Tibial Tuberosity avulsion

March 18, 2007

Check out orthodogs.com, a Colorado company, that makes hinges

braces/orthotics. Good luck.

Spears

tibial tuberosity avulsion

Hello group. This is my first posting, and I would appreciate any

advice/suggestions.

I just evaluated a 2 yr old spayed female, 100# Newfoundland with an

original dx of Grade II-III MPL. She underwent patella stabilization

sx 5/06, and developed a tibial tuberosity avulsion that was

stabilized 3 weeks later. This sx failed and implants were removed in

8/06. A second attempt to stabilize the tibial tuberosity was made

one month later, and also failed. The owners are very hesitant about

undergoing another surgery, but understand it is needed and will be

looking for a second opinion at the Univ of Fl. The dog presently

lacks 20 degrees of stifle extension, has significant tibial torsion,

a medial rotating hock with some laxity and clicking, atrophy, and a

negative drawer. My thoughts are to protect the stifle and hock with

bracing/splints to prevent further laxity and improve alignment,

attempt careful strengthening until the dog undergoes another surgery,

and manual therapy to improve extension. The gait is very sloppy and

I'm concerned about the ACL and hock.

Would appreciate any advice or information on bracing in this

situation (companies, etc), or any other thoughts that may help this

big girl.

Kathie Touhey, PT, CCRT pending

March 19, 2007

With the braces/orthotics,

Look at orthodogs.com, the s is very important. Orthodog is not close to

being the same. They have great things.

Spears

tibial tuberosity avulsion

Hello group. This is my first posting, and I would appreciate any

advice/suggestions.

I just evaluated a 2 yr old spayed female, 100# Newfoundland with an

original dx of Grade II-III MPL. She underwent patella stabilization

sx 5/06, and developed a tibial tuberosity avulsion that was

stabilized 3 weeks later. This sx failed and implants were removed

in

8/06. A second attempt to stabilize the tibial tuberosity was made

one month later, and also failed. The owners are very hesitant about

undergoing another surgery, but understand it is needed and will be

looking for a second opinion at the Univ of Fl. The dog presently

lacks 20 degrees of stifle extension, has significant tibial

torsion,

a medial rotating hock with some laxity and clicking, atrophy, and a

negative drawer. My thoughts are to protect the stifle and hock with

bracing/splints to prevent further laxity and improve alignment,

attempt careful strengthening until the dog undergoes another

surgery,

and manual therapy to improve extension. The gait is very sloppy and

I'm concerned about the ACL and hock.

Would appreciate any advice or information on bracing in this

situation (companies, etc), or any other thoughts that may help this

big girl.

Kathie Touhey, PT, CCRT pending

September 19, 2008

It is really important when posting to this list that each question or

issue have its own email string. One of the benefits of the group is that

we can all go to the yahoo website and search for past information about a

topic. But that is only easily done if the subject line is accurate to what is

being discussed. I am resending the email below for Maja. If

everyone could respond to this subject line, it will make things easier.

Thanks. Read on….

I recently rescued a 5yr old boxer-x (60#). He is an orthopedic

nightmare. He has bilateral hip dysplasia (grade IV on right, Grade III

on left), came with bilateral CCL rupture (2yr old injury), and an un-united

anconeal process at the right elbow. He had bilateral TPLOs 6 weeks

ago. Rehab was commenced immediately post-op - icing, pROM, Laser

therapy, and now includes controlled leash walks, therapeutic non-impact

exercises. We started swim therapy last week (controlled, assisted, 15min

maximum swim time). 7 days post-op he developed severe inflammation and

heat in his left hind limb - was diagnosed as a Staph infection via FNA and

cytology, and was placed on ABs. 3 weeks post-op he became acutely lame

on his right hind limb - this resolved in a week and did not include

inflammation. 6-week post-op rads were taken yesterday and showed

bilateral tibial tuberosity avulsion and left fibula fx, with bilateral,

proximal, displacement of the patella. Scary rads! It appears that

this is a rare complication following TPLO sx, happening in 7% of cases, but

occurs most often in bilateral cases. The surgeon suggests that we wait a

month and re-check rads then. Hopes are that the fx will heal and that

there will be no need for revision. After reading several veterinary

articles on this complication, it appears that revision - involving removal of

hardware - was indicated. So the question to all of you is simply, has

anyone had experience with this type of TPLO post-op complication and what was

the surgeon's course of action?

Again, thank you for the input,

Maja Wichtowski, RVT, CCRP

Orenbuch

evelynvet@...

Cell

hm/off

www.evelynvet.com

Vice Pres - American

Assoc. of Rehab Veterinarians - www.rehabvets.org

From: VetRehab

[mailto:VetRehab ] On Behalf

Of tsavo13@...

Sent: Thursday, September 18, 2008

1:03 PM

To: VetRehab

Subject: Re: Re:

Swimming and TPLO

Thank you everyone for your input on this subject.

A surgeon mentioned a possible concern regarding swimming and TPLOs.

Specifically, he recalled an article that suggested that swimming may

compromise the recovery of TPLO patients. Has anyone ever read such an

article? The surgeon asked that I ask the VetRehab group about swimming

and TPLOs in general. All of your input confirms my understanding of the

proper use of this modality.

2nd question to the group: