Recovery of a dog after knee surgery. Spine operations

Dog after surgery

Normal dog recovery after surgery directly depends on how carefully the owner looks after her. The veterinarian will instruct the pet owner in detail how to care for him and what he needs to know, but there are also general rules for caring for a sick animal.

A dog recovers after surgery in about 14 days, although there are cases when the rehabilitation period lasts up to 60 days.

A special place is occupied by maintaining rest for the animal. It is necessary to take care of a comfortable, favorable, warm, but not stuffy place:

To recover, the animal must experience minimal stress and rest more. During the operation, the pet experienced stress, so it may be aggressive.

On the first day dog after surgeryNot Maybe There is and take a long walk.
It is mandatory to dress blanket for dogs after surgery so that she does not touch the seams.
Stitches in a dog after surgery require special care, therefore suture treatment after surgeryin a dog must be carried out with a local antiseptic solution once a day. After the wound has been treated, antiseptic ointment is applied.
All medications are given strictly according to the instructions prescribed doctor, to dog felt comfortable.
Pain relief for dogs after surgery are given exactly according to the schedule, since a disrupted medication schedule can have a negative effect on the recovery process.

Postoperative nutrition for the animal

The dog owner wonders: how or feed the dog after surgery? We offer the following:

Feeding should be done little by little so as not to burden the body, since a lot of energy is spent on digesting food.
After surgery, the dog does not eat or drink for several hours. This is especially true for operations performed on the peritoneum.

There is no need to be afraid that the dog does not go to the toilet after surgery. This is natural, because she doesn’t eat anything. And to avoid constipation, you need to stick to a diet. It is better to give dietary food, which is sold in special canned food. Hard food softens in warm water. This type of diet is observed for about 30 days. It is better to return to your normal eating rhythm gradually. To do this, the usual food is gradually mixed into the diet.

In the postoperative period, it is preferable to give the dog broth, cottage cheese, kefir and porridge.

There must be fresh drinking water near the dog.

The owner must inform the treating veterinarian about negative reactions to food in the form of vomiting, diarrhea, constipation.

What is the feature of the protective structure?

A collar for a dog after surgery serves as a kind of limiter or barrier in protective therapy. The technique helps protect the dog from causing various types of damage to itself and prevents it from biting or scratching itself. This increases the likelihood of the wound healing quickly. These devices are prescribed by veterinarians in case of surgery, as well as in other incidents.

Pets do not like to visit clinics, so restraints in the form of collars make it possible to visit doctors less often. The wound heals faster, the risk of infection is reduced, and the dog does not come into contact with drugs used to treat the skin.

The device has the shape of a cone, which is cut off at the top. The material can be anything that holds its shape. The positive thing is that an animal with such a device eats food calmly. Try to get the dog used to this thing, and then it will stop worrying and accept it better.

What complications can occur after surgery?

A dog after surgery needs quality care because she is more susceptible to complications that may arise against this background. Among other things, you cannot always force the dog to rest in order to allow the wound to heal normally. This is due to the fact that you cannot explain to her how to behave after the operation, namely:
If the dog is not stopped in time, it can damage the wound and this will lead to the resorption of the sutures.
Allergies can also occur in dogs. The owner does not always know the reaction of the dog’s body to one or another type of drug.
Swelling after surgery in a dog may occur due to excess fluid that has accumulated near the wound. Swelling will cause the stitches to come apart and the wound will be vulnerable to infection.
Bloody discharge from a wound in the first days after surgery should be a cause for concern.
If the sutures dissolve early or are placed incorrectly, a hernia may form.

What body temperature should be after surgery?

Moscow Veterinary clinic "Alisavet"

Key Points of Patella Dislocation

A luxated kneecap is usually painful and results in lameness.

Restoring limb function may be recommended, especially in large breed dogs. To recommend the need for any intervention to eliminate a dislocation, you need to know what the frequency of dislocation is over time.

Concurrent cruciate ligament injuries may be present in dogs that have an unstable patella, so this should also be assessed.

The kneecap moves inward (medially) or outward (laterally) relative to normal. As a rule, pathology occurs on both sides (left and right limbs). About 80% of dislocations occur inward (medially). The pathology is transmitted genetically, dogs of dwarf breeds suffer more often than others (Yorkshire terrier, toy terrier, Spitz, Chihuahua, toy poodle, pug, etc.) Trauma, unplanned nutrition, deformation of the axis of the pelvic limbs (X-shaped and V- Figurative curvatures of the pelvic limbs) can also serve as a cause for this pathology. But in large breeds of dogs, on the contrary, a lateral (external) dislocation is more often present and, as a rule, there is an X-shaped curvature of the pelvic limbs.

Ligamentous apparatus

X-shaped and O-shaped curvatures of the pelvic limbs.

The term luxating patella (patellas luksacija, luxating patella) is also often used - this is a condition in which the patella (kneecap) moves out of its normal position, that is, it moves.

Norm and pathology (dislocation)

How to diagnose a luxated kneecap?

The kneecap moves in a groove at the bottom of the femur at the level of the knee joint called the trochlear groove.

Trochleoplasty

Trochleoplasty and transposition of the tibial tuberosity

Knee surgery

Trochleoplasty

Patellar dislocation is often caused by congenital pathology. Usually at the level of the hip joint and leads to an abnormal distribution of forces acting on the kneecap, which ultimately begins to move out of the groove. If patellar luxation occurs in young animals, the tibia and femur become twisted.

In dwarf breeds of dogs, lameness is not regular, periodic, usually a dislocation of 2-3 degrees. If your dog suddenly stands up or jumps off the couch, there may be pain and lameness, which then goes away. If this is not a habitual dislocation, but a traumatic one, then the pain and lameness do not go away on their own.

To clarify the diagnosis, a physical examination by an orthopedic surgeon and a series of x-rays are required. Very often, a dislocated kneecap can be combined with other pathologies of the joints and ligaments. For example, Perthes disease requires an additional image of the hip joint. Osteophytes may be present in the joint. Damage or rupture of cruciate ligaments, etc.

Classification of patellar dislocation

Assessment of the severity of patellar dislocation according to Putman (1968)

I - degree. After forced dislocation, the kneecap returns to its position.

II - degree. The arm dislocates when bent and sometimes returns to its correct position.

III - degree. Flexion and extension leads to dislocation.

IV - degree. The kneecap is constantly in a dislocated position and cannot be adjusted.

Clinical signs

1. Lameness

2. Periodic skipping of gait, jumping to the other limb.

4. Hind limb stiffness

5. Dogs with this condition typically show only one sign, while other orthopedic problems show many other signs.

6. Failure to comply with the treatment requirements for this disease can lead to progressive arthritis of the knee joint.

Surgery

If the groove where the kneecap moves is not deep enough or is severely deformed, and therapeutic treatment does not produce results, then we can deepen the groove surgically. We typically use an advanced technique to perform this procedure called a trochlear osteotomy, V-socket, or trochleoplasty. There are also other options for stabilization, suturing the capsule, creating stability using a ligament with attachment to the sesamoid bone. As a rule, a combination of several surgical techniques is used simultaneously. This gives a more durable result to prevent re-dislocation.

After surgery 2 weeks

The patella ligament attaches to the crest of the tibia, and if it is in the wrong position, it also requires surgery. If the bone has a varus deviation of more than 14 degrees, this operation is necessary. The operation is done by displacing the crest of the tibia and reattaching it to the tibia so that the kneecap slides smoothly in the groove and does not have an abnormal angle to the dislocation. Wires and cortical screws are used to attach to the bone in the new location. Pins are usually not removed unless they migrate out of position or unless a fluid bubble (seroma) may develop at the end of the pin.

A support bandage is not usually used after surgery, so rehabilitation therapy can be started soon after surgery.

Caring for a recovering dog.

Analgesics and nonsteroidal anti-inflammatory drugs as directed by your pet's surgeon.

Excessive activity should be limited for approximately 2 to 3 months

Rehabilitation therapy is a very important tool for limb rehabilitation.

Recovery

10-14 days after surgery, your pet should touch the ground with its toes while walking.

By 2 to 3 months after surgery, your pet should be using the limb satisfactorily.

If your pet does not feather normally on a limb after 2-3 months, you should see your doctor again.

Surgery has an approximately 90% success rate. Success is defined as return of good limb function

Unfortunately, surgery will not remove arthritis that may already be present in the knee. As a result, your pet may have some limb stiffness in the morning. In such cases, modern allopathic drugs and homeopathy give good results. Additionally, your pet may have some lameness after strenuous exercise.

Large breed dogs that have patellar luxation are at increased risk for patellar weakening if corrective femoral osteotomy is not performed.

Possible complications

Anesthesia during surgery can cause the death of a dog.

Infection of the surgical site, although not common, can occur.

Migration of the pin or fracture of the displaced bone.

Formation of seroma at the ends of the pins.

If the dog is actively moving during the first 8 weeks after surgery, displacement of the reduction may occur, followed by reoperation.

Veterinary clinic "Alisavet", Moscow

Postoperative care is a fairly broad topic, because there are almost as many nuances of postoperative patient management as there are different types of operations. Let's consider some general and specific aspects of postoperative patient management.

The postoperative period can be divided into “acute” and “chronic”.

The acute postoperative period begins immediately after the patient leaves the operating room.

Although technically the operation of ovariohysterectomy is comparable to that of sterilization, the general condition of the patient is immeasurably more severe due to intoxication. With such interventions, the animal may spend several days in the hospital. (In uncomplicated cases, infusion therapy (drips) on an outpatient basis is possible, but owners should be prepared for a significant investment of time (4-9 hours).

If the condition is clinically satisfactory, a long (7-14 days) course of antibiotic therapy (injections or tablets) is prescribed. Processing and removal of seams, blanket - as indicated above.

Surgeries to remove tumors (eg breast tumors). As a rule, in this case, a unilateral mastectomy is performed (removal of the entire ridge with capture of the lymph nodes). This is a major operation accompanied by significant tissue damage.

Patients often belong to the older age group and have a number of concomitant pathologies. Infusion therapy may be required for 1-3 days, the animal must be anesthetized (injections of opiate analgesics or NSAIDs) for the first 2-5 days, a course of antibiotics for 5-7 days.

The sutures are treated with levomekol ointment and are usually removed on the 14th day.

Quite often, with such interventions, a seroma (liquid) forms under the skin along the suture on days 4-5, which in some cases must be aspirated (“sucked out” with a needle) or even the cavity drained. If you experience symptoms of “ichor” discharge along the seam or a “water ball” “rolling” under the skin, it is better to see a surgeon.

Urethrostomy.

The most common indication for surgery is the resulting blockage of the urethra. The essence of the surgical intervention is to dilate the urethra and form a new, shorter urethra; In cats, the scrotum and penis are removed. During the operation, a urinary catheter is installed and sutured, which should remain in place for 3-5 days until the stoma is formed. The bladder is sanitized (washed) through a urinary catheter 2-3 times a day. Patients after urethrostomy usually require a long course of antibiotics, antispasmodics, hemostatic drugs and a strict special diet. If acute renal failure occurs, intensive infusion therapy (drips) for several days and observation in a hospital are required.

The formed stoma must be carefully protected from licking at least until the sutures are removed (the sutures are removed on days 12-14) (put an Elizabethan collar or diaper on the animal). After the operation, a specialized diet is prescribed.

(removal of non-viable teeth, opening of oral abscesses, osteosynthesis of jaw fractures, etc.) in the postoperative period require feeding with soft, mushy food for 7-20 days and thorough treatment of the oral cavity after each meal with an antiseptic (for example, copious rinsing with chamomile decoction or Stomadex tablets). An antibiotic is usually needed.

