Tplo surgery vs rehab/conservative management of cruciate rupture - Golden Retrievers : Golden Retriever Dog Forums

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Old 09-24-2012, 03:21 AM
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Tplo surgery vs rehab/conservative management of cruciate rupture

My Eddie is almost 9 and has ruptured (or torn?) his cruciate ligament. He is not a show dog, but a family pet and beloved family member - child. I visited two superb orthopedic surgeons who both recommended TPLO surgery. Also spoke at length to the owner/vet (who is also a certified animal acupuncturist and a certified rehab therapist) of a well regarded animal rehab center. She told me that the leg will not be 100% whether rehab or surgery - and that she has worked with 1000+ dogs with cruciate tears, and has been able to bring them back almost to normal with various rehab modalities.

History: Eddie had major surgery several years ago when he inhaled a foxtail that formed an abscess and lodged between his lungs. The surgeon was brilliant and saved his life -- but he had terrible complications with a MRSA staph infection afterwards, which took a year to resolve -- only after the chest wires from his surgery (median sternotomy) were removed. I would do almost anything to avoid another surgery for him -- the thought of another surgery that places metal in his body keeps me up at night - not to mention the small chance of osteosarcoma at the bone fracture site.

Does anyone have any experience with rehab vs. surgery for an ACL rupture? My thought is that after 12-16 weeks of rehab, the surgery option is always there if I need it...however, I don't want to cause him crippling arthritis in the meantime. I am told that arthritis will set in either way -- whether the choice is surgery or rehab.

Would love to hear other opinions on this.
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Old 09-24-2012, 09:05 AM
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My Golden had TPLO last October and he did great and recovered nicely. In my opinion and from what I heard, read and know, a torn cruciate ligament cannot be repaired with rehab alone. Surgery IS the only option. About arthritis, the longer you wait with surgery, the more the muscles in that leg atrophy and the more likely of getting arthritis in that joint.
I never gave it a second thought that there is a metal plate and screws in my dog's leg. Humans have such procedures done all the time without any problems. Never heard about chances of osteosarcoma being increased with metal plates. To me it is just "hear say".
My advise, if you want your dog to be able to run and play and be pain free, PLEASE listen to the orthopedic surgeons and have the surgery done.
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sheilajgw (09-24-2012)
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Old 09-24-2012, 11:32 AM
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Thanks so much for your quick response on this...I going to take Eddie to my GP vet today and talk with him about it again. This is such a huge decision...
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Old 09-24-2012, 11:39 AM
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If the ligament is torn fully it can't be repaired with rehab/time. If it is just partially torn you might be able to reapir it with rehab.

Robbie tore his ligament, we went the route of replacing the ligament with durable suture line. 3 months later the suture line came loose (more due to the wrong vet doing the surgery than that particular repair method being bad), and he was on three legs again. We had to go TPLO for the the second surgery, after recovery he has been rock solid on that leg, no limp, no weakness. The only thing that I have noticed is the very slightest difference in extension when he trots, but walking and full out running there is no difference in the legs, and he has no complications. TPLO was 6 years ago.

fyi - following the activity restrictions and PT instructions after TPLO surgery is absolutely critical to a full recovery. The leg is healing just like a bone break, so follwing after care instructions is crucial.
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Old 09-24-2012, 11:42 AM
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I have heard of success with both methods. In fact there was just someone on another list I am on who successfully used the more conservative method. I think the outcome can depend upon the age and size of the dogs, as well as the injury itself. Can you talk to owners of dogs who have had the surgery, and owners of those who chose the more conservative route? It might help you make your decision.

And you are right that surgery will always be there-have the surgeons given their opinions on what additional damage if any would be done by waiting?
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Old 09-24-2012, 12:59 PM
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I have just finished reading this article -- and will talk with my GP vet today about options and consequences of each method. The owner of the rehab facility is also a DVM and she has an east-west therapy approach. Alternatives to Canine Surgeries - Whole Dog Journal Article

I desperately want to do the right thing -- Eddie still has many good years ahead of him. Will have to make a decision this week for sure..
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Old 09-24-2012, 01:01 PM
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In fact there was just someone on another list I am on who successfully used the more conservative method.

Tahnee GR - can you give me the contact for the person on another list who used the conservative method? Much appreciate..Sheila
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Old 09-24-2012, 01:09 PM
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Cruciates partial or complete can not be healed with conservative therapy or rehab. It is IMPOSSIBLE to keep the dog/leg completely immobile for the weeks it would take. Dogs need to go to the bathroom with their legs. With every bend the knee makes it continues tearing. I am going through this right now with my husbands labrador. She is not 3. She has a partial tear. The vet said let her be a dog, if she completely ruptures it between now and surgery the repair is the same.

A vet friend rested her dog for 12 weeks, the slowly rehabbed back into work only to have the cruciate tear again and have to do surgery. It won't hold.

Now that being said. TPLO is not the only option for surgery. Just the most expensive. If you dog is a pet, you could probably do a traditional repair for about 1/3 the cost. It is not recommended for large active dogs, but for an older dog who doesn't go mach speeds everywhere, it would most likely be fine. I was only informed about a TPLO when Maxine tore her first knee. By the second (oh and usually if one goes the other does too just be prepared) I knew about options. We thought about the traditional but because she had 1 TPLO we chose to go forward with another. She never limped again through the rest of her life, after rehab. She ran, jumped, played, swam a happy life. She was 100% in my book. A friend had a mixed breed (dane, lab, boxer) who she did the traditional on, she lived to be 15 1/2 years and never limped again.

Do some more research. Quinn's TPLO is scheduled for 10/11. Because she is a HIGH drive dog and does agility and field we are going with this procedure. Our surgeon says she will come back 100% and be able to play again...until her next knee goes and she says it will go.
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sheilajgw (09-24-2012)
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Old 09-24-2012, 01:20 PM
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Maxes Mom --I have also been told by DVMs and the two vet surgeons I've seen that surgery is necessary. I am continuing to do the research and hoping against hope that we can be successful without it - that the rehab side will outbalance the surgery side of the ledger. Have not made final decision, however -- but am very anxious - especially because of Eddie's history with MRSA staph and metal in his body.
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Old 09-25-2012, 12:42 AM
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Just to welcome you on the forum. I am sorry for you Eddie, sending positive vibes and best wishes in making your decision.
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