while Josie is still young?

    I would discuss these things with your vet/surgeon and you could discuss it with OrthoPet also.

  2. yeah I agree. I have did a little more research and have just realized I am going to work hard to get her sx knee in working order and hope for the best. I will try and find some more in on the procedure but I don’t know of any where specifically to go to read up about it yet. I have also considered stem cell therapy for not only her knees but hips also. Do you feel it has helped Jasmine?

    1. Oh, stem cell therapy – great stuff! Yes, we believe it did miracles for Jasmine. If you can afford it I would definitely do it.

      We used it to help healing after the extracapsular repairs and in her other sites of arthritis. She is 8 years old now, and you wouldn’t tell. She is happy and active as if there was never anything wrong with her.

  3. Hi Everyone:
    Gosh, I wish I had the money to try some of these wonderful procedures and treatments…..my dear girl Jasmond is really struggling with seperation anxiety right now,with here little sister/buddy Daisy having to be euthanaised yesterday.We found a mass on her liver….she went downhill very fast, and we are both in mourning rght now…..she was almost seventeen yo little Daisy…whew…this is hard….for both of us….
    And with Jazz reinjuring herself after over 3 weeks on the CM mend,with her torn Left rear ACL…altho her R rear is even worse after going to the surgeon, taking x-rays and finding hip dypslasia (Sigh) in both hips as well.

  4. continued Jasmond….
    I can only start the process all over again with confining her the best I can, giving her all her meds and supplements, heat pad for circulation, and she is really enjoying her massaging couple or three times a day….I am senior on a fixed income…and I just spent a fortune on Daisy, so surgery on Jazz is probably out of the question, and the Vet. pretty much agreed. She is almost 10 y.o. and with both legs being bad, and both hips in bad shape, CM is what he though was best for her anyway….and now with Daisy gone, I can really devote the next few months just to her and getting her better…..

  5. Hi Eileen,

    re: continued
    Perhaps a brace would be a way to go? Much more affordable than a surgery, and given her age probably a better idea anyway.

  6. HI EILEEN, I am very sorry as well. I understand completely Josie have severe hip dypslasia as well.If josie was older I think it would have been a much different situation.
    We were thinking of doing the stem cell therapy for her injury’s and also her hips. I am defiantly going to look further into it.

  7. Marie,
    Over the years I have fallen in love with Cane Corso’s. I love the look and Josie is such a lovely girl. I had not heard of the swivel lock technique before. It certainly makes sense. I am glad she is mobing forward nicely with her physio.

    I am finding stem cell therapy is fascinating. I am so happy Jasmine at 8 is happy and active, much like a younger dog. We used to have a long term Rottweiler house guest (3 years) named Jasmine. I’ve always loved the name.

    I am so sorry about Daisy. My goodness Jasmond sounds like a real trouper to be dealing with the loss of her friend, both legs and both hips. CM does sound like the option for her. It’s good that you have each other and you have the time to devote to Jasmonds recovery.

  8. Hi Marie,

    it certainly is [stem cells therapy fascinating]. I was hooked on it the moment I started researching.

    It was tougher than, as it was relatively unknown and the vet Jasmine had at the time wouldn’t even hear about it.

    We ended up changing vets and got an awesome vet in the process too! 🙂

  9. Hi, I am wondering if any of your dogs that had acl repair suffered a fascia tear during recovery?

    My 3 year old rottie, Lily, just had extracapsular repair on her left leg. All was going really well… she was toe touching when she came home and bearing about 50% by day 14. She was strictly crate confined except for eating / bathroom breaks and physical therapy but somehow (I think in the car on the way to the vet to remove staples) she re-injured.

    She’s completely pulled the leg up at this point and seems in a fair amount of pain. Vet says joint is still stable so he doesn’t think she tore the repair but rather the fascia. He’s going to reopen the incision and stitch it up but can’t until next Tuesday.

    Meanwhile, Lily has a a fluid pocket (second one, first one vet drained and said it was clear of infection) about the size of an egg that is warm to the touch. I called and vet gave me antiobiotics (even tho’ he doesn’t think it’s infected) until he can see her next tuesday.

    My question: could it be an infection rather than a fascia tear causing the pain and limping?

    Anyone ever heard of or experienced a fascia tear? She is in more pain from this than than in the original acl tear or surgery! Does that seem right?

    Sorry for the long post but I’m a sick with worry and vet is gone until Tuesday.

  10. Oh, of course you are worried sick. Tuesday is a long way off, and your girl is hurting. I’m so sorry.

    A recurring fliud pocket can be the pain culprit. A fascia injury is amoung the candidates for pain. Most likely, the antibiotic is a preventative.

