Re: Prolotherapy followed by surgery?

[Guest guest]

My own dog underwent prolotherapy treatment for a torn cruciate about 3 years ago, along with therapy, but it was not successful in stabilizing the joint sufficiently, so he then underwent a TPLO about 3 months later- the surgeon did not report any complications with the surgery due to having had the prolotherapy first. I don't have any scientific evidence to back it up, only this anecdotal evidence.

Bedenbaugh, PT, CCRP

Prolotherapy followed by surgery?

Hi All,

At the NAVC I was at a lecture on Prolotherapy and the lecturer assured us that if prolotherapy is not successful, surgery can be the next step. Since I've never seen a prolotherapy treatment and I don't do surgery, I was hypothesizing that there would be an awful lot of fibrous tissue in the joint after prolotherapy that could make it difficult to do a successful surgery. Does anyone have any thoughts on this view that surgery is always viable if prolotherapy fails? The lecturer showed some convincing MRI's of a human ACL pre and post prolotherapy - but I'm still a bit skeptical.

I have an 8 1/2 year old Shih Tzu who had a lateral suture placed for a CCL partial tear. He showed increased limping several weeks post-op. A second surgeon went in and removed the implant and felt the crimps used were too big and were invading the joint capsule. The surgeon has since recommended a TPLO, but the owner is a PT herself and wants to try rehab first. Would prolotherapy be a reasonable option for this pup? And if the joint did not stabilize, can surgery be done following prolotherapy?

Thanks to all for their input!

Tina

[Guest guest]

TinaI think a TPLO in a dog this size is like trying to kill a frog with an elephant gun!1) I'd be curious if the medial meniscus is damaged2) If the surgeon feels the crimps were impinging on the joint capsule, then I'd jsut replace the suture and tie knots, not use crimps-the other  option is, do nothing-many toy breeds will do fine after 6-10 weeks of PT so prolotherapy may not be needed either- there have been studies to show that the difference between surgery and no surgery in dogs this size is  less than 10% show a difference down the road- so if this was my case, I'd give the owner an option of just progressive rehab and no prolo

Freedman VMD CCRTAssociate editor VIN Orthopedics and Soft Tissue surgery-- Regards,

[Guest guest]

Thanks everyone. The owner is going to do at home exercises and hydrotherapy -

we'll see how he does - hopefully, we can get him more comfortable!