Laterl Imbrication Complication

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Hello

I am writing for info regarding a complication I have seen. Following a CCL tear on a dog that have had a lateral imbrication procedure. We had a 2-year-old PBT mix dog with lameness 4mos post surgery. His rehab had gone great with no issues and he was full functioning prior to his intermittent lameness. He has a palpable snapping along his suture. His cranial drawer is not lax. Passive flex/extn ROM is normal. No crepitus is detected. Conservative efforts to decrease irritation were not successful. A surgeon in our area removes the nylon suture when this occurs. Here are my questions?

1. Will the dog lose stability when the suture is removed? If not why and how soon post surgery can they be removed safely?

2.Is there any advise to prevent this complication from occurring in the first place?

In human physical therapy we treat knee irritation conditions(chondromalcia, IT Band rubbing, Pat Tendonitis etc.) by supporting the knee structures from joints above and below it. If a foot is rolling in medially at the metatarsal region (pronation) this affects the biomechanics of the knee. If the ankle does not have enough flexion range of motion the heel will impact the ground with less cushioning ability sending increased force to the knee. At the hip a lack of hip extension (tight Illio Psoas) and decreased mobility when the hip is first extended than adducted (tight IT Band) will affect knee function. As for hip strength weak lateral hip stabilizers will impact how the femur rotates (biomechanics with both the tibia and the patella), and the ability to stand on one leg during stance and gait

1. In dogs since they stand on their metatarsal heads, their metatarsals should be stable if their neutral but what if their conformation is cow-hocked? Could a cow-hocked dog be similar to a human with a pronated foot? Could a prosthetic device be used in a symptomatic animal? (In humans flat feet are not usually addressed when not symptomatic)

2. Is lack of hock flexion an issue in dogs?

3. Has anyone incorporated hip and stifle stretches or hip strengthening for their stifle patients? (HD dogs would complicate this area)

4.Has anyone picked up deficits of PROM for hip and hock joints on stifle patients?

Thanks for your time

Amy Flannery MS PT CCRP