Operations on the stomach and intestines.

After most surgical interventions performed on the organs of the digestive system (removal of foreign bodies and neoplasms from the stomach, intestines or esophagus, surgical interventions for volvulus/acute dilatation of the stomach), the patient needs a strict fasting diet for 2-4 days - no water, no food should not enter the gastrointestinal tract.

Fluids and nutrients must be given parenterally (intravenously). Since in such cases we are almost always talking about high volumes of infusion therapy and the need for strictly calculated administration of parenteral nutrition drugs, such animals are indicated for observation in a hospital before the start of feeding.

After discharge, you will need a course of antibiotic therapy, special dietary nutrition, and in the first weeks a fractional feeding regimen (5-6 times a day in small portions)

Osteosynthesis and other orthopedic operations.

Osteosynthesis- surgical intervention for fractures of varying complexity. It may involve installing an external fixation apparatus (Ilizarov apparatus in large dogs or a wire fixation device in small animals), introducing a plate, screw, wire, wire cerclage, etc.

In simple cases, the owner will need to treat the sutures daily (chlorhexidine + levomekol) and limit the pet's exercise. The external fixation apparatus requires careful care (treatment of sutures and places where pins are inserted), protection with a gauze bandage until its removal (depending on the complexity of the fracture, up to 30-45 days, sometimes longer). It is mandatory to take a systemic antibiotic; in the early period, injections of analgesics may be required.

For a number of orthopedic interventions, the patient is given a special soft Robert-Johnson fixation bandage for up to a month, which must be changed from time to time in the clinic.

Spine operations.

Patients with spinal injuries (fractures) or disc herniations usually require inpatient observation for the first 2-3 days. The rehabilitation period until full restoration of supporting ability can last from several days to several weeks. The owner must monitor regular urination and, if necessary, express urine or catheterize the bladder. The animal must be limited in mobility (cage, carrier). The sutures are treated with levomekol ointment; a protective bandage is usually not required. Spinal patients require a course of antibiotics and steroids for 3-5 days.

To speed up rehabilitation, massage, swimming, and physiotherapy are indicated.

With severe physical overload, joint problems often occur. Experts say that the most vulnerable parts of the human body are the knees. Due to their complex anatomical structure, these joints bear the majority of any physical load. It is especially fraught for them to perform physical exercises without special training or with a violation of the technique. As a result, the knee joints become deformed. There is also a high risk of more serious complications (the affected leg may stop bending).

Description of the term

Arthroscopy is a special method of surgical intervention in human joints. An instrument called an arthroscope (a type of endoscope) is inserted into the cavity through a microincision. In the case of diagnosis and treatment of the knee joint, two micro-incisions are made at once:

for surgical probe;
for arthroscope.

Compared to traditional surgical procedures, the arthroscopy procedure has enormous advantages. There is no need to completely open the joint, exposing it. This means that the healing process and recovery after arthroscopy of the patient’s knee joint will be several times faster and easier. During such an operation, the risk of damage to connective tissues is virtually eliminated.

Stages of diagnosis by arthroscopy:

Soft tissue incision.
Insertion of the arthroscope.
Examination of the knee joint through an arthroscope lens.
Studying the video recording on the monitor transmitted by the arthroscope.
Establishment of a specific pathology.
If the accompanying conditions allow, arthroscopic surgery can begin immediately.

The need for surgery

The initial purpose of arthroscopy is to diagnose the internal condition of the joints of the knee, shoulder, hip, elbow and wrist. The following pathologies are most often found:

meniscus injuries;
partial destruction of cartilage;
arthritis;
cruciate ligament injury.

Once the doctor has made a specific diagnosis, a decision is made on the date of an operation called surgical arthroscopy. In some cases, immediately after diagnosis, the patient is sent to the surgical table.

Possible consequences

Arthroscopy is one of the safest operations. However, even after it some complications occur. The most common symptom after knee arthroscopy is swelling. In some cases, the leg simply does not bend due to the huge amount of fluid.

The causes of edema vary. Most often this is due to uneven load on the sore leg during physical therapy. If even slight swelling appears in the joint area, you should immediately consult a specialist.

Sometimes the swelling is inflammatory in nature. This is fraught with infectious contamination. Therefore, if you experience unexplained swelling and pain, you should consult your doctor.

Recovery

Rehabilitation after knee arthroscopy is simple and often short-lived. If the operation was successful and no swelling occurred after it, after two to three months, with a mandatory visit to exercise therapy, the joint will return to normal.

If complications associated with various factors arise during the rehabilitation process, you should adhere to certain medical recommendations.

Inpatient procedures

During surgical arthroscopy, the patient is given anesthesia. Depending on the duration and complexity of the operation, it can be either local or general.

In the first case, the patient is sent home within a few hours along with a detailed recommendation from an orthopedic doctor, a referral for exercise therapy and a list of corrective menus for the coming days. During the rehabilitation period, it is not recommended to eat too much salt or drink liquids at night. It is strictly forbidden to drink alcohol, because its toxic effects only increase the risk of swelling.

In the second case, the patient is transferred to the intensive care unit after surgery. After the anesthesia wears off, the patient is prepared for discharge with typical recommendations.

When swelling occurs, specialists prescribe various diuretics that help remove excess water from the body. To eliminate pain, drugs based on analgesics are recommended.

During the rehabilitation period, patients may be prescribed the following restorative procedures:

massage;
electrical stimulation.

Self-rehabilitation

After knee surgery, you need to give your body some rest. Particular attention should be paid to the sore leg. The development of the knee joint should occur gradually without overload. Minimize walking and use a stick or cane for some time. Do not overexert yourself during exercise therapy. If swelling occurs, be sure to apply ice wrapped in a soft, thick cloth. The procedure must be repeated 3-4 times a day.

