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Thread: Help! Need advice for torn ACL--surgery or not? Reply to Thread
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Topic Review (Newest First)
02-18-2014 10:28 AM
katdog5911 Glad all is going well. I think the hardest part is keeping them quiet after they feel better!
I have a 115 lb newfie/lab mix that tore his left ccl several years ago when he was around 5 yrs old. We opted not to do the tplo as it was too pricey and seemed so drastic. We had the lf type surgery done even though the vet did say that it was not always successful on large dogs. There was a lot of rehab work after the surgery, swimming being a big part, but it mended and was almost as good as new. Unfortunately as is often the case, his rt ccl tore about a year later. We opted to try conservative management. That too has healed and now at 11 he still doing fine. He doesn't run as far or as long but he is happy. I sometimes try and see which one works better, but really don't know. Perhaps internally there is a difference, but they seem to work about the same.
I am sure there is some arthritis and such as well. He was also on adaquan for quite some time and continues with different supplements now.
02-17-2014 11:28 PM
billsharp Update:

Liesl is doing very well. She is now 5-6 weeks post op. Her incision healed well. She is now putting about 30-40% weight on the leg. When she walks it is almost perfectly normal, just a hint of a limp. She still has some soreness in the leg after napping, but it goes away almost immediately. We are now walking her about 1-2 miles per day, with no ill effects. She's trotting about the yard and seems very confident in her use of the leg.

We did gradually work her up to this--only small walks at first! Also, we have scrupulously adhered to the vet's advice to keep her tied/crated unless she is on a leash, so she can't chase squirrels and inadvertently re-injure herself. The worst part is that she has been dying to RUN. I've been substituting obedience training in the house, tummy rubs, etc. to try and keep her satisfied. She has been a very understanding patient.

Overall we've been very pleased with the Lateral Repair. We know a friend who about the same time had the TPLO and her dog's bone failed to knit--she's very disappointed. I can't promise you will have as good a result as Liesl has had, but I provide this info for your use in making your decision. I really think that using the strong 100 lb test line for this 80 lb dog may be the factor that is making this work so far.
01-22-2014 07:33 PM
halo2013 I always say by what what your Dr recommends. Sometimes you need it but if its not severe or bothering your pet you way not.
I had a pit bill that had a torn acl occasionally he would go limp with it but it never affected him. He suggested stuff for His joints and if it started to really brother him then it was time foe surgery. Acl's are pricey.

LVT. N.Latham
01-22-2014 06:33 PM
Lilie Good to see she is doing well!
01-22-2014 05:47 PM
Gretchen Wow, Bill you really researched surgical options thoroughly. I'm so happy to hear she is walking well for a decent distance. With our TPLO, we were not walking that much. Would love to see some video or photos soon.

Our TPLO is holding up well, its been 10 months - it is the non-surgical side we've had to watch for the last month. Hope Liesl's "good" side stays good for a while.
01-22-2014 05:28 PM
SoCal Rebell My 100 lb. Golden Retriever completely tore her rear ACL, I had one of the best vets to bring her to Animal Specialty Group here in the L.A. area. got the choice of holding the joint together with a nylon strap or a new therapy of grinding the joint down and heal naturally, didn't like that one strap surgery, in a cast for a month, recovered fairly well.
01-22-2014 05:03 PM
billsharp UPDATE: Thank you all for the great advice and perspectives.

We ended up choosing the lateral fabellar repair over TPLO. I was leery of TPLO because I did not want the osteotomy and increased risk of complications, and the significantly greater expense of the surgery.

The primary criticism I had found of the lateral fabellar repair was that it was not recommended for dogs over 50 lbs (Liesl weighs 80 lbs), apparently because it was felt that they weighed too much for the 40 and 60 lb monofilaments being used. However, it was considered the gold standard repair technique before the TPLO was developed. The advent of the tightrope, using an extra strong braided filament, and its success stories, seemed to indicate that a LF repair using a stronger monofilament might have a greater chance of success than it was previously thought to have with larger dogs.

I spoke with several vets and surgeons and found a vet, not ortho, who had experience and success doing LF repairs in larger dogs, using 80 lb test monofilament. He told me that there is a company which makes 100 lb test for this surgery, and he was willing to use this for Liesl (at a much more reasonable price than the orthos wanted for TPLO).

