Various Orthopedic Surgical Services

Tibial Plateau Leveling Osteotomy (TPLO)

When a pet ruptures their cranial cruciate ligament (similar to the ACL in humans) a Tibial Plateau Leveling Osteotomy is often recommended. This is the preferred method of repairing the CCL in larger dogs since the other methods that replace the ligament are not as strong and can't always hold the weight of a larger dog. So for heavier pets this is a more permanent solution. If not performed, the injury can lead to early or more significant arthritis down the line.  During the procedure the surgeon will level the surface at the top of the tibia from a slope to a flat surface. This helps the force to travel downward rather than having the tibia slip forward and give away. Then it is held in place by plates and screws. 

For more details see the video below.

Tibial Tuberosity Advancement 

Similar to the TPLO (See Tibial Plateau Leveling Osteotomy), a Tibial Tuberosity Advancement is recommended when your pet's cranial cruciate ligament (similar to the ACL in humans) ruptures. If not performed, then with time the injury can lead to early or more significant arthritis.This method is also typically performed in larger dogs and involves reshaping the bone in order to remodel the knee joint. In this case, the surgeon would be advancing the attachment of the quadricep muscle forward so it is perpendicular to the tibial plateau. Then it is secured with the correctly sized plates and screws. 

For more details see the video below.

Medial Patellar Luxation 

Patellar luxation is a condition in which the patella (kneecap) becomes dislocated from the groove in which it sits located on the end of the femur (thigh bone). Patellar luxation is one of the most common orthopedic conditions found in dogs. Though often common in smaller toy breeds like Chihuahuas, French Poodles, Terriers and Pomeranians it can be found in dogs of all sizes. Genetics likely play a role in the majority of cases of patellar luxation though rarely it can result from a traumatic injury to the knee causing severe lameness to the limb. 

Symptoms of Patellar Luxation can vary based on severity of the dislocation but frequently include limping or lameness, shaking or extending the leg, "skipping"--or carrying the limb every few steps or holding up the affected leg. A thorough orthopedic exam will help determine diagnosis while surgery to correct a luxation depends on the grade or severity of displacement. 

Femoral Head Ostectomy

A femoral head ostectomy or FHO is a surgical procedure that should be considered for both dogs and cats where there is pain and/or lameness of a diseased or damaged hip which is not alleviated by weight loss, pain medication or any other surgical or non-surgical procedure. 

An FHO is typically used as a salvage or last resort procedure to restore pain-free mobility in pets with severe osteoarthritis or hip dysplasia. It involves total removal of the femoral head (the "ball" part) and neck of the femur in which the bones of the joint no longer contact, causing surrounding muscle to develop and support the area as a sort of "false joint". This false joint works well to support the weight of small dogs and cats and may be less effective in large breeds over 50lbs, however your veterinarian may recommend an FHO for a large dog if doing so would be appropriate. 

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