{"id":542,"date":"2019-05-30T11:40:54","date_gmt":"2019-05-30T11:40:54","guid":{"rendered":"https:\/\/caledonvet.com\/referral\/?page_id=542"},"modified":"2026-03-17T08:54:10","modified_gmt":"2026-03-17T08:54:10","slug":"orthopedic-surgery","status":"publish","type":"page","link":"https:\/\/caledonvet.com\/referral\/orthopedic-surgery\/","title":{"rendered":"Orthopedic Surgery"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--link_color: #333333;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-bottom:20px;--awb-flex-wrap:wrap;\" id=\"sec2\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\">\n\t\t\t\t<p class=\"rs-p-wp-fix\"><\/p>\n\t\t\t\t<sr7-module data-alias=\"caledonvet-sec2\" data-id=\"22\" id=\"SR7_22_1\" class=\"rs-ov-hidden\" data-version=\"6.7.34\">\n\t\t\t\t\t<sr7-adjuster><\/sr7-adjuster>\n\t\t\t\t\t<sr7-content>\n\t\t\t\t\t\t<sr7-slide id=\"SR7_22_1-23\" data-key=\"23\">\n\t\t\t\t\t\t\t<sr7-txt id=\"SR7_22_1-23-51\" class=\"sr7-layer\">Changing Lives<\/sr7-txt>\n\t\t\t\t\t\t\t<sr7-txt id=\"SR7_22_1-23-52\" class=\"sr7-layer\"> In everything we do, we are driven by two values: innovation and\ncompassion. We are working to catch the veterinary field up to the cutting edge of human orthopedics. To\ncreate a truly exciting future of patient care, we utilize advanced imaging, minimally invasive techniques,\nand a surgeon with over 20 years of experience and training in orthopedics. Orthopedic care can\ndramatically change the quality of life in pets, and we are working to build a brighter future.<br>\nCheck out Dr John on Instagram: <a href=\"https:\/\/www.instagram.com\/drjohn.orthovet\"target=\"_blank\">(https:\/\/www.instagram.com\/drjohn.orthovet)<\/a><\/sr7-txt>\n\t\t\t\t\t\t<\/sr7-slide>\n\t\t\t\t\t\t<sr7-slide id=\"SR7_22_1-131\" data-key=\"131\">\n\t\t\t\t\t\t<\/sr7-slide>\n\t\t\t\t\t<\/sr7-content>\n\t\t\t\t\t<image_lists style=\"display:none\">\n\t\t\t\t\t\t<img data-src=\"\/\/caledonvet.com\/referral\/wp-content\/uploads\/2020\/06\/DR1.jpg\" data-libid=\"1314\" title=\"DR1\" width=\"0\" height=\"0\" data-dbsrc=\"Ly9jYWxlZG9udmV0LmNvbS9yZWZlcnJhbC93cC1jb250ZW50L3VwbG9hZHMvMjAyMC8wNi9EUjEuanBn\"\/>\n\t\t\t\t\t<\/image_lists>\n\t\t\t\t<\/sr7-module>\n\t\t\t\t<script>\n\t\t\t\t\tSR7.PMH ??={}; SR7.PMH[\"SR7_22_1\"] = {cn:100,state:false,fn: function() { if (_tpt!==undefined && _tpt.prepareModuleHeight !== undefined) {  _tpt.prepareModuleHeight({id:\"SR7_22_1\",el:[750,750,600,550,906],type:'hero',shdw:'0',gh:[750,750,600,550,700],gw:[1440,1440,1024,778,480],vpt:['-200px&#039;,&#039;-200px&#039;,&#039;-200px&#039;,&#039;-200px&#039;,&#039;-200px'],size:{fullWidth:true, fullHeight:false},mh:'0',onh:0,onw:0,bg:{color:'{\"type\":\"solid\",\"orig\":\"#ffffff\",\"string\":\"rgba(255, 255, 255, 1)\"}'},plType:'2',plColor:'#FFFFFF'});   SR7.PMH[\"SR7_22_1\"].state=true;} else if(SR7.PMH[\"SR7_22_1\"].cn-->0)\tsetTimeout( SR7.PMH[\"SR7_22_1\"].fn,19);}};SR7.PMH[\"SR7_22_1\" ].fn();\n\t\t\t\t<\/script>\n<div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-bottom:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-1\"><p style=\"text-align: center; margin-top: 20px; margin-bottom: 0px;\"><span class=\"head_1\">Orthopedic Services<\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:60px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-2\"><h3 class=\"head_note\">THR: Cementless Total Hip Replacement<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/BilateralTHR-updated-img.jpg\" alt class=\"img-responsive wp-image-1736\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/BilateralTHR-updated-img-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/BilateralTHR-updated-img-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/BilateralTHR-updated-img.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">Dr. John performs Total Hip Replacements (THR) on dogs to relieve their pain, improve hip function and mobility and allow\n<span id=\"target-id69ee4743ab671\" class=\"collapseomatic_content_inline colomat-inline \"> \n them to return to an active, happy life. An implant replaces the arthritic joint, eliminating the\npain caused by bone rubbing against bone. This also restores the full range of motion of the limb.\nDogs with hip dysplasia over 9 months of age and weighing between 4 pounds - 170 pounds are likely candidates for THR.\nBefore committing your pet to surgery, we will perform a mandatory pre-operative exam to rule out other\nproblems. If your dog has undergone a femoral head excision, they will likely not be a good candidate for THR.\nThe overall goal of this surgery is to alleviate your pet\u2019s pain, return them to normal hip function and improve\ntheir quality of life. Other benefits include an increase in muscle mass, improved hip motion and increased\nactivity levels.\n  <\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743ab671\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-3\"><h3 class=\"head_note\">TPLO: Tibial Plateau Leveling Osteotomy<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/tplo-new01.jpg\" alt class=\"img-responsive wp-image-1201\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/tplo-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/tplo-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/tplo-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">The procedure is based on the fact that the top part of the tibia bones normally sloped, resulting in tendency for the femur to \n<span id=\"target-id69ee4743aee94\" class=\"collapseomatic_content_inline colomat-inline \"> \nslide 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.