This is a little write up mum did on ACL tears back in Feb.2005. It talks about all the treatment options available and her experience with me.
A torn (partial or complete) ACL is often diagnosed with the palpation of the stifle for a "drawer sign" (sliding motion of the knee joint) along with x-rays. X-rays do not show torn ligaments, but it in term will show symptoms (ie, arthritis, joint effusion) associated with a torn ACL. For the muscle to be relaxed enough for a drawer sign to be detected, the dog usually has to be put under anesthetic. If a drawer sign is detectable while the dog is awake, then the chances of its being a complete rupture are high.
MRIT aka. Traditional Repair
The Traditional surgery involves tightening of the knee joint with nylon lines or fishing lines along with the building of scar tissues to stabilize the knee joint. This type of surgery is less expensive, less invasive, takes less time to do, and can be redone if it ever fails. The down side to it is that, the nylon lines can snap, the scar tissues can break, and that means the dog would come up lame again. It also does not slow down the progression of arthritis. Here is a slide show by a rehab vet (not TPLO certified) that explains how the Traditional repair works.
Tibial Plateau Leveling Osteotomy (TPLO)
1. If something goes wrong, it goes very wrong, and most of the time, it will need additional surgeries to fix the problem. So the experience of the surgeon is key to this type of surgery.
2. Any metallic implant has the potential to cause bone cancer in humans and animals. And there is a plate and 6 screws used in this surgery to hold the repositioned tibia in place until the bone heals. However, plate & screw removal is always an option.
Here is an abstract of a medical journal published by four surgeons, including Dr. K Sinibaldi, the experienced surgeon who operated on my Sunshade:
The recovery period for both types of surgery is about the same: the first 6-8 weeks of confinement, followed by another 6-8 weeks of slowly building up the normal activity level. With the Traditional repair, you want the scar tissues to build up and be strong enough to hold the nylon lines in place. With the TPLO, you want the bone to heal.
Conservative management is always an option for a strained or partially torn cruciate, or if surgery is not an option. Conservative management includes: physical therapy (hot/cold packs, electric muscle stimulation, ultrasound, treadmill, underwater tread mill, swim therapy), acupuncture, knee brace (http://www.woundwear.com/product3.cfm), and supplements.
There is a group on Yahoo that deals with that specifically:
The Yahoo Orthodogs group is also a good place to get information and advice. 80% of the people on the list have either dealt with or are dealing with torn ACL’s. Paola is also on this list.
My 5 year old girl (60 lbs), Sunshade, had 2 TPLO's done back in 2003. To make a long story short, in Feb of 2003 I noticed that she was starting to have intermittent lameness in her right hind leg after exercise. Took her to the vet for x-rays. The x-rays showed mild joint effusion, no arthritis, a strained or partially torned cruciate was suspected. My vet put her on Ligaplex I (acute cruciate damage at the time, was later switched to Ligaplex II as it was chronic by then) along with other joint supplements. We started conservative management with her in the hopes that scar tissues would build up to stabilize the joint and no surgeries would be needed. The CM went really well and the intermittent lameness went away........Until one day, while she was in the yard, a DAMN squirrel decided that he wanted to run along the top of my fence. And that was it, her ACL was completely ruptured. Surgery was Sunshade's only hope for "quality" of life since she lived for her beach walks. So in May of 2003, she had her first TPLO, and her second in December of 2003.
As of today, I am very glad that I chose the TPLO procedure because Sunshade is simply doing FANTABULOUS!!! Her x-rays showed at 1 year & 1.5 yr post op, there is still no signs of arthritis. I did, however, had her plates and screws removed from both of her knees as the thought of Osteosarcoma just freaked me out.
Sunshade's surgeries were done in Seattle, WA and it was $3000 US for her first knee, $3500 US for the second knee (had the plate and screws from the first TPLO removed at the same time).
Here is a picture of Sunshade doing hydrotherapy at 8 weeks post her first TPLO. Scroll down, you will see her little cousin having his first swim lesson at 10 weeks of age.
1 day post TPLO surgery #1 - mum came to visit me at the hospital (05/07/03)
I was so brave and was already using my surgery leg (05/07/03)
Me doing rehab with my therapist Barb - 8 weeks post TPLO #1
Therapy with Barb
Look at us having so much fun!!! Because I was recovering from surgery, I couldn't be groomed, so.....I looked like a woolly mammoth!
Last note, it is a very good idea to be on a monthly pet insurance plan BEFORE any health issue arises. It will save you lots of money should something unexpected happens, like a torn cruciate ligament.