TPLO Surgery
ACL disease management
Tahari: 3 yrs old
What you need to know about CCL disease in dogs:
> The CCL (called ACL in people) stabilizes the knee, without it the joint is loose.
> It is painful to repeatedly walk or run on a joint when it is unstable.
> The TPLO surgery or a TTA surgery is designed to stabilize the joint.
> Those surgeries do not address the arthritis that will still happen in the joint.
> Surgery does not normalize the muscles and tendons around the joint - rehab exercise is essential!
> Non-surgical approach to full recovery is not necessarily less expensive than knee surgery, this is not easy and takes alot of time, medicine, and appointments to get through.
> Dogs with a partially torn CCL can still tear it more or fully later - despite rehab!
>> The best outcome for an athlete is obviously going to involve surgery to stabilize the knee and to remove debris from the joint.
Full recovery takes about 12 weeks if rehab protocols are followed for symmetry and strength after surgery and pain is well managed in recovery.
> These dogs will need long term arthritis prevention and management to stay comfortable while active.
> These dogs will always have higher risk of re-injury and more arthritis due to instability.
What does a surgical recovery look like?
Tahari is a speed demon. It is hard to slow her down. When she tore her ACL during agility, her mom wanted her to be fixed and to recover as quickly as possible.
She was scheduled for a TPLO surgery as soon as possible.
She started the rehabilitation process with:
1. Home laser
2. Joint supplements
3. Rehab therapy x 90 days: weekly x 6, then twice weekly plus therapy at home 3 days per week to rebuild stability.
She was back in competition at 12 weeks.
This is a common scenario for early treatment of an uncomplicated ACL tear. She will need care and I recommend regular chiropractic visits to make sure her spine is comfortable with her new knee and gait patterns as well as 6 month pain management checkups.
Many dogs benefit from platelet rich plasma or joint lubricating supplements injected into the joint after this surgery if they are not fully recovered by 8 weeks, it is common to have a little early arthritic or tendonitis pain. This can be solved! Don't wait!
Shockwave can relieve tendon pain and truly accelerate recovery for these dogs at the 6-8 week stage if they are not 100% yet.
ACL disease: How Surgery Stabilizes the knee to Prevent Worsening Arthritis
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01.
Tahari's Therapy Goals:
Stabilize her knee
restore her body symmetry and strength to prevent injury
return her to sport condition asap so she can run with out pain
We did it!
She has been running well for 2 years, so far.
> Progress exercises to peanut and balance work with jumping for ultimate core and spine strength
> Regular (3d week +) strength and fitness exercises at home with regular fitness workouts at the clinic monthly
> Many dogs see me monthly for acupuncture and chiropractic to keep the pain cascade from amping up and for a check up.
> Most dogs do need and will benefit from shockwave for the compensatory muscle soreness and to reduce overall fricition in the knees, back and hips on a 3-6 month interval. We will see how it goes.
> Dog with very mild arthritis may benefit from a platelet rich plasma injection instead of Synamid. We will discuss your particular dogs needs.
phase 5: regular pain prevention in the clinic and home exercise
> Exercises start to include stairs, circles, step ups, circles and things to prepare for jumping.
> We do a slow intro to trot in the treadmill, then on land, and gradually work up to running and playing!
> We transition off of pain meds and onto anti-inflammatory supplements (see the bottom of my Resource Hub page
PHASE 4: WORKING UP TO PLAY AND MAINTENANCE TO BE OFF DRUGS AND PREVENT RE-INJURYDAY 90-120
> Weekly therapeutic exercise at the clinic and home exercise 3 days per week to work on balance and stability
> Massage, stretching, and water therapy in the clinic in some sessions to work on flexibility and comfort of her spine and knees
> Exercise restriction from running or jumping to prevent negative progress
phase 3: rehabiliation exercise and rebuilding symmetry- day 90-120
>. Radiographs: spine, hips, stifles (both) for big picture assessment
> Surgical stabilization with TPLO by Dr. Moorer at Trek Veterinary Surgery
> A Joint injection with a lubricant that also improves shock absorption within the joint called Synamid
> Shockwave therapy to reduce myofacial pain (pain from muscle spasm), treat patellar tendonitis, and stimulate cartilage healing (more info on my You Tube video)
phase 2: surgical stabilization and myofascial care - day 30-90
> Medications to control the inflammation from arthritis (more info at the bottom of the Resource Hub Page)
> Medications to reduce maladaptive pain
> Home Laser therapy rental for two weeks - 15 min daily treatment
phase 1: Pain Management - day 1 to 30 days
"She recovered at lightening speed and is back to normal!"
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DR. MARIES HEALTHY DOGS: INFORMATION AND TRAINING TO RECOGNIZE PAINFUL CONDITIONS IN DOGS AND RECOVER THEM TO THEIR BEST ACTIVE LIFE.
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