Walker Street Veterinary Surgery (Fraser Coast Veterinary Services)

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Surgical Case

The story of Shadow Beatson's knee reconstructions (TTO Surgery)

Shadow is a 7 year old red male Husky and he has got quite a story to tell!
In the space of 4 weeks he managed to rupture both his left and right cruciate ligaments.
The first one happened on Christmas Day.
Luckily for Shadow he is a much loved member of the Beatson family and he was booked in for reconstructive knee surgery straight away.

The two main ligaments in a dog's knee are called the cruciate ligaments as they form an 'X' or cross. They allow the knee joint to swing back and forth without rotating or sliding.
When dogs rupture a cruciate ligament it is usually the front (or cranial) one and they immediately lose the function of the leg. It is very painful and arthritis sets in quickly. 

Some vets repair large dog's knees using the De Angelis technique. 
It involved replacing the ruptured ligament with a nylon prosthesis which tries to mimic the original ligament. While this method seems to work well in small breeds it has a much higher failure rate in dogs over the 15-20kg weight range. The false ligament is prone to slipping, tearing out, pinching and generally causing disappointing results. 

In modern times we now have much better options to offer dog owners. One of the best procedures available to reconstruct the knee is called the TTO technique. It stands for Triple Tibial Osteotomy, which in english means it involves three cuts in the bone of the tibia (shin bone). The idea is to remove a triangular wedge of bone from the top of the tibia and collapse the top so that it forces the femur (thigh) bone to slide forward in the joint again. The joint is also opened to look for damage to the menisci or joint 'cushions'. 
The collapsed portions are then held in place by a T-shaped metal plate and bone screws. 
This procedure usually required our patients to be sent to a specialist down in Brisbane or the Sunshine Coast but we are now able to offer it right here in Maryborough.

The advantages of the TTO are multiple but the main one is the success rate of dogs returning to normal or near normal function in a short time period. They also seem to get less arthritis and require less veterinary visits and pain medication in the future. 

A TTO was performed on Shadow's right knee on January 3rd. He was recovering well when he ruptured his left cruciate on the 30th of January! Everyone at the clinic and his owner's couldn't believe that poor Shadow had blown both his knees in the space of 4 weeks!
However his owners were undeterred and we performed the left TTO on February 4. 

Shadow was see again on Valentine's Day (February 14th) and he was walking almost 80% normally. He is a very tough dog but even we could not believe the speed of his recovery. 
Shadow's owners have been amazing with his post operative care and in particular with his weight loss program. We have no doubt that he will make a full recovery! 

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