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Orthopedic surgeries are commonly performed in our hospital. Fractures from accidents, cruciate damage (injured ligament in the knee), and luxating patellas (knee caps) are examples of orthopedic procedures that are performed.
Tibial tuberosity advancement is the newest technique available for repairing ruptured cruciate ligaments. Again, it is a complex surgery requiring specialized training in this technique. The objective of the TTA is to neutralize the forces placed on the knee by advancing the tibial tuberosity forward and eliminating thrust (forward movement) of the tibia. By advancing the tibial tuberosity the forces that are required to stabilize the knee are now perpendicular to the tibial plateau and thus neutralized.
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This procedure uses a fresh approach to the biomechanics of the knee joint and is meant to address the lack of success seen with the above technique long term in larger dogs. With this surgery the tibia is cut and rotated in such a way that the natural weight-bearing of the dog actually stabilizes the knee joint. The cruciate remnants may or may not be removed depending on the degree of damage.
The TPLO rotates (as indicated by the arrow) the sloped tibial plateau until it is perpendicular to the line between the stifle and the hock joint centers.
This surgery is complex and involves special training in this specific technique. TPLO and TTA are felt to be the best way to repair a cruciate rupture regardless of the size of the dog and are probably the only procedures to be considered for dogs over 50lbs.
Fractures are common in veterinary medicine. Some types of fractures can heal with casting, while others must be surgically repaired. We can perform fracture repair techniques such as interlocking nail, plating and wiring. Each patient is different and each fracture is unique to that patient, therefore it can be an exciting transformation!
PHOTO ON THE LEFT:
Complete fracture of the humerus in a 4 month old German Shepherd puppy.
PHOTO ON THE RIGHT: Fracture was repaired using an interlocking nail technique. This is a large steel post is drilled into the center of the bone and secured with screws from the outside on either end of the fracture site. This is one of the most stable fracture repair techniques available.
This is exactly how it sounds. Total hip replacement surgery is indicated for dogs with severe debihilitating hip dysplasia. For these dogs, the best choice may be to simply replace the hip (or hips) with a prosthetic hip. This procedure may sound radical but it has been commonly performed for nearly 20 years in dogs with great success.
Photos courtesy of KYON