Orthopedic Surgery For Dogs

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    What is Orthopedic Surgery for Dogs?

    Dogs who suffer from certain injuries or ailments may benefit from orthopedic surgery as a form of treatment. Any surgical technique that restores broken bones, vertebrae, muscles, joints, or torn ligaments is referred to as veterinary orthopedic surgery. Every orthopedic surgery technique aims to realign fractured bones to their proper positions and then pin or hold them in place firmly to prevent additional movement, allowing for proper healing to take place.

    german shepherd at vet

    What Kinds of Orthopedic Surgeries Are There for Dogs?

    Dogs with a good quality of health and not at risk of health problems due to anesthesia are good candidates for orthopedic procedures. Types of Orthopedic Surgery can include:

    Here is a closer look at some common orthopedic surgeries:

    TPLO SURGERY

    TPLO surgery stabilizes the knee by leveling the tibial plateau, which is one of the most common types of orthopedic surgery. The TPLO technique was designed to stabilize the knee by altering the biomechanics of the joint, eliminating the need for the dog’s injured CrCL (ACL or CCL). Surgeons realign the tibia, which is the bone that makes up the bottom part of the knee joint. Because dogs’ tibia bones are slanted, if the CrCL is ruptured or damaged, the femur may fall off the back of the tibia while the dog is carrying weight on the leg. TPLO surgery helps to level the slope and eliminates joint instability by allowing the dog to comfortably bear weight on the leg.

    Photo Credit: Lifelearn

    Total Hip Replacements (THR)

    Total Hip Replacements (THR) is done when hip dysplasia pain is so advanced to the point of no return and unable to be medically managed. This surgery involves replacing the femoral head and hip joint socket with a prosthetic composed of medical cobalt-chrome and polyethylene. Dogs that have undergone this surgery are likely to regain complete hip function and remain pain-free for the remainder of their lives.

    Cruciate Ligament Repair (ACL, CRCL, CCL)

    Photo Credit: PetMD

    Commonly performed orthopedic surgeries include torn, injured, and ruptured Cranial Cruciate Ligaments (ACL, CrCL, CCL), Cruciate ligament disease in dogs, and Extracapsular repair of the ACL, CrCL, or CCL. A CCL rupture is typically treated using a variety of surgical methods. Each technique has its own set of benefits and downsides. Your veterinarian will help you make the best selection for your pet by guiding you through the decision-making process and advising you on the best surgical option. 

    Shoulder OCD

    Shoulder OCD (osteochondritis dissecans) is an orthopedic disease in which a piece of the cartilage of the shoulder joint gets detached. This causes inflammation and discomfort, and osteoarthritis develops as a result. OCD affects puppies and causes forelimb lameness in the same way as elbow dysplasia does. Depending on the size of the lesion, surgery may be done either via arthroscopic removal or standard open-joint surgery. During surgery, the cartilage fragment is removed from the dog’s shoulder.

    Elbow Dysplasia

    Forelimb lameness is commonly caused by elbow dysplasia. Similar to hip dysplasia, elbow dysplasia is very complex and usually develops when a dog is very young, as well as being detected before they are a year old. Treatment is often completed via arthroscopic examination and surgery. Some of the steps of surgery include removing coronoid fragments and loose cartilage, altering the elbow joint to shift weight away from the damaged areas, and possibly replacing the joint depending on the severity. Without treatment, elbow dysplasia can lead to osteoarthritis.

    Photo Credit: PetMD

    Intervertebral Disk Disease (IVDD)

    IVDD syndrome is one of, if not the most painful diseases a dog may have, and surgical treatment may be the best option. The disc can exert pressure on the spinal cord and surrounding nerve roots due to extrusion, protrusion, or bulging. This results in neurological symptoms (weak or paralyzed legs, alterations in cutaneous feeling) as well as severe pain. In extreme cases of extrusion, the disc’s core may erupt and slam onto the spinal cord, leaving this part of the cord concussed (damaged after being struck), contused (bruised), or edematous (swollen).

     If a dog is diagnosed with IVDD, the severity is determined to figure out the prognosis. IVDD surgery relieves pressure on your dog’s spinal cord, restores normal blood flow and movement, reduces discomfort, and prevents disc issues in the future by removing unhealthy intervertebral disc material. A variety of operations may be necessary to attain this aim.