Give your leg a two-hour day rest every day. To do this, take a horizontal position and place your sore leg on a soft pillow. It is important that the leg is above the level of the heart. This ensures proper blood flow and relaxes the limb.

There are also therapeutic exercises for developing the knee joint. To do this, you need to take a horizontal position on a hard surface and raise/lower your leg, while the knee should not bend. Manipulations should be carried out 15–20 times every 2–3 hours. After 2–3 months, you can increase the load and switch to an exercise bike.

If possible, you should wrap your leg with an elastic bandage. This minimizes the risk of swelling.

Question - answer

Quite often, the patient has a lot of questions that he tries to answer for himself. However, it is worth remembering that health must be protected and you cannot rely on chance. Here we will try to answer some frequently asked questions. But this is not a substitute for a full consultation with a specialist.

Question: I experience pain when doing home exercises. Is it worth continuing?

Answer: Rehabilitation exercises should not be painful. The most you will feel is a slight discomfort associated with micro-incisions. If you feel pain, you should stop exercising immediately and consult a doctor.

Question: While taking a bath, the wound got wet. What to do?

Answer: In the postoperative period, doctors recommend tying the leg with polyethylene during hygiene procedures. If the wound gets wet, you should consult a doctor and immediately clean the wound and change the dressing. Delay is fraught with infectious diseases and inflammation.

Question: Do I need to see a doctor after arthroscopy?

Answer: After such an operation, the doctor makes appointments for the patient within 10–15 days. After this, the patient engages in his rehabilitation independently at home. If he has no complaints, there is no need to visit a doctor.

Question: Do I need to wear post-operative orthoses?

Answer: There is no need to wear orthoses (special fixing structures) without a doctor’s prescription. But if the doctor, after examining the joint, finds that the muscular system is too weak, then supporting and fixing orthoses will be prescribed to you without fail.

Arthroscopy was previously used only for the diagnosis and treatment of professional athletes. Now this practice is available to any patient. Knee arthroscopy is a simple and effective procedure. However, without making efforts to self-rehabilitation and proper recovery, it will be very difficult to avoid swelling, severe pain and other complications.

How to restore and develop the meniscus after surgery?

The layer of cartilage in the knee joint, located between the surfaces of the femur and tibia, is called the meniscus. It functions as a shock absorber and stabilizer, but under certain types of load, especially during sports, it may rupture. This injury is one of the most common and accounts for about 75% of all closed injuries of the knee joint.

Restoring the meniscus after a tear is possible using stitching with a special thread. If this cannot be done, then it is removed. In some cases, synthetic prostheses are implanted, which take on the functions of the meniscus.

Rehabilitation after surgery consists of physical therapy and physiotherapy; the duration of this recovery period depends on the nature of the injury.

Rehabilitation set of exercises

If resection of the meniscus (its complete or partial removal) was performed arthroscopically*, then the restoration complex can begin 1-7 days after the operation.

* That is, using special video equipment through two punctures on the sides of the knee joint.

If the injury caused damage to the ligaments or the removal of the meniscus was performed using an open method, then physical therapy will have to be postponed, because the knee needs rest at first. The same situation is observed in the case of suturing the edges of the meniscus, which need to heal before putting weight on the knee again. This period can take up to 5-7 weeks after surgery, depending on individual characteristics.

Early recovery

The main goals of early rehabilitation after surgery include:

normalization of blood circulation in the damaged joint and elimination of inflammation;
strengthening the thigh muscles to stabilize the knee;
prevention of contracture (limitation of range of motion).

Physical therapy should be carried out in different body positions:

sitting, passively extending the operated leg, placing a cushion under the heel;
standing on a healthy limb;
lying down, tensing your thigh muscles for 5-10 seconds.

All these exercises can be performed only with the permission of the attending physician in the absence of effusion (inflammatory fluid) and blood in the joint after surgery.

Late recovery

The objectives of late rehabilitation are:

For this, exercises in the gym and in the pool are most effective. Cycling and walking are very beneficial. Do not forget that the first few weeks after meniscus resection, it is not advisable to squat and run.

Examples of exercises

Physiotherapy

Physiotherapy in the postoperative period is aimed at improving blood circulation and metabolism in the knee joint, as well as accelerating regeneration processes. Massage, laser therapy, magnetic therapy and electrical muscle stimulation are effective for these purposes.

Massage should be performed when there is swelling and limited mobility of the knee. For greater effectiveness, it is advisable to teach the patient self-massage, which he will perform several times a day. It is not recommended to massage the joint itself in the early postoperative period. To perform other physical procedures, you will need to visit the clinic.

Surgical repair of meniscus

The meniscus plays an important role in the normal functioning of the knee joint, so during surgery it is not completely removed, but rather an attempt is made to preserve the maximum amount of intact tissue. There are two main methods of surgical repair of the meniscus after injury:

Applying a suture, which is performed in cases of linear rupture, if no more than a week has passed from the moment of damage. It makes sense to apply it only in an area of good blood supply. Otherwise, the tissue will never heal and after some time it will rupture again.
Meniscus replacement with special polymer plates is used quite rarely, usually with extensive destruction and removal of most of the cartilage tissue. In addition, there is the possibility of transplanting fresh frozen donor tissue.

In conclusion, it is worth recalling that if you have suffered a knee injury, you need to contact an experienced traumatologist. The doctor will determine the nature of the damage and provide the necessary treatment. Performing simple exercises for rehabilitation and restoration of meniscus function after surgery will very soon allow you to forget about the unpleasant incident and return to your previous active life.

Anterior cruciate ligament rupture is a common problem in various dog breeds resulting in pelvic limb lameness due to pain and instability in the stifle joint. In the future, this pathology will lead to the development of a chronic inflammatory process and osteoarthritis, as a result of which the dog will lose the ability to fully use its paw.