    Now, are you icing the leg at all? A nice cool gel ice pack (in a cover) can be secured with inexpensive, reusable grip wrap. I would be doing that at least twice a day.

    Is she still on a pain med? She should be. Think about it. It’s as if she has a surgically broken leg. We humans would still be on crutches and drugs. She needs pain management as much as she does to have the swelling go away. Swelling is very, very painful.

    Raven did not have this proceedure, but she will be on tramidol for at least 3 months. Stetson, is only a few days post op, so he is on Deramaxx. (Both had TTO’s)

    Also do you have a sling for getting her in and out of the car? You can purchace one. Just google fourflagsoveraspen. It makes a huge difference both for the dog and your back. =) A medium would work for a Rottie. The only difference is the width of the sling. All straps are adjustable. OR… of you’re handy, you could make one. 😉

  11. Wow I am actually so glade that you wrote this. About 3 weeks ago Josie and I had a major set back. She was doing GREAT and I mean GREAT at about 8 weeks post op and then it all changed. She walk walking and my other dog ran past her and slammed her into the coffee table and she was instantly 3 legged-ed. She would not put any weight on it at all. I was completely devastated. I took her back to the vet and he said also that the knee was stable and he didn’t think that she had broke down the repair but there was something defiantly wrong. She was also in more pain and using it less then the original injury. They did not mention anything about a fascia tear as being a possibility. He was unsure what was going on. He was thinking about possibly opening up the knee and exploring it but if he needed to explore the joint then we would have break down the surgery we just did. I was very reluctant to put her through another surgery so I decided to take her to a specialist that specializes in knee disease. She had more x-ray done and they all looked good. He knee was very swollen and painful. He thinks that it is an infection due to the injury. He prescribed 2 weeks of antibiotics and said that if she improves we will want to keep her on there for about 2 months. She defiantly improved over the first week and the swelling went down dramatically. She is using it better but still limping. I am about 3 weeks into the antibiotic therapy and I am just keeping my fingers crossed that she will continue to improve.

    I would be interested to see what happens with Lily and if it was a fascia tear? Please keep me updated.

  12. Lucy — thank you so much for replying. I am icing the leg and alternating with warm compresses. Vet says the compresses are to improve blood flow and draw out the fluid, ice is of course to reduce general swelling.

    She is on tramadol for pain and up until this event, she didn’t seem to be in any discomfort at all. I’m sure the tramadol is still helping, but I don’t think it’s eliminating pain like before.

    She’s day two on the antiobiotics and althought the swelling is the same, her spirits seem better. I got a tail wag this morning (haven’t seen that since last Tuesday) and she looks clearer in the eyes. Still not using the leg AT ALL, but I think the anti’s may be helping (wishful thinking perhaps). Oh, I’ve been using a towel as a sling but it’s awkward. I will definately purchase as you suggested. Thank you!

    Marie — so sorry to here about Josie’s setback. I am crossing every finger that you will not need to re-open her leg. So far, it’s sounds promising that the swelling has reduced so much.

    From what I understand, the fascia is stitched as well during surgery so my vet is guessing she opened up some portion of that stitching. I don’t *think* he needs to touch the joint to get to it as I *think* the fascia is on top of the joint. He told me it will take 30 minutes to fix it.

    If your Josie doesn’t improve enough perhaps ask if it’s a fascia problem. I can’t imagine at 8 weeks she still had stitches but maybe the area was still weak. I certaintly hope not just to spare Josie more cutting and recovery.

    I will keep you posted on Lily and you do the same on Josie. Thank you.

    1. Hi again. I was wondering how everything went with Lucy??? Unfortunately I got some bad news today. Josie has been on the antibiotics for six weeks now and the swelling is all but gone. Which sounds good but in reality we were able to get a good feel of the need at her follow up exam today and there is major instability in the knee. So this means that a another surgery is going to be our solution. The Surgeon recommended a TTA or TPLO. He will choose which one after getting some x-rays. This is a awful situation but I take comfort in at least knowing what’s going on and knowing what I have to do to correct the situation so she can have a long, healthy, pain free life!!! The only thing that’s gonna be hurting any more after surgery is gonna be my pocket book but she’s family so what are ya gonna do…

      1. Hi Marie, so sorry about that. This stuff can happen, I was always freaking out when JD went pass Jasmine too closely when she was after her surgeries. But it can happen no matter how much one tries, one slip, one bump … can stretch or tear the suture and you’re back to square one.

