The procedure is based on the fact that the top part of the tibia bones normally sloped, resulting in tendency for the femur to slide backward when the dog stands and puts weight on its knee. The Cranial Cruciate Ligament (CCL) normally holds the femur in place and prevents this motion. But when the CCL has ruptured, the femur can slide back and forth along the sloped tibia, when the dog is standing or walking. The continued motion contributes to pain and degeneration in the knee joint.

A solution to the knee joint instability would be to either replace the torn CCL, or remove the slope in the tibia. The TPLO does the latter: after making a cut in the top part of the tibia, the surgeon rotates this segment of bone until it is almost perpendicular to the ground. To allow the cut bone segments to heal, the tibia is then stabilized with a bone plate and screws. The result is that when your dog stand on its leg, the femur is resting on a flat tibia surface, and there is no longer the sliding motion in the knee.

For a video overview of the TPLO procedure, please see below video:

This technique was developed to provide a minimally invasive and improved method for extracapsular stabilization of the cranial cruciate ligament (CCL). This technique does not require cutting of bone like the TPLO or TTA procedures. Instead, it uses small drill holes in the femur and tibia to pass a synthetic ligament-like biomaterial through a small incision to provide bone-to-bone stabilization during healing. The biomaterial used for the CCL repair is called FiberTape®️. This is a kevlar-like material that is used extensively in human surgery for many orthopaedic applications. This material has properties that make it stronger and less prone to failure than any other suture materials currently being used for CCL reconstructions.

When the structures that make up your pet's knees (stifles) are misaligned or misshapen, a problem called a patellar luxation often occurs. Your pet's kneecaps are an important component of a normally-functioning knee joint. These kneecaps (patella) are meant to ride in a groove on the face of the femur. The patella acts as a pulley, giving leverage to extend the knee as your pet walks. When a pet has a luxating (out of place) patella, this small bone jumps out of its normal grove as the leg is in motion. In over 90% of these cases in dogs, the patella jumps out of its tract to the inside of the pet's knee (medial patellar luxation or MPL). The signs you will see in your dog depend on how severe the problem is and how long the problem has been present.

Repair of patellar luxation involves three important steps

• Exploration of the knee joint to identify any ligament or cartilage damage.
• Realignment of the tibial tuberosity with the femoral groove.
• Formation of a normal femoral groove by deepening and widening it.

A FHO is a surgical procedure that involves removal of the femoral head. The procedure is performed when hip joint disease results in continuing pain and other methods of treatment are not feasible or did not produce the desired results. The procedure exposes the head section of the femur bone (the ball of the ball and socket joint), and then the head is removed using a small saw or a bone hammer and chisel. Rarely both sides are done in one operation, most times one side is done and allowed to heal before the other side is done. Unlike most other hip surgeries, the head of the femur is not replaced, When the femoral head is removed, the pain from pressure on the joint capsule and the cartilage is relieved. The patient forms what is called a pseudarthrosis, which is a fibrous (scar) tissue joint. The neck of the femur is usually removed at the same time as the head.

The goal of the DPO is to alter the dog’s natural hip joint and prevent the progression of arthritis. This procedure involves cutting the pelvis in two places to allow the hip socket to be rotated at a predetermined amount in order to fit a specially designed bone plate, thus improving the stability of the hip joint. Plate and screws are used to keep the rotation in proper position.

Dogs experiencing complete luxation of the hip and grade IV hip dysplasia are not ideal candidates for the DPO procedure. The best candidates are younger dogs (between five and 10 months of age) with sufficiently deep hip sockets to accommodate rotation of the hip bone, and hip joints untouched by arthritis.

Arthrodesis is a surgical fusing of a joint to eliminate movement in that part of a limb. An arthrodesis is generally performed when there are no other options to save a joint and give a patient pain free function. To perform an arthrodesis, the cartilage in the joint is removed and a bone graft is generally placed into the spaces between the bones to promote fusion. The bones in the joint must then be rigidly stabilized using a plate and screw system and sometimes an external fixation device. Following surgery a bandage or cast may be applied to provide further immobilization of the joint. Activity is restricted for 8-12 weeks until there is radiographic evidence that the bones in the joint have fused.

Medial Compartment Disease (MCD) is the final stage of elbow dysplasia where the inside section of the joint collapses and results in the grinding of bone on bone. To correct this, we can offer CUE surgery as a safe and effective option for dogs that can no longer benefit from arthroscopic treatments and other non-surgical alternatives.

With CUE surgery, we focus on the medial compartment. The CUE implant allows us to spare bone and provide a much less invasive alternative for resurfacing the medial compartment while also preserving the patient’s own cartilage in the lateral compartment. Overall, this procedure can reduce or even eliminate the pain and lameness associated with bone-on-bone contact.