Anterior cruciate ligament rupture often occurs in large and medium-sized dog breeds: Rottweiler, Caucasian Shepherd, Canecorso, Labrador, Boxer and others. In our veterinary practice, it is also not uncommon to see ruptures of the anterior cruciate ligament in small breeds of dogs, such as Yorkshire terriers, miniature poodles, pugs and chihuahuas. In extremely rare cases, this pathology occurs in cats and, as a rule, has a traumatic origin.

The age of dogs can vary. This is due to the cause of this pathology, but most often dogs from 5 to 7 years old suffer from ACL rupture.

Rupture of the anterior cruciate ligament in dogs accounts for 60-70% of the total number of pathologies of the knee joint.

To better understand the cause of an ACL tear, the mechanism of the tear itself, and its consequences, you need to have a good understanding of the anatomy of the knee joint.

The knee joint includes the distal epiphyses of the femur, the patella, the proximal epiphyses of the tibia and fibula and respectively consists of the femur joint, the patella joint and the proximal intertibia joint.

The dog's knee joint is a complex uniaxial joint, since movement in this joint is possible in the lateral sagittal plane.

The femoral joint is formed by the femur and the kneecap. The lateral and medial holders of the patella originate in the ligamentous tuberosities of the femoral condyles and end on the kneecaps. The straight ligament of the patella starts from the apex of the patella and ends at the crest of the tibia.

The femur joint is a complex joint. In addition to the femur and tibia, it includes the lateral and medial menisci, which are involved in smoothing the incongruent articular surfaces. The menisci have a semilunar shape and each of them is connected to the tibia - the cranial and caudal tibiomeniscal ligaments. The lateral meniscus also has a femoral meniscus ligament.

The lateral and medial sesamoid bones (vesalian bones) are located on the caudal side of the joint and are connected to the femoral condyles.

The proximal intertibia joint connects the head of the fibula to the lateral condyle of the tibia via the cranial and caudal ligaments of the fibular head.

The cruciate ligaments are located in the center of the joint and consist of intersecting bundles of collagen fibers.

The anterior cruciate ligament originates from the posterior portion of the lateral condyle of the femur and runs anteriorly in a ventromedial direction to the tibia and inserts in front of the intercondylar eminence of the tibia. The posterior cruciate ligament begins in the caudal ligamentous fossa of the intercondylar eminence and ends in the intercondylar fossa of the femur. The anterior cruciate ligament itself consists of longitudinally oriented collagen fibers, the purpose of which is to prevent displacement of the tibia in the cranial direction during flexion and extension of the knee joint, rotation of the tibia, and prevention of hyperextension of the knee joint.

Accordingly, when it ruptures, the dog experiences instability in the knee joint and with each step the lower leg moves in the cranial direction and normal movement of the limb becomes impossible. Instability in the knee joint very often leads to damage to the medial meniscus, which further aggravates the course of the disease and prognosis.

Etiology of ACL rupture in dogs

There are several causes of anterior cruciate ligament rupture, but the most common is degenerative changes in the ligament itself. Due to various predisposing factors, the cruciate ligament becomes thinner, its nutrition is disrupted, the ligament becomes inelastic and any unsuccessful movement of the dog leads to its rupture.

With degenerative changes in the anterior cruciate ligament, its rupture, as a rule, occurs gradually, and clinical signs increase over time. That is, first the dog’s cruciate ligament is torn, and the dog begins to limp, then with a slight jump or playing with other dogs, it completely ruptures with clear clinical manifestations. As stated above, rupture of the anterior cruciate ligament due to degenerative changes in the ligament itself is the most common cause of rupture in dogs aged 5 to 7 years.

In younger dogs, degenerative changes in the anterior cruciate ligament and its rupture can occur as a result of congenital deformities of the knee joint itself or other pathologies of the pelvic limb, for example, hip dysplasia or luxation of the patella in small breeds of dogs. As a result of improper load on the ligament, it undergoes changes and ruptures.

Rupture of the anterior cruciate ligament due to injury to the knee joint practically does not occur in veterinary practice, and if it does occur, it is usually due to severe sprain of the knee joint, for example, during a car injury.

Another cause of anterior cruciate ligament rupture is immune-mediated or infectious inflammatory arthropathy.

Predisposing factors for anterior cruciate ligament rupture may also include excessive slope of the tibial plateau or excessive caudal slope of the superior articular surface of the tibia and stenosis of the intercondylar recess of the femur.

Excessive tilting of the tibial plateau places excessive stress on the cruciate ligament and can cause it to become damaged and rupture.

The theory of insufficient intercondylar recess has its origins in humane medicine. In humans, anterior cruciate ligament rupture can occur as a result of impingement of the medial surface of the lateral femoral condyle with the cranial cruciate ligament. In dogs, this theory has reason to exist, since when studying knee joints, scientists in 1994 noted that all studied joints with torn anterior cruciate ligaments had less pronounced intercondylar grooves compared to healthy joints.

Clinical signs of ACL rupture in dogs

The most common clinical sign of anterior cruciate ligament rupture is pain when moving the knee joint. With a partial rupture, the pain syndrome may not be very pronounced and the dog will limp slightly on the affected leg. With a complete rupture, the pain syndrome is more pronounced, the dog experiences severe lameness of the supporting type, or the dog generally loses the ability to use the affected paw and keeps it in a bent state.

When the anterior cruciate ligament ruptures, swelling of the knee joint and increased local temperature may occur. This may be due to infection in the knee joint or secondary inflammation due to instability after rupture.

The presence of instability in the knee joint, this clinical sign is usually assessed by a veterinarian using tests that are performed on the knee joint. In a complete rupture that has occurred recently, the instability is usually much more pronounced and can be easily assessed by a veterinarian. Also, instability in the knee joint is well diagnosed in small breeds of dogs and can even be noticed by the dog owners themselves. In large breed dogs, instability after approximately 3-4 weeks may be less pronounced due to the presence of chronic inflammation and peri-articular fibrosis, which complicates diagnosis. With a partial rupture of the anterior cruciate ligament, instability in the knee joint will not be observed, but pain and lameness will be clinically observed. Swelling of the knee joint is rare.