        Best of luck and hugs for Josie

  13. Marie I am sorry to hear that Josie will need another repair! Poor pooch has more recovery time ahead. But at least you know what is happening and can take some action. Let us know how it goes.

    After I posted last time, Lily’s swelling got worse and eventually split open the incision site (which was closed, staples removed). It was quite disgusting actually, but vet decided to leave it open and allow the fluid to drain. Her pain improved dramatically and she began to use the leg a bit more.

    Vet is convinced the fluid caused the fascia tear and we are trying conversative treatment (i.e. no surgical repair) as the knee joint is still tight and in tact. I’m happy to avoid surgery (and the expense) however the recovery from this tear is slooooow. She’s toe touching with some small steps but not where she should be almost 5 weeks post op. Vet feels it is healing so now we just wait.

    I guess I’m always wondering if we are doing the right thing but for now, we will just watch and wait.

  14. How I can help my big dog without surgery,I definetly can not afford pay for it.I just want to less his pain,when he try to move.Please,try to help us,not reach people very love their dogs too.Regard.Lana

  15. Lana, the best thing would be if you could at least afford a knee brace. That stabilizes the knee also. Not all surgeries are as expensive as TPLO, traditional extracapsular repair is cheaper, less invasive and worked for our Jasmine (Rottweiler) just beautifully.

    Your vet will most likely prescribe NSAIDs for pain management. It does work for that. But you should have blood test done prior starting them and keep a close eye on any changes your dog might show after on the (eating, drinking habits, not just the obvious such as vomiting). NSAIDs work well to control pain and inflammation (for most dogs) but can have serious side effects with some dogs.

    There are alternatives you might discuss, such as Traumeel (really a holistic version of an NSAID); not sure whether it might work with such a major trauma, but it might.

    Main points are finding a way of keeping the knee as stable as possible (conservative management or brace if not surgery; no stairs, no jumping on and off things …) and pain and inflammation management.

    If the ligament isn’t completely torn you might want to look into considering prolotherapy also.

  16. Wow, Joan and Marie! You two have had a fair share of extracarricular difficulties with Lily and Josie. It boggles my brain. Both, If I put things together correctly in my head, have had some degree of infection. In Lily’s case, a healed suture line slpit and was allowed to drain. Both Lily and Josie may have fascial tears. Yes, progress with that would be a snails pace.
    I’m thinking the targeted fascia involved would be what is on either side (lateral) of the knee. That would be what would seem crucial to holding the knee together post surgically. Marie, my goodness! A second surgery on poor Josie. I wish you both strength and resolve with your beloved girls. It must be very draining and worrysome. I am hoping from here on in you experience more smooth sailing!
    Lana, Dogs who’ve had the benefit of conservative management or knee braces do quite well. I was just reading a bunch of success stories, here, the other day. If that is the option you have, it is viable and worthwhile. In fact, I know a Lab thru the vet office who is doing conservative management. He has a bit of a limp and seems to be coming along nicely. Keep your dog from jumping and stairs. Google 4 flags over Aspen and perhaps order a sling to help your dog in and out of a vehicle… or if your home has stairs. The large unlined is only $19. Or you perhaps you can make one. Fold a towel lengthwise and sew some handles on it. Your vet will likely prescribe some pain meds, some of which require periodic bloodwork. You sound very concerned. Be strong. I hear your love for your dog in your own words. =)

  17. Well Josie has her surgery scheduled for Oct 14th. I am happy but also feel bad for her. I know it’s for her own good so she can have a pain free life but to go through the recovery all over again makes me sad. I am sorry to say that I lost my 14yr old American Bulldog about 2 weeks ago. It was very awful but he was old and he was at a point where he was suffering. This I think will make recovery a little easier for Josie. Josie is really heart broken. Jake was her best friend. She defiantly needs another dog but we need to get her well first! Wish us luck and we will follow with some updates.

  18. Marie, good luck! Sorry about your other dog too! I’m sure Josie will recover just fine. It seems like it’s taking forever but it doesn’t. The day when it’s all over will come (((hugs)))

  19. I’ll bet you’re glad to have the date set. It marks a point from which things have an opportunity to improve and become OK again. Josie will be fine. Oh, {{Marie}}, I’m so sorry to hear about Jake.
    Keep us updated! Best wishes.

