VSC offers a wide range of orthopedic procedures and surgeries, from full joint replacement to minimally invasive arthroscopy. Many conditions have multiple possible treatment options, so we work with you and your primary veterinarian to come up with the treatment plan that is best for your pet.
When a bone breaks or is cracked, this is referred to as a fracture. Radiographs are the most common tool used to diagnose fractures, as they are an efficient method for veterinarians to visualize the affected bone. In rare cases a CT scan may be recommended to provide a 2 and 3 dimensional image of the affected bones in order to diagnose fracture and plan for a surgical repair.
The primary goal when dealing with a fracture is to immobilize the affected area. This not only helps decrease the animal’s pain, but it can prevent further damage to the surrounding soft tissues from the sharp edges of bone fragments. Often, veterinarians will use a splint to immobilize the bone until a more permanent treatment (such as surgery) can be obtained. In rare cases, splints or casts can be used as the primary treatment option to immobilize the fracture so it can heal. In most cases, this is often not enough to allow the bone to properly heal, so surgical measures must be taken. External fixation involves the surgical placement of pins into the bone, which then exit through the skin where they are connected to a rigid bar. Comparatively, internal fixation refers to the internal placement of a stabilizing device, either inside the bone itself or on the bone’s surface. Such devices include pins, wires, screws and plates, and are not typically removed after the bone has properly healed.
The hip joint consists of the femoral head which rests in a socket referred to as the acetabulum. This type of ball and socket joint is what allows for the wide range of motion seen in hips, and is very similar to the human hip joint. If the femoral head does not sit properly in the hip socket it can lead to instability in the joint, which over time will result in cartilage loss, arthritis, and scar tissue development. This instability and looseness of the hip joint is referred to as hip dysplasia.
Picture this: make a fist with your right hand and lay your left hand over it. This represents a healthy hip joint, where the femoral head (your right hand) fits snugly inside the hip socket (your left hand). If the femoral head moves abnormally within the socket, it will wear down the cartilage, and create bone spurs and scar tissue. Keeping your hands in the same basic shape, gradually separate them until only the fingertips of your left hand are touching your right. Notice how much looser and instable your “joint” is: this represents a displaced hip. If you placed a weight on top of your hands in this position it would be much harder to support the weight and move your right hand compared to when your hands fit comfortably together. While this is a very basic visualization of hip dysplasia, it demonstrates the impact this condition can have on an animal’s daily life.
Hip dysplasia can be seen in pets of all ages. It usually affects young dogs and older dogs and a plateau effect in middle aged animals.Many dogs do not have any symptoms, and symptoms can appear at any stage of the disease’s development. The severity of the hip dysplasia is classified based off of how much of the femoral head is covered by the hip socket, and can be used to help determine the best treatment option for the animal at that time. Treatment options include medical management (such as weight loss, non-steroidal anti-inflammatory drug, controlled exercise and physical rehabilitation) and surgery.
At VSC we offer four primary surgical options for pets with hip dysplasia: total hip replacement, triple pelvic osteotomy, and femoral head ostectomy (FHO).
- Triple Pelvic Osteotomy: TPO involves cutting the pelvic bone in three places. The segments are then rotated to increase coverage of the femoral head, thus decreasing the hip laxity.
- Juvenile Pubic Symphysiodesis: This procedure uses electrocautery to destroy a specific growth plate in the pelvis allowing continued growth to increase coverage of the femoral head. It is most effective if performed from 12-20 weeks of and is routinely combined with spaying and neutering.
Cruciate Ligament Tear
The cranial cruciate ligament (CrCL) is used to stabilize the knee joint, and is comparable to anterior cruciate ligament (ACL) in humans. While humans typically suffer some sort of trauma or stress to trigger an ACL tear, tearing of the CrCL in dogs is usually the result of degradation of the ligament over time. For this reason, it is relatively common for dogs that have torn the CrCL in one knee to develop a similar problem in their other knee during their lifetime.
Dogs who have torn their CrCL are often painful in the affected limb, causing them to be stiff, lame, and unwilling to perform normal tasks such as jumping into a car or playing. If a popping noise is heard, this can indicate the tear has affected the meniscus, a cartilaginous structure inside the knee CrCL tears can be partial or complete, and can be diagnosed using a combination of physical exam, radiographs, MRI and knee arthroscopy.
Treatment options depend on the severity of the rupture, as well as the pet’s age, size, and activity level. In most cases surgery is the best option as it is the only method that can permanently repair the instability in the knee joint. There are two categories of surgical techniques used to treat CrCL ruptures: osteotomy-based techniques and suture-based techniques. Regardless of the technique, it is impossible to repair the CrCL itself as the ligament lacks the ability to heal once it is torn. The two aforementioned techniques work to stabilize the knee without the presence of the CrCL ligament. Osteotomy-based CrCL repair changes the biomechanics of the knee joint to eliminate the need of a CrCL ligament (or equivalent). With suture-based the stability offered by the CrCL is replicated using a heavy guagesuturearound the joint. Your surgeon will determine which technique is right for your pet based, and discuss the benefits each has to offer.
The patella, also referred to as the kneecap, normally rests inside a groove in the femur (the thigh bone). If the kneecap migrates outside of this groove when the knee is flexed, this is known as patellar luxation. Symptoms for this disease vary, but one of the most common symptoms is an animal suddenly lifting the limb up for a few steps (“skipping”). The condition can be diagnosed by physical exam and radiographs.
If surgical intervention is needed, a combination of techniques are used depending on the case: reconstruction of soft tissues surrounding the kneecap, transposition of the tibial crest, correction of abnormally shaped femurs, and deepening of the femoral groove.
Elbow dysplasia is typically caused by growth differences between the radius and ulna (the two bones located between the elbow and wrist). There are different variations of this disease depending on if the radius or ulna is growing slower (it is more common to see the radius growing slower). Regardless, the disease will eventually result in arthritis, causing joint pain and loss of function in the affected elbow joint. Symptoms often will appear at a young age, when an animal becomes chronically lame in one or both of their front limbs.
Diagnosis of elbow dysplasia is made based off of physical examination, radiographs, advanced diagnostics such as CT or MRI scans and arthroscopy Once the severity and type of dysplasia has been determined, the veterinarian can establish an appropriate treatment plan. If surgery is required, it is most often performed arthroscopically as this minimizes damage to the surrounding tissues while allowing for a faster recovery time for the patient.
One of the most common forms of arthritis, osteoarthritis is caused by the loss of cartilage in an animal’s joints. This can lead to new bone formation around the joint, as well as painful inflammation. This is a chronic illness, which is normally secondary to some other orthopedic abnormality such as hip dysplasia.
Treatment for osteoarthritis depends on the individual patient, and it can take time to determine what treatment works best. Some of the most common options include nonsteroidal anti-inflammatory drugs, joint supplements, intra-articular injections into the joint, acupuncture, weight loss, and the limitation of high-impact activities such as jumping. Surgery can be warranted in certain cases to treat the underlying source of the arthritis.