A clicking sound may also be heard when the knee joint flexes. This clinical sign is observed when the medial meniscus is damaged, when the torn part of the meniscus can bend between the articular surfaces of the medial femoral condyle and the tibial plateau and create a characteristic sound when the knee joint is flexed. This is not uncommon in large dogs. Damage to the medial meniscus can worsen over time, when the meniscus is rubbed against the articular surfaces and becomes even more unusable. If the medial meniscus is damaged, then over time arthritic changes will be observed in such a joint, since the meniscus performs very important shock-absorbing functions in the knee joint.

Usually, with a complete rupture of the anterior cruciate ligament, at first the clinical signs will be very pronounced, but over time they begin to subside, and the dog may begin to move on the affected limb and, accordingly, this is not very good for the meniscus. Prescribing painkillers accordingly is also not permissible in order to avoid movement in an unstable joint.

As for long-term clinical signs, this is atrophy of the thigh muscles, arthrosis of the knee joint, which is not uncommon for dogs with a rupture of the anterior cruciate ligament.

Atrophy of the hip muscles develops if the dog does not put proper weight on the affected leg, while he can walk on both legs, but try to transfer his body weight to the healthy hind limb. Atrophy can be easily seen by comparing a healthy paw and a diseased one; a paw with a ligament rupture will appear thinner, the muscles will feel flabby and lack normal tone.

It is more difficult to determine atrophy when the anterior cruciate ligaments are torn in both legs, simply due to the impossibility of comparison, but an experienced specialist should be able to cope with this.

With arthrosis of the knee joint with rupture of the anterior cruciate ligament, upon palpation and flexion of the knee joint, crepitus may be felt in the joint itself, the knee joint will be increased in size, especially on the medial side, and contracture may be observed.

Diagnosis of anterior cruciate ligament rupture in dogs

A torn anterior cruciate can be diagnosed using special tests performed by a veterinarian at an appointment and special diagnostic studies.

When examining a sore joint, two special tests must be performed to diagnose anterior cruciate ligament rupture:

Sometimes it makes sense to carry out both tests under anesthesia, especially if you suspect that the rupture occurred a long time ago and there is already arthrosis in the knee joint. When diagnosing old ACL tears, tests may not be very informative and displacements during tests may be insignificant due to the presence of peri-articular fibrosis, so minimal displacement can only be noticed in a relaxed joint, so such patients are given a sedative.

If the anterior cruciate ligament is torn, these tests will be negative.

X-ray examination for rupture of the anterior cruciate ligament is not a specific and sufficiently informative study, since the diagnosis is mostly made on the basis of a clinical examination of the joint. X-ray diagnostics can be useful for detecting consequences after rupture of the anterior cruciate ligament, in particular the presence of deforming osteoarthritis. During X-ray diagnostics, the following changes will be noticeable: osteophytes will be present in the area of the patella, on the medial side of the knee joint and in the area of the sesamoid bones. The articular surfaces of the knee joint may also have defects; there may be loose fragments of cartilage and bone structures in the joint cavity.

Computed tomography of the knee joint in case of rupture of the anterior cruciate ligament, as well as radiographic examination, is not sufficiently informative for this pathology. With CT, we can clearly assess the bone structures of the joint, their changes or the presence of osteophytes. Soft tissue structures such as the lateral and medial menisci and the cruciate ligament are difficult to assess.

Special attention should be paid to such diagnostic research as arthroscopy of the knee joint.

Arthroscopic examination of the knee joint is extremely important in cases of partial rupture of the anterior cruciate ligament. This method makes a diagnosis in the absence of a positive response to the drawer test or calf compression test. Also, arthroscopic minimally invasive surgery of the knee joint is actively used in our clinic. Using it, we can assess the condition of the menisci, carry out manipulations for partial or total removal of the meniscus, remove fragments of the anterior cruciate ligament - minimally invasive!; that is, with the least surgical trauma, and then apply a technique to stabilize the knee joint.

MRI of the knee joint is a diagnostic area that is currently beginning to be considered as a highly informative study of the knee joint in veterinary medicine. An MRI of the knee can show damage to the meniscus, partial or complete tear of the anterior cruciate ligament, and other joint structures. Unfortunately, due to the high cost of equipment, not every clinic can afford to conduct such a study.

Treatment of cruciate ligament rupture in dogs

The choice of treatment method for a ruptured anterior cruciate ligament depends on various factors, such as the dog’s body weight, the angle of the tibial plateau, the duration of the disease, etc., but in any case, everything should be aimed at eliminating pain and improving the dog’s quality of life.

There are two methods of treating a torn ACL:

Therapeutic treatment

Therapeutic treatment for anterior cruciate ligament rupture means:

Limiting the dog's mobility is walking with the animal on a leash or keeping the dog in a small enclosure where active movements are not possible. Accordingly, you need to avoid active games with the dog, various jumps, etc. Restriction of mobility should be carried out for one month, in some cases for a longer period.

Non-steroidal anti-inflammatory drugs. Drugs in this group are prescribed to eliminate pain and inflammation in the knee joint.

These NSAIDs are very widely represented on the veterinary market, but in our practice we most often use only a small range of drugs from this group.

For small breeds of dogs we use the following medications:

Loxicom (0.5 mg meloxicam in 1 ml) suspension.
For dogs weighing up to 5 kg. The drug is prescribed on the first day of administration, 0.4 ml per 1 kg of body weight, then 0.2 ml per 1 kg of body weight of the animal, strictly after feeding. Course up to 10 days. The drug can be used for animals from 6 weeks of age.
Previcox 57mg (firocoxib) tablets.
For dogs weighing over 3 kg. The drug is prescribed in a dosage of 5 mg per 1 kg of body weight, strictly after feeding the dog. The drug can be used from 10 weeks of age and if the dog weighs more than 3 kg.