    What Happens During Orthopedic Surgery?

    Before surgery, dogs will be given a general anesthetic and the area that the surgery is taking place will be shaved and sterilized. Surgeons may incise over the fracture site and dissects down to visualize the damaged bones, joints, or tendons under thorough aseptic conditions. While the technique is varied based on the procedure being done, it is common to return all of the broken bones back where they belong and immobilize the fractured portions of the bone so that they cannot move against each other. This includes preventing fracture ends from slipping and preventing rotation around an implant. 

    Prior to surgical wound closure, intraoperative X-rays are taken during fracture repair surgeries to ensure that the bones and implants are in the best possible position. Before closure, the fracture site is lavaged with sterile saline, and a local anesthetic may be used to alleviate postoperative pain. Follow-up x-rays are obtained to ensure that the repair is satisfactory, the surgery site is sutured, and the patient is permitted to awaken in a comfortable resting position.

    What Kinds of Fractures Are There That Require Surgery?

    Hairline Fractures

    A hairline fracture is a common and most simple bone fracture as the bone is still intact while minimal cracks run up the middle of long bones such as the leg bone. They are easy to manage as they often don’t cause displacement misalignment of the bone. But while small, this fracture still compromises the structural integrity of the fractured bone.

    Multiple-Piece Fractures

    Multi-piece fractures are just what they sound like. They are a result of a strong impact causing the bone to shatter into multiple pieces. Due to this, they are often more complicated to fix and require surgery the majority of the time.

    Joint Fractures

    Joint fractures are more severe as they can lead to arthritis even after the bone has healed due to the role that joints play in daily movement.

    Open Or Compound Fractures

    Open or compound fractures are severe fractures in which the bone is exposed outside of the skin. Sharp shards of bone can pierce surrounding tissues, causing damage to tendons, muscles, nerves, and blood vessels in severe fractures. Furthermore, if a bone is left outside the dog’s body, it is more likely to become unclean and infected. This can develop into serious infections that might be life-threatening and necessitate immediate medical attention. It’s important to follow your vet’s instructions to ensure your dog has a proper recovery.

    How Do You Care for a Dog Post-Orthopedic Surgery?

    The time it takes for your dog to recover after orthopedic surgery is usually determined by a variety of factors, including the kind of operation, your dog’s age, general health, and rehabilitation requirements.

    Managing Effects of Anesthesia 

    Dogs may be nauseous from the anesthesia and they will usually lose their appetite. During this period as they should be fed a bland diet of rice and chicken for the first 24 hours after surgery until the anesthesia has worn off to help ease their digestion.

    Restrict Movement

    Dogs may need to have restricted movement for a couple of weeks after surgery. It’s usually recommended to keep them in a large crate or in a small area of the house blocked by a dog gate to keep them from moving too much depending on their size and energy level. Calmer dogs may be able to do their recovery in a room in the house that doesn’t have anything they can jump on. It is critical to keep your dog from running, leaping, climbing stairs, or engaging in other vigorous activities while they recuperate from orthopedic surgery

    Photo Credit: My Fantastic Friend

    Medication

    Your dog will likely be prescribed pain medication to help aid in their recovery and be given written instructions on the dosage. Staying on schedule with pain medications is crucial to ensure efficacy and reduce the chance of side effects. Dogs may also be prescribed antibiotics to prevent infection. If your dog is high energy and will have difficulty being on restricted movement, they may also be given an anti-anxiety medication or mild sedative to help them remain calm during the recovery process.

    Surgical Site Care

    After surgery, it’s imperative to keep dogs from chewing, licking, biting, or scratching at their incision site. This can result in infection and opening up the site again. Your vet may suggest your dog wear a cone (available as in hard plastic or soft version). If dogs are struggling to get used to a standard cone, there are other options such as recovery jumpsuits they can wear and donut-style collars. Consult with your vet on the best route to take if your dog won’t wear a cone.

    Dogs will usually have to go back to the vet about 10-14 days post-surgery to have their stitches removed but the vet may also use stitches places inside the wound which will dissolve on their own. 