After reading more of the literature comparing outcomes of these two techniques I felt that the LF was overall the best solution for us. It is less invasive than TPLO; the 100 lb test has virtually no chance of breakage in an 80 lb dog, recovery time would be quicker, and the cost was about 45% less than the price of a TPLO at the respected ortho hospitals.

Her pre-op workup was uneventful. An incidental finding from her pre-op x-ray was that her right hip (bad stifle) was great, but her left hip had early dysplasia, predicted to become a problem for her potentially in 3-5 years. She had a complete rupture of the cruciate, but no meniscal damage, and only a little arthritis beginning in her joint. The vet told me after surgery that her sound meniscus was instrumental in helping her have a positive result so far--if it had been damaged there would have been another source of instability potentially complicating the recovery.

Liesl had her LF repair two weeks ago, on 1/7/14. She was placed in a very substantial padded bandage that acted a bit like a cast and provided support for her stifle. She was walking on the leg from the 2nd day after surgery, although gingerly. She required anti-inflam, pain meds, and prophylactic abx, but had no complications. We kept her under strict control and observation--leash or crate only, even when lying on her pillow, and short walks only to potty.

The bandage was removed one week later and she limped a bit more due to the loss of that support, but still walked willingly on the leg, and improved quickly. We did not have to do any warm or cold compresses, and she walked around the house enough that we did not have to do any ROM for her, although I did some anyway to be sure she wasn't getting tight. We started walking just a few feet or so down the street, but have increased now to walking about a quarter of a mile twice a day, on level paved streets.

Today we got the steel staples removed, uneventfully. Our biggest problem over the last few days has been keeping her from overusing the leg. She wants to run, jump, chase squirrels, etc. She still limps slightly on it and is not putting full weight on it obviously, but she has improved steadily since the surgery, and her atrophied leg muscles seem to be coming back. When she walks it is with a full stride, normal extension and bending of the stifle, and enough weight put on that leg that her limp is barely noticeable. She uses the leg to squat and relieve herself without problems.

I am aware that we are not out of the woods yet, but I am very, very pleased with our result so far. I will post some vids of her walking on YouTube soon and link them here. I plan to periodically post vids of her recovery, good or bad, and discuss it frankly here, so others who face this in the future will have this input regarding lateral fabellar repair with a stronger monofilament to consider when deciding what surgery to choose.
12-13-2013 08:01 PM
Katy1985 Hi, Greta had TPLO surgery when she was 7. We did let it rest 1.5 mos before surgery and also had her on a diet to loose a little weight so the recovery would be better. This was the vets suggestion. We have an orthopaedic vet close by and also a regular vet that had done 1000s of the TPLO surgeries. I got references and called them. She had the surgery in December and was back hiking that summer. The only thing that did happen was, When she had the pre-surgery xrays of her back and pelvis, we learned of advanced arthritis in the contralateral hip. SO.... because they have to be so quiet for 8 wks following the surgery, she lost much of the muscle mass holding the bad hip together. She built up the muscle again, but was never as strong as before. The leg with the repair was great. She could still do 10 mile hikes and was a happy dog. Didn't regret it for a second.
12-11-2013 05:12 PM
middleofnowhere There's also a TTA or something like that which is what the surgeon that I trusted recommended. Go with a board certified surgeon and someone that has a strong record of repair on large breed dogs. I blew it with Barker the Younger's first surgery - a waste of time and money. (main resentment on my part was that dogs lives are short & I hated that I wasted months of hers with the old style surgery.) After that I opted for the more expensive one, healing still took a long time (leash walks forever it seemed) but the result was much better. Don't mess around with your general vet or someone new to the procedure. Go with the board certified guy.
That's more than 2 cents worth but I'll give it free....
12-11-2013 05:06 PM
billsharp Thanks everyone. This has been very helpful. I think we're going with the TPLO to try and get the best result, and hope that we have no more tears. Regardless, Liesl's days of chasing balls with abandon are over We'll be exploring treadmills and swimming to keep her fit and adequately exercised.
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