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nA 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. \n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nFor a video overview of the TPLO procedure, please see below video:\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\n<iframe width=\"535\" height=\"300\" src=\"https:\/\/www.youtube.com\/embed\/VsCq353sy14\" title=\"CCL Tears and How a TPLO Surgery Works\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe>\n<div class=\"su-spacer\" style=\"height:20px\"><\/div>\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743aee94\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-4\"><h3 class=\"head_note\">Arthroscopy<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthroscopy-image-updated.jpg\" alt class=\"img-responsive wp-image-1734\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthroscopy-image-updated-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthroscopy-image-updated-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthroscopy-image-updated.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:20px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\">Arthroscopy is a minimally invasive surgical technique where a small camera is inserted into a joint in order to visualize and \n<span id=\"target-id69ee4743b2c1a\" class=\"collapseomatic_content_inline colomat-inline \"> \n diagnose joint problems. Once the joint has been evaluated, small instruments can also be\ninserted into the joint in order to treat and repair certain types of joint damage. The benefits to an arthroscopic\nprocedure when compared to an open procedure include:\n<br><br>\n<div class=\"su-list\" style=\"margin-left:0px\">\n<ul class=\"fnt-lst-styl\">\n \t<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Improved visualization of the joint to allow for better diagnostic accuracy<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Reduced scar tissue formation<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Faster recovery times<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Reduced rates of infection<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Decreased surgical pain due to smaller incisions and less tissue trauma<\/li>\n<\/ul><\/div>\n\nArthroscopic procedures are generally performed on the elbow, shoulder, stifle (knee), and hock (ankle). We\nutilize arthroscopy in the following procedures:\n<br><br>\n<div class=\"su-list\" style=\"margin-left:0px\">\n<ul class=\"fnt-lst-styl\">\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Evaluating meniscal health<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Osteochondritis Dissecans (OCD)<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Fragmented Coronoid Process (FCP)<\/li>\n<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Ununited Anconeal Process (UAP)<\/li>\n<\/ul><\/div>\n\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743b2c1a\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-5\"><h3 class=\"head_note\">Total Elbow Replacement<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-4 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2026\/03\/TMER-after1.jpg\" alt class=\"img-responsive wp-image-1887\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2026\/03\/TMER-after1-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2026\/03\/TMER-after1-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2026\/03\/TMER-after1.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:20px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\">Dr. John Brajkovich performs Total Medial Elbow Replacements (TMER) on dogs to relieve chronic elbow pain,\n<span id=\"target-id69ee4743b8049\" class=\"collapseomatic_content_inline colomat-inline \"> \n \nimprove joint function, and help them return to a more comfortable, active life. An implant replaces the damaged joint surfaces, eliminating the pain caused by bone rubbing against bone and restoring smoother, more natural movement of the limb.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\n\nDogs suffering from severe elbow arthritis or advanced elbow disease that has not responded to medical management may be candidates for TMER. Before committing your pet to surgery, we perform a pre-operative exam and advanced imaging to ensure there are no other underlying concerns and that this procedure is the right fit.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\n\nWe use advanced 3D-printed, patient-specific guided systems to enhance surgical precision and consistency. These innovations help reduce surgical time, lower the risk of complications, and support a smoother recovery.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\n\nThe overall goal of total elbow replacement is to alleviate your pet\u2019s pain, restore comfortable joint function, and significantly improve their quality of life. Many patients experience improved limb use, increased strength, and a noticeable return to activity following recovery.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\n\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743b8049\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-6\"><h3 class=\"head_note\">Extracapsular Cruciate Repair &#8211; Arthrex System<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-5 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/Extracapsular-Cruciate-Repair-new01.jpg\" alt class=\"img-responsive wp-image-1200\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/Extracapsular-Cruciate-Repair-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/Extracapsular-Cruciate-Repair-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/Extracapsular-Cruciate-Repair-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-4 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">This technique was developed to provide a minimally invasive and improved method for extracapsular stabilization of the cranial\n<span id=\"target-id69ee4743ba5d7\" class=\"collapseomatic_content_inline colomat-inline \">\ncruciate 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\u00ae\ufe0f. 