    The bandages should be kept dry at all times so if your dog goes outside make sure to keep them covered with cling wrap or a plastic bag to keep it protected from the wet or damp grass. The plastic should be removed as soon as they are inside as keeping it on can lead to infection. 

    Rehab and Physical Therapy

    Human patients who engage in systematic physiotherapy and rehabilitation programs after surgery heal more quickly and completely than those who are just given advice on how to exercise appropriately, according to scientific research. There is mounting evidence that dogs and cats are the same. All of these patients require a combination of exercises and activities to enhance strength, mobility, reduce pain and suffering, and regain agility and confidence. You can find a physical therapy and rehab specialist in our specialist directory. Physical therapy comes in many forms including but not limited to:

    Range Of Motion And Stretching Exercises

    Human patients who engage in systematic physiotherapy and rehabilitation programs after surgery heal more quickly and completely than those who are just given advice on how to exercise appropriately, according to scientific research. There is mounting evidence that dogs and cats are the same. All of these patients require a combination of exercises and activities to enhance strength, mobility, reduce pain and suffering, and regain agility and confidence. You can find a physical therapy and rehab specialist in our specialist directory. Physical therapy comes in many forms including but not limited to:

    Superficial Thermal Modalities

    Cryotherapy

    In the initial postoperative phase, ice compresses are an effective way to help manage pain and inflammation. Cryotherapy is helpful not only during the acute period of tissue damage and inflammation but also after exercise and throughout rehabilitation when inflammation develops.

    Heat therapy

    Heat should only be applied to tissues after the acute period of inflammation has passed, which is usually three to five days following surgery or injury. Vasodilation occurs as a result of surface heat, which enhances circulation to the superficial tissues, boosts tissue oxygenation and metabolite transport, and speeds up enzymatic and biochemical processes to aid tissue repair.

    Hydrotherapy

    Yellow Labrador in a hydrotherapy machine at physical therapy

    Hydrotherapy with underwater treadmill work essentially allows for rehabilitation and exercise by taking the weight off of the compromised joints and allowing movement that would otherwise be painful or impossible. The viscosity of the water actually increases the work that the muscles are doing at the same time. There is also pool-based and whirlpool hydrotherapy.

    Laser Therapy

    Laser therapy is a non-invasive photobiomodulation therapy to help in the rehabilitation of different conditions. Laser therapy uses light as a way to increase blood circulation and stimulate cell regeneration. It’s been used on humans for decades but laser therapy has been used on dogs in recent years. It essentially promotes healing while reducing inflammation and pain. 

    Shockwave Therapy

    dog receiving shockwave therapy

    For shockwave therapy for dogs, a series of focused high-pressure acoustic pulses (sound waves) are generated by the equipment and pass from the probe into the skin and soft tissue. The energy contained in the shock waves is released and interacts with the tissue when it meets tissue interfaces of varying densities, such as where soft tissue, tendons, ligaments, cartilage, and bone meet, creating both mechanical and cellular consequences. 

    How Much Does Orthopedic Surgeries Cost?

    Orthopedic surgery in dogs is expensive, costing anything from $100 to $3,000 each procedure. The overall cost is determined by the type of surgery performed by your veterinarian and the exact condition that your dog is experiencing. Consult a veterinarian for an exact estimate of how much orthopedic surgery will cost for a specific ailment.

    How Can Orthopedic Surgery Be Prevented?

    Orthopedic surgery can be prevented by taking the proper steps to prevent injury or joint degradation in your dogs. Unfortunately, some ailments may be difficult to prevent such as hip dysplasia in dogs born with the genetic predisposition but you can help the severity of it which would result in a less complicated surgery later on. Here are some tips to prevent needing orthopedic surgery based on the common causes of injuries:

    • Avoid picking dogs up by their front legs
    • Don’t put dogs in the back of pick up trucks untethered and tether them inside as well to keep them from jumping out windows
    • Check under vehicles and behind tires if dogs like to nap outside in the shade before taking off 
    • Don’t let small children carry puppies
    • Give smaller dogs and those prone to back injuries like dachshunds a ramp or stairs to get onto couches and beds
    • Exercise your dog regularly and keep them on a good diet to prevent obesity
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