Damaged Ligament - surgery options

[JADA2005]

I have a (just turned) three year old female, that has just been x-rayed and been diagnosed with a damaged ligament (rear right leg).
My vet does the surgery (roughly 7 a year), but informed me that there is an orthapedic specialist (2hrs travel) that could also do the surgery.
They both offer different techniques. And my vet charges $700(canadian)
and she would stay for 2days, the orthapedic specialist charges $3000(canadian) plus travel costs and might require that my dog stay several more days then at my vets. (increasing the cost, depending on how long she would have to stay).

Now I have to decide which way to go. I'm just looking for abit of outside input, to help me make a more informed decision.

[tom134]

I'm in the states (Maryland) and my girl had both done about a year apart. It was the cranial cruciate ligament. The vet that did the surgery actually used a piece of skin from the incision as the replacement. No problems since (unless you count the recently diagnosed ostecaroma). I think it was $2,500 per including pre-op stuff, meds, etc. We dropped her off one day, picked her up the next.

[Anne]

I've never heard of a piece of skin being used to replace a ligament. A piece of skin is not strong enough to replace a ligament I wouldn't think.

My girl had TPLO on both knees, also a year apart. The cost of each surgery here was about $4000. She stayed at the vet hospital only one night.

Jada, do a google seach on TPLO and TTA and you will find the information. There are also many threads on this forum about ligament surgery. Scroll to the bottom of this page and a few threads will come up.

[rottie40]

Sounds to me by the difference in price that one vet will be using the dogs own muscle tissue to repair the ligament (I have had this done over the years about 6 times with different dogs) and the other will be using the TPLO method where they cut into the bone making a V.
My dogs have never had a problem with replacing the ligament naturally, There is some concern that cutting into bones can increase the risk of bone cancer at that site but I dont think there has been any veterinary studies into this yet??

[cally01]

I mentioned in another thread about many people having great success with a leg band - WoundWear brace (A-Trac) http://animalrehab.on.ca/index.asp?tag=braces

Here is another link to review Dog ACL CCL Ligament Recovery Without Surgery No TPLO

canine hip dysplasia surgery, fho, tpo, jps, thr, dog surgery

Here is a yahoo group you can join to discuss ACL tears ConservativeManagement : Canine Conservative Management

Our Newf Cassie tore her Cruciate when she was young, then a partial tear in her other leg at 10 years of age. The partial tear we just allowed to heal naturally. She is now soon to be 12 years and has no arthritis in either leg and very flexable :)

Good luck

[spidey]

$700 is suspiciously cheap. I would not have high hopes for a good outcome for that. Conservative management would also not be my choice for a cruciate rupture on a big dog. $2500-3000 sounds about right for an experienced surgeon, good intra-op monitoring and good post-op pain management and rehab. If there is no rehab, find somewhere that does offer rehab.

[tom134]

I should clarify - the skin was dipped in a solution (don't have a clue what) and then used as a ligament. Ours had both done and absolutely no problems since and she's 120 pounds - solid. That's just one data point of course - all dogs are different. Do some digging - they've examined deceased dogs after surgery and have found those ligamnets in excellent shape.

I agree with Spidey - $700 sounds cheap. There was no specific rehab for our dog - We just let her do what she wanted to - they somehow know what they can and can't do.

[JADA2005]

You are correct Rottie40 exactly. Those were my two options.

I made my choice and put my trust in my own vet to do the surgery.
While the specialist may know more, it would have been a much more drawn out repair. With back and fourth visits (2hrs each way) and a longer heal period. From the info I could find online, it also sounded like it involved alot more pain as well, even weeks after the surgery was completed.

I had the surgery done almost a week ago. She came home after 2 days, with far more energy (even with a full leg cast) then she's had in a month or two! The cast & stitches come out in a day. Then we begin some aquatic therapy to help build her strength back up in that leg.

As it goes right now, she's recovering very well. And continues to move better in the cast then she did on that leg, before the surgery. It shouldn't be any problem getting her back to full strength by summer.

[spidey]

Do NOT trust a dog to know what it can and cannot do after a cruciate surgery. It's a waste of money to have the surgery done and then leave the dog to its own devices afterward: the months post op can make or break the success of the surgery.

[lcerizo]

Might be worth reading up on a new alternative called the Tightrope CCL procedure. It's minimally invasive, very cost effective and less complications than TPLO or TTA. No bone cutting, no plates or screws. Just bone tunnels made through small incisions. News article:

Human Injury Treatment Modified To Fix Dogs' Knees - Science - redOrbit