RE: Re: Cruciate Brace

[Guest guest]

Outcome measures include objective measurements such as muscle girth, weight

bearing, gait, ROM, and function, along with subjective findings via owners

observations including 3 consecutive subjective client surveys immediately

post-op, at 4 weeks and 8 weeks. These surveys include, a pain inventory (a

modified Glasgow composite pain scale), and a functionality index. Full

recovery meaning return to previous level of function, resolution of pain,

normal gait, symmetrical muscle girth, and ROM equivalent to unaffected side

to name a few. The present study will be a prospective case series report.

Re: Re: Cruciate Brace

Hi Liz, regarding this statement:

" Saving the ligaments and cartilage (further tear of the meniscus) will

prevent post-op arthrtitis "

This has been a statement that has been shown to be untrue going back to the

pond-nuki dog model. With the very first injury to the ACL, even minor, the

osteoarthritis process begins, and no matter whether surgery is done, and if

it is, no matter what procedure is done, they will develop OA and/or it will

progress. As far as humans, I believe this is also true. but I am not an MD

or PT. The surgeon that just recently did a hamstring graft on my daughter's

knee also said that she would in the future develop OA. In dogs, we cannot

take an joint with an injured ACL or an ACL deficient knee and return it to

normal biomechanics and normal function. The unfortunate truth is that no

technique and no brace at this time is able to accomplish this feat. Further

evidence of early OA formation is seen time and time again when dogs present

for early subtle lameness and radiographs of the knee reveal enthesiophyte

formation on the distal patella, mild remodeling of the ventral asp ect of

the fabellae and a very mild effusion. Those are the earliest radiographic

signs of osteoarthritis seen in the ACL affected joint and are the result of

the biomechanical change seen with even a tear as minimal as few % (which

can be seen well with an arthroscope and even arthrotomy). The reason we do

surgery is to flush and debride the joint, assess damage to the mensci and

treat appropriately, grade any cartilage lesions, to stabilize an ACL

deficient joint, and in cases of very minor tears, to unload the remaining

ACL with one of the procedures that eliminates cranial tibial thrust.

Extracap stabilization does accomplish this latter procedure also, but

results in a biomechanically more abnormal knee than the osteotomies. There

has been recent studies in VCOT that showed that TTA results in the closest

to normal condyle to plateau contact through the functional joint ROM when

compared to TPLO. I also believe compared to extracapsular it does also, but

I would ha ve to check that latter thought. Intuitively I would think it

does as compressing the lateral aspect of the joint does not seem like it

would yield anywhere near normal contact during tibial thrust or rotation.

Anyway, just some thoughts. Thanks for your posts of your experiences, as

they are helpful to my thought processes and cases.

Mark Parchman, DVM, DACVS, CCRT, CVA

Bend Veterinary Specialists

Cruciate Brace

> > To: VetRehab <mailto:VetRehab%40yahoogroups.com>

> > Date: Tuesday, April 24, 2012, 2:39 PM

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> > Hi,

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> > Does anyone have any suggestions on what brace to use for an 8

> year old Lab with a complete cruciate tear. The surgeon is very

> suspicious of a meniscal tear and the owners know that surgery is the

> best option for their dog. However, they would like a brace to use

> until they get surgery done and to be used afterwards during

> recovery.>

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> > Thank you,

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> > CCRA

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