Our beautiful 22 month old girl blew out her left anterior crutiate ligament. She will need surgical repair. We have two options, an extracapsular repair where they use a nylon suture to stabilize the knee until tissues heal and "hold" the repair, or a newer more radical repair called TPLO where they cut the bone, level the tibial plateau and hold the repair in place with a plate and screws until the repair heals. The difference between the two is almost $1000, but if one is better than the other we will pay what we need, to get our girl up and active again.
Thanks in advance for any feedback you have.
At her age do the TPLO. I just had the other done and it had to be repeated because the cords didn't hold. There is a 15% failure rate for either repair but at her age the TPLO is better.
Fergus just had his surgery done on Tuesday for this same injury (he'll be one next week). We opted to have the traditional method done...not the TPLO. We did a lot of research and talked to a few vets and that was what we were more comfortable doing. At least if something goes wrong it can be fixed...if you do the TPLO that means cutting bone and once it's cut you can't glue it back together if it doesn't work out (IMO). I know there are a lot of people on this forum and other places that have had great results from the TPLO surgery, but we just weren't comfortable with that choice. If I were you I'd so some research on both procedures, and talk it over with more then one vet if you can. Do what feels right for you! Good luck with everything and keep us posted.
♣ Laura ♣
my swiss mountain dog had tplo and it went well...
the healing time does go quick. the first few days are tough, but by the end of week 1, they are feeling pretty good.
he got it done at the AMC in NY, by a top orthro vet, whom we loved...it was expensive, about 3500-4000 when all was said and done. I had pet insurance and they covered like 2 grand of it...
if you have any questions, post them here.
Hudler had one TPLO last June, and the other 3 months later. Our orthopedic surgeon did not recommend the fixing the ligament option if the dog is active. He said the success rate was much lower and you could run the risk of more surgeries if it doesn't take. We've had 100% success with both of Hudler's knees and you would never know that he's had it done. Completely recovered.
Long term outcome for both is very similar. There actually is a study done in labs where they measured gait and force and the traditional had a slightly higher success rate.
Alot depends on the surgeon's skills and the rest depends on post op management.
The G. has had a TPLO on one knee and an extracapsular (traditional on the other). He had an ongoing infection for months after his TPLO, which is one of the more common complications. He also developed severe arthritis in his knee 6 months post op. His traditional repair is by far more successful.
I've been Xraying him yearly since his TPLO 3 years ago - degeneration in that knee has slowed down. His traditional is good.
It's a very personal choice and, as with most medical things, there is no black and white. TPLO has a higher rate of complications, but most cases are successful. Educate yourself about procedures, ask alot of questions and, if in doubt, get another opinion. Find a surgeon who does either one or two who use different procedures. Ask about their complication rate, how many surgeries they do/have done, post op protocols and rehab* etc.
Don't rush into surgery unless you're comfortable. As long as you restrict your lab, waiting a few weeks won't cause any harm.
If you want files, studies and first hand information from a vast amount of people who have gone through multiple surgeries or have dealt non surgically with CCL injuries, I'd suggest you join both Orthodogs : http://groups.yahoo.com/group/orthodogs/ and the Conservative Management list : http://groups.yahoo.com/group/ConservativeManagement/
You will find files, a surgeon database, rehab tips etc.
My Sophie had two traditionals done. One leg when she was about 4 and the other about 6 months later. She was 13 in March. She just started having problems with both legs due to arthritis.
Kona at 4 1/2 yrs had the traditional repair done. The ortho surgeon who did his felt that was the best way to go for him. He said his joint was very stable structure-wise. The surgeon was informed of all the physical activities (obedience and field training/retrieving) that Kona does and still recommended the traditional repair. We are back to competing in obedience but are holding on field work for now (working on highest level of obedience skills and want to get that title first before hunt tests).
"In moments of joy all of us wished we possessed a tail we could wag." W. H. Auden
Linda, Kona and Bo
Take a look at this: http://home.earthlink.net/~tiggerpoz/index.html
In my opinion you have to try with conservative management before doing anything.