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. \n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743ba5d7\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-7\"><h3 class=\"head_note\">TPLO \/ Patellar Luxation<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-6 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/TPLO-Patellar-Luxation-UPDATED-IMG.jpg\" alt class=\"img-responsive wp-image-1742\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/TPLO-Patellar-Luxation-UPDATED-IMG-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/TPLO-Patellar-Luxation-UPDATED-IMG-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/TPLO-Patellar-Luxation-UPDATED-IMG.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-5 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">This procedure combines a TPLO and a Patellar Luxation repair for patients who suffer from both a cranial cruciate  ligament\n<span id=\"target-id69ee4743bbf52\" class=\"collapseomatic_content_inline colomat-inline \">\ntear and a patellar luxation in the same knee.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nThe procedure is based on the fact that the top part of the tibia bones normally slope, resulting in a 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.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nA 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 stands on its leg, the femur is resting on a flat tibia surface, and there is no longer the sliding motion in the knee.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nIn addition to the TPLO procedure to remove the slope in the tibia to give stability back to the knee, spacers are placed to offset the TPLO plate allowing realignment of the patellar ligament. The patellar groove where the patella sits is also deepened to allow the patella to sit deeper in the groove.\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743bbf52\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-8\"><h3 class=\"head_note\">Patellar Luxation<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-7 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Patellar-Luxation-updated-img.jpg\" alt class=\"img-responsive wp-image-1738\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Patellar-Luxation-updated-img-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Patellar-Luxation-updated-img-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Patellar-Luxation-updated-img.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-6 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">When the structures that make up your pet's knees (stifles) are misaligned or misshapen, a problem called a patellar luxation often\n<span id=\"target-id69ee4743c1a89\" class=\"collapseomatic_content_inline colomat-inline \">\n 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.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nRepair of patellar luxation involves three important steps\t\t\t\n<div class=\"su-list\" style=\"margin-left:0px\">\n<ul class=\"fnt-lst-styl\">\n \t<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Exploration of the knee joint to identify any ligament or cartilage damage.<\/li>\n \t<li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Realignment of the tibial tuberosity with the femoral groove.<\/li>\n    <li><i class=\"sui sui-paw\" style=\"color:#ED1C24\"><\/i> Formation of a normal femoral groove by deepening and widening it. <\/li>\n<\/ul><\/div>\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743c1a89\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-9\"><h3 class=\"head_note\">FCP: Fragmented Coronoid Process<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-8 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FCP-new01.jpg\" alt class=\"img-responsive wp-image-1196\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FCP-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FCP-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FCP-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-7 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">The elbow joint is made up of three bones: the humerus (upper arm bone), radius and ulna (forearm bones). In this disease a small \n<span id=\"target-id69ee4743c4ed2\" class=\"collapseomatic_content_inline colomat-inline \"> \nportion of the ulna breaks off into the joint. This portion of the bone is called the medial coronoid process. FCP is the result of unequal growth rates of the radius and ulna, either individually or together. The joint space between the ulna and humerus is narrower than the joint space between the radius and humerus. The resulting uneven pressure on the medial coronoid process can develop cracks or fragments of the coronoid process.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nSurgery or arthroscopy is generally indicated for your pet if he or she is lame or painful, and surgery and arthroscopy can stop or slow the progression of DJD. Surgery and arthroscopy tend to be more successful in younger patients (less than 12 months) and in patients that have not yet developed significant arthritis. Arthroscopy allows the surgeon to visualize the joint, remove the fragmented piece of bone and help smooth out any lesions in the joint. Surgery usually involves exposing the medial coronoid process via one of several methods and removal of the fragment.