Orthopaedic
Orthopaedic Surgery
At Noosa District Animal Hospital the surgical suite is state of the art and backed by exceptional diagnostic and radiology facilities. From simple fractures to advanced knee reconstructions we are equipped with modern instruments.
Dr Dion and Dr Stephanie, attained their Memberships in Small Animal Surgery, from the Australian and New Zealand College of Veterinary Scientists Together they have many years of experience and have special interests in orthopedics especially the repair of cruciate ligament ruptures in the knee with advanced procedures.
Dr Liam attained his Memberships in Avian medicine and surgery, and has a special interest in small critters, birds and reptiles
We pride ourselves not only on our exceptional surgical facilities but also the stringent protocols we follow to ensure safety of your pet during surgery. All patients prior to ortho surgery have a complete health check including a blood test to establish their health status. Intravenous antibiotics and pain relief at 3 levels (opiods, non steroidal antiinflamatories and impregnated patches) is used to ensure their post operative comfort and well being.
The operating theater has single access with positive pressure ventilation through viral and bacterial filters to avoid contamination. We only use the finest Stryker* tools for our orthopedic procedures, and imported implants the likes you would find in a human operating room.
The anaesthetic during the procedure is maintained with oxygen and isoflurane. Monitored by experienced Cert 4 veterinary nurses and a battery of measuring instrumentation. Recovery is in the ICU ward and when awake they are hospitalised for their recuperation.
Cranial Cruciate Ligament Repair
What is the cruciate ligament?
There are two cruciate ligaments in the stifle (knee joint), the cranial (or anterior) cruciate ligament and the caudal (or posterior) cruciate ligament. The cranial cruciate ligament is very commonly injured in dogs and this causes instability of the knee and may lead to other problems such as meniscal (cartilage) injury and osteoarthritis. It is rare for the caudal cruciate ligament to be injured.
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What can be done to treat the condition?
The cruciate ligament seems to weaken gradually in dogs, particularly in some larger breeds, and this means that the cruciate ligament may eventually rupture even during normal activity. Some large breed dogs can suffer cruciate ligament rupture from quite an early age (1-3 years) and often in both knees. However, many dog breeds can suffer from cruciate ligament rupture.
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What are the signs of this condition?
Rupture of the cruciate ligament may occur suddenly or gradually and this can be reflected in the appearance of the signs of the condition which include lameness and stiffness of the knee. Full rupture of the cruciate ligament causes instability of the knee and this may lead to joint swelling and wasting.(atrophy) of the muscles of the hind limb, particularly the quadriceps muscle group. Dogs with cruciate ligament rupture often prefer to sit with the affected limb straightened out in front of them rather than tucked up; this is because they do not like to flex the knee.
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How are these conditions diagnosed?
A clinical examination by a veterinary surgeon is the first step in diagnosis. If cruciate ligament rupture is suspected, further tests may be required, including x-rays, or exploratory surgery. Once the cruciate ligament is ruptured, about 40-60% of knees will also develop injury to one of the cartilages of the knee. Osteoarthritis will develop in all knees with cruciate rupture, but may not cause problems for many months or years.
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What can be done to treat the condition?
If causing persistent problems, and especially in larger dogs, the condition is best treated with surgery to stabilise the knee.
In the long run, all joints with cruciate ligament rupture will develop some degree of osteoarthritis. However, for most dogs the response to surgery is good and the osteoarthritis does not seem to cause problems for several years.
The success of surgery depends on early intervention. An unstable joint result’s in the joint being irreparably damaged and response to surgery is marginal. If you suspect a ruptured cruciate have it dealt with as soon as possible to avoid progressive joint destruction.
Triple Tibial Osteotomy (TTO)
Triple Tibial Osteotomy (TTO) is a newer, specialized surgical technique to repair the cranial cruciate ligament, by correcting the tibial plateau angle. Measurements are taken from radiographs which are specific for the anatomy of each patient, and calculations are then made using a biomechanical formula. Based on these calculations, the TTO technique involves 3 straight bone cuts made in the tibia below the stifle joint (Knee) and removal of a bone wedge-the angle of which corresponds to the correction angle obtained from the formula, this defect is then closed and a TTO bone plate applied with bone screws to support the repair.