Re:post-op extracaps and TPLO's

[Guest guest]

We don't do TPLOs where I am at but our TTA patients do the same thing! I was wondering this as well.

Felicity Talbot

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[Guest guest]

Hi,The surgical procedures we do for dogs with ACL disease are TTAs and FSG/LSS. When I see what I believe you are describing it seems to be the a result of off-shifting weight (lameness) from the injured limb and, in my experience, usually resolves as the dog heals. Simply put, I think it is just easier and more comfortable for them to externally rotate the knee and abduct the limb than it is to engage the muscles needed to support and carry the limb during normal ambulation.

Another thing to consider, if you haven't already, is the pivot shift that is commonly associated with TPLO procedure. I am not a surgeon so I will not go into details about pivot shift, but it is not uncommon among dogs who have had TPLO surgery to exhibit this mechanical deviation. (we've seen a few TTA's too).

Any other thoughts out there? Wolter, CVT, CCRABend Veterinary Specialists

We don't do TPLOs where I am at but our TTA patients do the same thing! I was wondering this as well.

Felicity Talbot

Email message sent from CompuServe - visit us today at http://www.cs.com

[Guest guest]

-

I agree with the pivot shift being something to consider. We do a lot

of TPLO's here at Texas A & M and a lot of them externally rotate after

surgery, especially if it is a chronic condition with severe quadriceps

and cranial tibial atrophy. Patients we see with acute tears (although

it takes a month to get an appointment here-so how acute are they?)

don't externally rotate as bad. For the severe pivot shifts, we have

found that the shift resolves with strengthening exercises, and as the

animal regains strength the external rotation (and pivot shift for that

matter) resolve.

As for TTA's, we performed TTA's on ten research animals with

transected cruciates that were models for OA about two months after

transection, and almost all of these dogs exhibited external rotation,

probably due to lack of musculature because their atrophy was

significant after spending two months on an unstable stifle. These dogs

were started on a rehabilitation regime and the external rotation

improved after regaining strength.

From my own experience, I have had two knee surgeries. I had external

rotation due to lack of medial quads and my rotation resolved after

intense physical therapy sessions to strengthen my medial quadriceps.

Just some thoughts...

J. Sessum, RVT

Texas A & M University

College of Veterinary Medicine

Small Animal Rehabilitation &

Surgery Technician Supervisor

http://vmth.tamu.edu/rehab.shtml

>>> " Wolter " 9/6/2008 9:11 AM >>>

Hi,

The surgical procedures we do for dogs with ACL disease are TTAs and

FSG/LSS. When I see what I believe you are describing it seems to be

the a

result of off-shifting weight (lameness) from the injured limb and, in

my

experience, usually resolves as the dog heals. Simply put, I think it

is

just easier and more comfortable for them to externally rotate the knee

and

abduct the limb than it is to engage the muscles needed to support and

carry

the limb during normal ambulation.

Another thing to consider, if you haven't already, is the pivot shift

that

is commonly associated with TPLO procedure. I am not a surgeon so I

will

not go into details about pivot shift, but it is not uncommon among

dogs who

have had TPLO surgery to exhibit this mechanical deviation. (we've

seen a

few TTA's too).

Any other thoughts out there?

Wolter, CVT, CCRA

Bend Veterinary Specialists

> We don't do TPLOs where I am at but our TTA patients do the same

thing!

> I was wondering this as well.

>

> Felicity Talbot

> ------------------------------

> Email message sent from CompuServe - visit us today at

http://www.cs.com

>

>