\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743c4ed2\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-7 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-10\"><h3 class=\"head_note\">FHO: Femoral Head Osteotomy<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-9 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-1.jpg\" alt class=\"img-responsive wp-image-1197\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-1-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-1-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-1.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-8 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">A FHO is a surgical procedure that involves removal of the femoral head. The procedure is performed when hip joint disease\n<span id=\"target-id69ee4743c751a\" class=\"collapseomatic_content_inline colomat-inline \"> \nresults 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.\n  <\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743c751a\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-11\"><h3 class=\"head_note\">UAP: Ununited Anconeal Process<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-10 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01.jpg\" alt class=\"img-responsive wp-image-1194\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/FHO-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-9 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\">The anconeal process is a large piece of bone located at the growth plate at the top of the ulna. Normally, in \n<span id=\"target-id69ee4743c9463\" class=\"collapseomatic_content_inline colomat-inline \"> \ngrowing dogs, this area will close or fuse between 16-24 weeks of age. An ununited anconeal process is the failure of the anconeus to fuse with the ulna. Instability within the joint leads to damage of the articular cartilage, lameness and arthritis of the elbow joint. Surgical treatment is necessary to correct this condition and surgical excision is the most widely accepted method. In this procedure, the loose anconeal process is removed to prevent further irritation to the joint. \n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743c9463\"  tabindex=\"0\" title=\"\"    ><\/span>\n<div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-8 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-12\"><h3 class=\"head_note\">DPO: Double Pelvic Osteotomy<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-11 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/DPO-new01.jpg\" alt class=\"img-responsive wp-image-1187\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/DPO-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/DPO-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/DPO-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-10 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">The goal of the DPO is to alter the dog\u2019s natural hip joint and prevent the progression of arthritis. This procedure \n<span id=\"target-id69ee4743cb1f8\" class=\"collapseomatic_content_inline colomat-inline \"> \ninvolves cutting the pelvis in two places to allow the hip socket to be rotated at a predetermined\namount in order to fit a specially designed bone plate, thus improving the stability of the hip joint. Plate and\nscrews are used to keep the rotation in proper position.\n<br><br>\nDogs experiencing complete luxation of the hip and grade IV hip dysplasia are not ideal candidates for the\nDPO procedure. The best candidates are younger dogs (between five and 10 months of age) with sufficiently\ndeep hip sockets to accommodate rotation of the hip bone, and hip joints untouched by arthritis.\n \n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743cb1f8\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-13\"><h3 class=\"head_note\">PAUL: Proximal Abducting Ulnar Osteotomy<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-12 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/paul-new01.jpg\" alt class=\"img-responsive wp-image-1191\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/paul-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/paul-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/paul-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-11 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">A PAUL surgery is performed on dogs that suffer from elbow dysplasia. This procedure involves making a controlled surgical\n<span id=\"target-id69ee4743cd0b2\" class=\"collapseomatic_content_inline colomat-inline \"> \n cut to the ulna and securing it in a new position with a plate and screw system. The surgery\nis categorized as a load-altering osteotomy as it aims to unload the medial compartment of the elbow to\nreduce pain and improve function and use of the limb.\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743cd0b2\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-9 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-14\"><h3 class=\"head_note\">Arthrodesis (Carpal and Tarsal)<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-13 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthrodesis-updated-img.jpg\" alt class=\"img-responsive wp-image-1740\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthrodesis-updated-img-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthrodesis-updated-img-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2024\/03\/Arthrodesis-updated-img.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-12 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">Arthrodesis is a surgical fusing of a joint to eliminate movement in that part of a limb. An arthrodesis is generally performed  \n<span id=\"target-id69ee4743d0968\" class=\"collapseomatic_content_inline colomat-inline \"> \n when there are no other options to save a joint and give a patient pain free function. To\nperform an arthrodesis, the cartilage in the joint is removed and a bone graft is generally placed into the\nspaces between the bones to promote fusion. The bones in the joint must then be rigidly stabilized using a\nplate and screw system and sometimes an external fixation device. Following surgery a bandage or cast may\nbe applied to provide further immobilization of the joint. Activity is restricted for 8-12 weeks until there is\nradiographic evidence that the bones in the joint have fused.