For dogs of larger breeds, we most often use drugs such as:

Previcox 227 mg (firocoxib) tablets.
The drug is prescribed in a dosage of 5 mg per 1 kg of body weight, strictly after feeding the dog. Also, the dosage calculation table is given above.
Rimadyl 20,50,100 mg (carprofen) tablets.
The drug is prescribed in a dosage of 4 mg per 1 kg of body weight, strictly after meals. The drug is not prescribed to dogs under 12 weeks of age.

It should be remembered that all nonsteroidal anti-inflammatory drugs can cause irritation of the mucous membrane of the stomach and intestines, leading to the development of erosions and ulcers, but when used correctly, this is extremely rare. NSAIDs are also used with caution in dogs with liver or kidney disease, as they may have hepatotoxicity and nephrotoxicity. Therefore, before using the drug, it is recommended to conduct a biochemical blood test to avoid subsequent problems.

Separately, the use of knee pads for dogs is not used as an independent therapeutic treatment. In complex therapy, for example, with insufficient limitation of mobility, this method can be useful as additional support for the knee joint when the dog moves. Most often, due to the anatomical structure of the dog’s limb, the knee pad slips off the paw or the dog itself tries to remove it, which makes this method ineffective.

In itself, the therapeutic approach to rupture of the anterior cruciate ligament is not the gold standard in the treatment of this pathology and often leads to the development of deforming osteoarthritis of the knee joint, which over time makes movement in the affected paw impossible. Therefore, in our clinic this type of treatment is offered to patients who have contraindications to general anesthesia or when surgical treatment is not possible at the request of the owners.

Surgical treatment of cruciate ligament rupture in dogs

Surgical treatment for anterior cruciate ligament rupture is the most reliable method that gives the best result. Let's consider several methods of surgical treatment for rupture of the anterior cruciate ligament:

Intracapsular methods.

The goal of the intracapsular technique is to restore stability to the knee joint by replacing the ligament with a graft. In the supra-apical method of surgery, the graft consists of the straight patellar ligament, the patella wedge, the patellar tendon and the fascia lata. It is placed along the course of the original cruciate ligament in the knee joint, in its normal anatomical position. Over time, the graft should take root in the knee joint, its blood circulation should be restored and over time it will resemble a healthy cruciate ligament.

All intracapsular stabilization methods have their positive sides: complete replacement of the anterior cruciate ligament. In biomechanical terms, this method has its noticeable advantages.

On the other hand, there are also some negative aspects: after replacing a ligament, it immediately puts a significant load on it and it may not take root and may rupture. Also, if a dog has a deformity of the knee joint, as a result of which degenerative changes in the cruciate ligament have occurred and it has torn, then there is no point in replacing the ligament. There are also operational technical difficulties in replacing it.

Extracapsular methods (FTS or lateral suture, muscle transposition).

Extracapsular techniques rely on stabilizing the knee joint with sutures or using soft tissue to support the knee joint.

Fabello-tibial suture or lateral suture.

Stabilizes the knee joint due to the formation of fibrous tissue around the implant (suture). The lateral suture is placed on the lateral side of the knee joint through a double hole in the area of the tibial tuberosity. The other end of the thread is passed through the lateral fabella with a needle. Next, both ends of the thread are passed through the clip, the thread is pulled tight and the clip is clamped.

This method is good for dogs no more than 12-15 kg. The ability to support the affected limb after surgery occurs on days 7-14, and by the 12th week the lameness disappears.

Transposition of muscles.

Stabilization of the knee joint is achieved by transferring the distal end of the biceps femoris muscle and the distal end of the sartorius muscle to the crest of the tibia. As a result, the knee joint remains stable when moving, and no cranial displacement of the tibia is observed.

This method is suitable for dogs of any weight and is quite inexpensive. The ability to support the affected limb is restored after 4-6 weeks. Complete lameness can take up to 4-5 months.

This method has its long-term disadvantages, such as secondary damage to the medial meniscus and the development of osteoarthritis.

Also, this method requires limiting the dog’s mobility for up to 4 weeks, which is not always possible, otherwise, separation of the displaced muscles may occur.

Around joint methods (Osteotomies: TPLO, TTA, TTO). These methods are based on changing the anatomical structures of the joint for restoration.

TPLO tibial plateau leveling osteotomy is a surgical method based on reducing the angle of the tibia, where the forces of movement during extension provide dynamic stabilization of the joint.

This method of treatment for rupture of the anterior cruciate ligament is one of the most reliable surgical techniques. Suitable for dogs of all weight categories with a tibial plateau angle greater than 15 degrees. The goal of TPLO is to dynamically stabilize the knee joint. The cranial displacement of the tibia in case of rupture of the anterior cruciate ligament is caused by the angle of inclination of the tibial plateau by the compression traction that occurs when the body weight is transferred to the injured limb, directed parallel to the longitudinal axis of the tibia. If the plateau angle is 5-6.5°, then there will be no displacement of the tibia in the cranial direction and the joint will be stable. Osteotomy is performed using an oscillating saw and a blade of a specially selected radius. Then, after changing the angle, the plateau is fixed relative to the tibia with a special plate for the TPLO (“clover leaf”) technique.

After this technique, dogs with a rupture of the anterior cruciate ligament have a fairly early ability to support the affected paw. After 5-7 days, dogs actively use their paws. Postoperative care does not require strict restriction of mobility; the use of antibiotics, non-steroidal anti-inflammatory drugs and suture treatment is recommended. If the meniscus is damaged with this technique, arthrosis of the knee joint develops much more slowly. Like any other technique, this method has its complications, such as infection of the implant (2%), avulsion of the tibial tuberosity (4.3%), secondary damage to the meniscus (3%).

TTA advancement of the tibial tuberosity (Tibial tuberosity advancement) - the surgical method is based on the advancement of the tibial tuberosity, where, during extension, additional dynamic traction is created, directing the tibial plateau to its natural position.