  20. Our 8 yr old chocolate Lab, Lucy developed issues with her left hind leg in early June, 2011. All xrays were negative, but she would not put any weight on that leg. Rather than think about a surgery that may not make any difference, we found Dr Spatt and the A-TraC Dynamic Brace online. We took the information to our vet who thought it would be worth a try. We were excited when Lucy’s brace arrived. We got it on her and wonder of wonders, after 6 weeks of no weight beariing, she started to put some weight on her leg immediately! She has had the brace on for 2.5 weeks now; doesn’t mind it; is putting more weight on her leg every day, and is almost back to her happy self. We are augmenting her treatment with Adequan (IM glucosamine) and have started short controlled walks to rehab those muscles.
    Dr Spatt from woundwear was very knowledgeable and answered all of our questions.
    Check out woundwear.com and give him a call!


  21. My Bernese mountain dog had a ruptured cruciate ligament – 3 vet surgeons said she required an operation. I did not want her to have op. so I took her to a warm water treadmill 3 times a week and she was sound within 7 months. without operation. We have never looked back and I recomend any one to try the natural healing using the dogs one healing by assisting in the warm water and boucancy and gentle running treadmill to build the muscles, which releives the weight on the stifle joint, and keeps the use of the normal gait pattern and range of movement, naturally.

    It works for lots of other ailments and injuries. I have seen so much success in the use of the treadmill I have now invested in one and run it from just outside Perth in Scotland.

    Telephone 01738583684 or 07926506156

  22. Two of my dogs have used the underwater treadmill after TTO surgery.  I chose the surgical option as my dogs are both performance agility dogs who enjoy their sport.  For them opting for a totally non-surgical method was not an option.  As, I wanted them to have what was joyous in their lives to remain.

    I’ve no doubt, the treadmill is helpful with non-surgical methods as well, tho.  I am pleased to hear your Berner did well with it.  Done slowly, gradually and methodically building the time in the treadmill on perhaps a weekly basis provides a lower impact method with increased workload on the muscles.  It’s a wonderful tool.  =)  Building up the musculature to more or less equal on both sides is, of course, important no matter what option is chosen by the owner.

    1. Hello So Josie is doing well. She is about 6 weeks post op TTA surgery. She is using the the much more then after the original surgery. She is already building her muscle back. I will start underwater therapy after her 8 week x-rays. Keeping my fingers crossed.

  23. That’s good to hear! I was just wondering about her. I’m sure the x-rays will be fine and you can get going on that treadmill. Keep us posted! It’s really a long haul, I am finding… 6 months is a very long time. Or maybe it’s just me. My 2 overlap for 4 months. Josie will be working hard and in the end, it will all have been worthwhile. Good luck!

  24. Just an update we are about 13 weeks post op and are doing AWESOME. Josie is 100% back to normal. I could not be more happy with her surgery and recovery! TTA was a great choice for her! I am super happy. She is doing so well that we are adding another addition to our family in the end of Feb. I am very happy! It was a long haul but we finally made it! Yay

    1. I don’t know if you still are active on here but I would LOVE to talk to you about your dogs recovery! Right now my dog is about 2 and half months post op and it seems she has started declining instead of improving…

      1. I check in every now and then. Did you mean me or Marie? Happy to help tho.

        While the bone is healed at 2.5 months, you’re working on rebuilding those muscles for another 4 months or so. You can always reassure yourself that all is well at your vet.

        He could have done too much ‘work’ or tweaked his leg. Limping = cutting back and leashed only activity. Well, it should be leash only anyway so you stand a chance at them not ‘ going for the squirrel’ when the opportunity arises.

        I had a great PT! Initially she seemed a bit overly cautious, but she was right. My boy, tho on lead at the time(!) tweaked his leg when he spotted a felonious woodchuck before I did. It set him back 6 weeks. Because of this, he was back on painkillers and much longer than my girl.

        With my girl, Raven, I remember she began limping one week. But I’d been told that if that happened, to cut back and give her leg a rest. It works to do that. It really does. It may be frustrating for you to do it, but it’s the right thing.

        Is animal PT available in your area or are you walking? I did both. I gradually increased the walks about every 7-10 days per discussions with the vet and PT. It’s better to do more sessions per day total than longer and longer sessions… at least at the 2.5 month mark. The longer walks can wait until month 5-6, at which time you can begin to add stairs. I had a lakeside park with an outdoor staircase between 2 parking lots. It was perfect! That high inside muscle is hard to work and the last to recover.

        Do measurements of your dogs leg: High (huge difference), med, and low on both legs for comparison. The closer you get to equalizing the surgical leg to the non surgical leg, the lower the chance he will tear the other side.

        At PT we did an underwater treadmill weekly for 6-8 weeks. Longer for Stetson due to his woodchuck incident. Both stories are here under TTO.

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