Does my dog really need surgery to fix suspected cruciate ligament injury

[bantaboy]

Over the last 2 years, 7 year old (72 lbs.) golden retriever had periodic limping following certain sessions of hard play.  Originally thought he pulled a muscle launching himself off the deck a few years ago to chase after a ball.  Periodically limping would return with stiffness upon getting up from a long nap...we (us and vet) believed that this was likely hip related.  X-rays approx. 2 years ago showed slight arthritic changes in the hips.  We left it at that, managed symptoms as they arose and began feeding JD and giving Glucosamine (sp?) and Chondrotin (sp?) supplements daily.  He had been doing great...only showing a very slight weight shift when standing, but running and jumping freely...until earlier in the summer he pulled up lame after a jaunt in the sprinkler.  We rested him for about a week, but was concerned his hips had gotten worse so I requested new radiographs.  Vet suspected a knee issue and not hip so radiographs were done of both areas.  The hip did not change since the last radiographs and the knee did show some arthritic change.  Vet suspected a cruciate ligament injury and that surgery would be needed to repair.  I have spent the last few months researching the issue.  We have seen a surgeon who specializes in TTA repair and he confirmed the diagnosis.

I am gearing up for surgery, but I still very concerned about which surgery is really the best optiont and what should I realistically expect as outcome.  My dog does not appear to be in pain.  I have reduced play time outside, but he runs in the house, jumps on beds and begs me to play.  Does this sound like a dog that does need surgery?  Is the TTA really the best or would the traditional or TPLO be better?  If one is better, why?  TTA and TPLO seem so drastic what if they fail?  I have a dog who can play, walk, run...if it fails where does that leave him?  If I don't have surgery what would happen to the leg...can it heal itself or would I be reducing his lifespan in some way?

[Mr_bhambra]

A related discussion, my 5 yr old pitbull/ sibrean huskey has torn his legaments was started.

[Phil Zeltzman, DVM, DACVS]

Bantaboy,

On second thought, some of your questions were never answered:

* Does this sound like a dog that does need surgery?  
No question in my mind!  Dogs can compensate but it doesn't mean that they are not in pain or that they can't hurt themselves some more.

* TTA and TPLO seem so drastic what if they fail?  
ANY procedure can fail, including the traditional technique.  That's why you should find an experienced, ACVS surgeon.

* If I don't have surgery what would happen to the leg...
More and more arthritis, pain, muscle atrophy, exercise intolerance, possibly a tear of the meniscus, and the worse case scenario: a tear in the other knee, which happens about 33% of the time.

* can it heal itself
I have yet to see a single one in a golden.  In short: no way.

* would I be reducing his lifespan in some way?
It's tough to live with a big dog who has both ACLs torn...

It's much easier to deal with 1 ACL tear.

Again, good luck.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com

[Phil Zeltzman, DVM, DACVS]

Hi Bantaboy,

Not to add any confusion, but I also would prefer the TPLO for a Golden... and I'm a surgeon :-)

I think that you should find an ACVS surgeon you trust and who has lots of experience with whatever procedure they use, rather than trying to find a "TTA surgeon" if there's such a thing.  As Dr Dew wrote, TTA is no better than TPLO as far as the literature is concerned.

So you're left with personal opinions.  Strong, personal opinions.

You may even end up with a surgeon who uses the TTA and the TPLO and the traditional technique!

The goals of the consultation include discussing which procedure they recommend and why, THEIR complication rate (not someone else's), what would be best for your own personal dog etc.

So I would suggest keeping an open mind, and choosing a surgeon you trust.

Good luck.

Please keep us posted.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com

[Jennifer Mathis, D.V.M.]

I personally prefer the TPLO, but recommend you choose based on an ACVS surgeon's recommendation in your area.

[bantaboy]

Thank you for your link to ACVS...is there a similar type directory for surgeons performing the TTA procedure or do I just need to start at the top of the ACVS list for my region and contact them to determine which procedure they do?

Thank you again.

[Terry Dew, D.V.M., M.S., DACVS]

Sorry to hear that your dog is having knee problems.

Cruciate ligament injury is very common in dogs and dogs respond well to cruciate ligament augmentation. There are well over 50 procedures described to help dogs with cruicate ligament ruptures. There has been no scientifically documented evidence that long term one procedure is statistically better than another. What does play a significant role in outcome is surgeon experience.

At the present time many veterinary surgeons, myself included, believe the TTA procedure gives a dog the best opportunity for excellent long term function, the quickest return to weight bearing function, the lowest likelihood for complications and limits the progression of degenerative joint disease.

If your dog has a ruptured cruciate it will benefit from surgery. You are wise for educating yourself concerning all your options, I would certainly suggest you have surgery completed by a board certified veterinary surgeon, you should see the initials ACVS after thier name, you may find a surgeon close to you by looking on www.ACVS.org.

I wish you the best.