The essence of this technique is that if an angle of 90 degrees is achieved between the direct patellar ligament and the tibial plateau, then the cranial displacement of the tibia will not be observed, and accordingly the knee joint will be stable.

The technique is suitable for dogs of different weight categories, as well as with a tibial plateau angle of less than 15 degrees. In the postoperative period, the use of antibiotics, non-steroidal anti-inflammatory drugs and suture treatment is recommended. The advantage of the method is also the early ability to support, the disadvantage is the development of postoperative seromas (33%) and separation of the tibial tuberosity (15%). TTA is not used as often in our clinic due to aspects of the high cost of the implants, as well as the higher rate of postoperative complications compared to TPLO.

TTO (Triple Tibial Osteotomy).

The essence of this method also lies in changing the anatomy of the tibial plateau, namely, changing the angle of the plateau and extending the tuberosity using osteotomy. This technique is performed on dogs whose plateau angle is less than 15 degrees. There are also a number of disadvantages, such as the traumatic nature of the operation, separation of the tibial tuberosity and strict postoperative limitation of mobility.

Prognosis for ACL rupture in dogs

The prognosis for recovery directly depends on the time of treatment after rupture of the anterior cruciate ligament.

A secondary problem after anterior cruciate ligament rupture is damage to the medial meniscus. If the dog has been walking with a tear for a long time, the meniscus injury may worsen and during surgery, the posterior horn of the medial meniscus is most often removed partially or completely. Removal of the meniscus, chronic inflammation of the knee joint, etc., leads to the development of arthrosis of the knee joint, which in the future will lead to the inability to fully use the paw.

Also, with prolonged pain in the dog’s knee joint, atrophy of the hip muscles occurs, which aggravates the rehabilitation period after surgery.

In conclusion of this article, I would like to note the main recommendation for animal owners - timely seeking help from a veterinarian.

Clinical case No. 1

The owners of an Alabai dog named Yuzbash contacted the State Educational Center "Pride" with complaints about lameness of the pelvic limb in their pet.

As a result of an orthopedic examination and x-ray examination, a diagnosis was made of a torn anterior cruciate ligament. This problem was solved using surgical treatment using the TPLO (Tibial plateau leveling osteotomy) technique. This is a modern technique that allows you to achieve quick and effective results. This technique involves changing the angle of the tibial plateau, at which the anterior cruciate ligament loses its functional significance.

5 days have passed since the operation, and Yuzbash can already use his paw. Rehabilitation after such an operation does not require a lot of time and expense for the owners.

Clinical case No. 2

A poodle dog named Dorphy was admitted to the Pride veterinary center because she began limping on her left pelvic limb. Over time, the lameness only worsened.

Veterinary orthopedic surgeon E.S. Maslova A series of examinations (clinical examination of the animal and x-ray examination) and tests (drawer syndrome) were carried out, which made it possible to diagnose a rupture of the anterior cruciate ligament. It was decided to surgically treat the problem using the fabellotibial suture (lateral suture). This technique is performed to stabilize the knee joint when the anterior cruciate ligament is torn in small breed dogs. The technique is considered non-traumatic and dogs recover very quickly after surgery. Dorfi, having passed all preoperative examinations, was allowed to undergo surgery. The dog tolerated the anesthesia, the operation itself and the recovery period well.

Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya

Clinical case No. 3

A dog named Kuzya (11 years old) was admitted to the State Educational Center “Pride” to the veterinarian orthopedic surgeon E.S. Maslova. with the fact that the day before at the dacha he stopped stepping on his right pelvic limb. At the appointment, using special tests and radiographic examination, medial dislocations of the patellas on both sides and a rupture of the anterior cruciate ligament on the right were diagnosed.

The causes of anterior cruciate ligament (ACL) rupture vary. In older dogs, ACL rupture occurs for two reasons: degenerative changes in the ligament and inflammatory processes in the joint. This pathology is extremely rarely traumatic in nature, and is always treated surgically.

Since Kuzi has a small body weight, they decided to fix his knee joint using a lateral or fabellotibial suture. This technique involves applying a suture from a special polymer thread (there are special kits for lateral sutures) that prevent instability of the knee joint. The method is also relatively inexpensive and produces good results, but only for small breeds of dogs. After a preoperative examination by doctor Maslova E.S. Kuza underwent this operation successfully.

Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist Smirnova O.V.

Clinical case No. 4

A Chihuahua named Lelya (9 years old) was admitted to the State Educational Center “Pride” to the veterinarian orthopedic surgeon E.S. Maslova. with lameness on the right pelvic limb. Using special tests and radiographic examination, medial patellar dislocation and right anterior cruciate ligament rupture were diagnosed. This pathology is very common in small breeds of dogs and can only be treated surgically.

Since Lelya is a miniature girl, they decided to fix her knee joint using a lateral (fabellotibial) suture. This technique involves applying a suture made of a special polymer thread, which prevents instability of the knee joint. The method is also relatively inexpensive, non-traumatic and gives good results, but only in small breeds of dogs. After a preoperative examination (blood tests and ultrasound of the heart) by orthopedic surgeon Lele, this operation was successfully performed. And after recovering from anesthesia in the hospital, she went home.

Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya

Clinical case No. 5

Labrador Uta was admitted to an orthopedic veterinarian E.S. Maslova. with the problem of pain in the left pelvic limb. After examination and a series of orthopedic tests, accompanied by x-ray diagnostics, the dog was diagnosed with crepitus in the knee joint and “drawer” syndrome. The doctor diagnosed him with a torn anterior cruciate ligament. This is a fairly common pathology among dogs. To solve the problem, surgical treatment using the TPLO technique is used. The most modern method that allows an animal to quickly begin to use its paw without the presence of a cruciate ligament. Uta was successfully operated on and went home after waking up under the supervision of his anesthesiologist and doctors in the inpatient department.

Veterinary surgeon specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya