Advanced Care

Orthopedic Surgery

Deer Creek Animal Hospital veterinarians are leaders in the field of orthopedic surgery, with a level of experience not found in most veterinary practices. We perform minimally invasive procedures using the latest technologies. We routinely repair kneecap problems, CCL repairs, medial patella luxations, elbow dysplasia, and a variety of knee joint injuries.

TPLO (Tibia Plateau Leveling Osteotomy)

TPLO is a surgical procedure to repair a partial to complete tear in one of the important cruciate ligaments in the knee. Damage to the cranial cruciate ligament (CCL) is the most common orthopedic condition in dogs. At Deer Creek, we’ve performed thousands of knee surgeries in dogs and have achieved an excellent result using the effective TPLO procedure.

The cranial cruciate helps to stabilize the knee. Tears in the CCL are often the result of the slope in the dog’s knees. Often dogs can tear the CCL doing something as simple as walking out the door. Larger dogs and certain breeds more commonly experience CCL tears; however, any breed can be affected, even small dogs.

Using palpations and X-rays, we are able to diagnose the need for TPLO in most cases. If left untreated, CCL tears will lead to arthritis in the knee joint. Unfortunately, about 40% of dogs that tear the CCL in one leg will subsequently tear it in the other leg.

TPLO surgeries are performed using a minimally invasive procedure called arthroscopy. A thin scope is inserted into the knee joint to clean out any loose or damaged tissue.

After the arthroscopy, a small incision is made over the inside of the tibia (shin bones) and the bone is cut with a curved blade to allow the cut portion to rotate and become level. A surgical steel plate is attached to the bone to hold it in the new position.

TPLOs are performed in the morning and typically patients will stay overnight. A certified veterinary technician will be present all night to make sure your pet is free of pain.

Patients go home with a pain patch and anti-inflammatory medicine to help manage pain and swelling. Most dogs need pain medicine for up to 14 days and should be closely monitored. About a week after your pet’s surgery, our animal rehabilitation specialist will provide physical therapy instructions. Full recovery from TPLO can take up to six months, with most dogs doing very well in one to two weeks.

If you suspect any of your pet’s limbs are uncomfortable, please don’t delay in giving us a call to have it evaluated.

Elbow Dysplasia

Elbow dysplasia is a condition in which the three bones in your pet’s elbow do not fit perfectly together. If left untreated, it will result in joint arthritis. The disease is believed to be genetic, as it is most common in seven larger breeds of dogs: Mastiffs, Rottweilers, Labrador Retrievers, Golden Retrievers, German Shepherds, Bernese Mountain Dogs, and Chow Chows. It can occur in other breeds as well.

Affected dogs may have varying degrees of lameness, arthritis, and instability in the joint. The condition often affects both elbows. A common sign of elbow pain is going down the stairs with the two front feet together.

Diagnosis of elbow dysplasia is made by observing clinical signs of lameness, as well as X-rays, CT, MRI, or arthroscopy procedures. Early screening and treatment can reduce or eliminate the advancement of the disease process. Elbow joint X-rays at six months of age, especially in the most common breeds, are recommended.

Three main conditions seen with elbow dysplasia are:

  • A section of ulna bone is not attached from birth and floats, causing pain and arthritis.
  • A small section of bone breaks off or fragments from the ulna, causing pain and arthritis.
  • A section of cartilage loses blood supply and detaches from the humerus, causing pain and arthritis.

Treatments involve several factors and depend on the severity of the disease, the type of dysplasia, and the dog’s age.

Medical treatment always involves weight management. Dogs with elbow dysplasia need to be kept very lean, which will help decrease the rate at which arthritis occurs and decreases the stress on the joint. Physical therapy, anti-inflammatory drugs, joint supplements, acupuncture, and cold therapy laser all may be beneficial.

Surgical treatment, using arthroscopy, is performed with a tiny scope inserted into the joint. This minimally invasive procedure is designed to remove the fragments (clean the joint) causing your pet’s pain. The procedure also allows a speedy recovery with the fewest side effects.

Surgical outcomes are greatly dependent on the amount of arthritis present at the time of surgery. The surgical goal is to slow down or eliminate the progression of arthritis. This is why early detection and intervention are so important.

Weight control is a crucial part of long-term success, as well as physical therapy. We start passive range of motion exercises one week after surgery. For most dogs, swimming is an excellent form of physical therapy, as it builds muscle, helps to keep weight down, and keeps the joints fluid.

Medial Patella Luxation

Medial patella luxation (MPL) occurs in the patella, or kneecap, which is the bone that lies in a groove at the base of the femur or thighbone. When it is not properly aligned, lying on the inside of the femur, it is called a medial luxation. MPL is a congenital problem that typically affects both rear legs.

MPL occurs most frequently in small and toy breed dogs, although we do see it in larger breeds occasionally.

Signs of MPL, which can affect one or both hind legs, include an occasional hop, skip, or limp on the affected leg. If left untreated, the bones may become bent and twisted. Cartilage loss, torn ligaments, and arthritis all may occur.

There are four classifications, or grades, of the MPL that define the severity of the injury:

  • Grade 1: The patella is in the groove and when it is pushed out, it comes right back in.
  • Grade 2: The patella may lie in or out of the groove.
  • Grade 3: The patella is out of the groove and when it is pushed into the groove, it luxates right back out.
  • Grade 4: The patella is out of the groove and is locked down and cannot be moved.

Surgery to correct the problem is always recommended for injury grades 3 and 4, and for grade 2 if there is a rough or grating feeling when the patella is moved in and out of the groove.

There is not always a progression from grade 1 to grade 4. However, routine regular examinations are recommended to evaluate clinical signs and potential treatment.

Surgical treatment involves realigning the MPL by creating a better groove for it to ride in and realigning the ligaments. The prognosis is excellent for grades 1–3. Grade 4 conditions are typically long-standing and require more treatment to attempt to obtain normal function. Depending on the severity of the injury, complete normal function may not be possible.

Typically, you will bring your dog in the morning of surgery and plan on your pet spending the night. A certified veterinary technician will be present all night to make sure your pet is free of pain.

Pain control is administered in multiple locations before and during the surgery. Your dog will go home with a pain patch and anti-inflammatory medicine to help manage pain and swelling. Most dogs need pain medicine for up to 14 days and should be closely monitored. It is normal to have a little swelling post surgery. Your pet can eat and drink normally, but let us know if you notice avoidance of food and/or water after the first couple of days.

About a week after your pet’s surgery, our physical therapist will instruct you on how to perform physical therapy. It is best to plan on four weeks of semi-confinement at home with no running, jumping, or climbing stairs.

Full recovery takes about four months, with the majority of dogs doing very well two to four weeks after surgery.