\n  <\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743d0968\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-15\"><h3 class=\"head_note\">Angular Limb Deformities<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-14 hover-type-none\" id=\"Nutrition\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2020\/01\/Angular-Limb-Deformities-new.jpg\" alt class=\"img-responsive wp-image-1292\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2020\/01\/Angular-Limb-Deformities-new-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2020\/01\/Angular-Limb-Deformities-new-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2020\/01\/Angular-Limb-Deformities-new.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-13 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">Angular limb deformities can occur as a result of a genetic defect, in which the growth plates in long bones stop growing \n<span id=\"target-id69ee4743d8bab\" class=\"collapseomatic_content_inline colomat-inline \"> \n prematurely in the animal\u2019s development. This condition can cause severe problems with\nmobility and function once the animal becomes unable to compensate for their deformity. Cats and dogs can\nadapt to having a shortened limb, but their gait will be affected, and the adjacent joints will be put under\ngreater strain. Over time, this can lead to degenerative joint disease. We can correct these deformities by\nsectioning and repositioning pieces of bone to correct the angular change.\n<\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743d8bab\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-10 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:40px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-16\"><h3 class=\"head_note\">Canine Unicompartmental Elbow (CUE)<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-15 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/CUE-new01.jpg\" alt class=\"img-responsive wp-image-1182\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/CUE-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/CUE-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/CUE-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-14 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">Medial Compartment Disease (MCD) is the final stage of elbow dysplasia where the inside section of the joint collapses and \n<span id=\"target-id69ee4743db91d\" class=\"collapseomatic_content_inline colomat-inline \"> \n results in the grinding of bone on bone. To correct this, we can offer CUE surgery as a safe and\neffective option for dogs that can no longer benefit from arthroscopic treatments and other non-surgical\nalternatives.\n<br><br>\nWith CUE surgery, we focus on the medial compartment. The CUE implant allows us to spare bone and\nprovide a much less invasive alternative for resurfacing the medial compartment while also preserving the\npatient\u2019s own cartilage in the lateral compartment. Overall, this procedure can reduce or even eliminate the\npain and lameness associated with bone-on-bone contact.\n  <\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743db91d\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-17 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last text_collapse\" style=\"--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-17\"><h3 class=\"head_note\">Fracture Repairs: Pinning, Plating &amp; Internal or External Fixation<\/h3>\n<\/div><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-16 hover-type-none\"><img decoding=\"async\" width=\"600\" height=\"335\" title=\"fracture-new01\" src=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/fracture-new01.jpg\" alt class=\"img-responsive wp-image-1195\" srcset=\"https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/fracture-new01-200x112.jpg 200w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/fracture-new01-400x223.jpg 400w, https:\/\/caledonvet.com\/referral\/wp-content\/uploads\/2019\/12\/fracture-new01.jpg 600w\" sizes=\"(max-width: 800px) 100vw, 600px\" \/><\/span><\/div><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-15 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-padding-top:20px;--awb-padding-right:20px;--awb-padding-bottom:30px;--awb-padding-left:20px;--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\">To repair a fracture, the ends of the bone must be brought together \n<span id=\"target-id69ee4743decdf\" class=\"collapseomatic_content_inline colomat-inline \"> \nand the continuity of the bone restored as close to normal as possible. This can be done with a closed technique\u2014that is without exposing the bones\u2014using traction and manipulation, trying not to disturb the natural healing processes already underway. Or, it can be done as an open technique, surgically exposing the bones by separating and, if necessary, cutting through muscle to visualize the fracture and to put it back together. The fracture must be immobilized to allow it to heal and this can be done in several ways.\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nExternal fixation describes the use of pins passed from outside the leg, through the skin and into the bones of the limb, ideally with at least three pins above and below the fracture. These pins can then connect to one another either by bars, or rods or cement or rings. External fixators can be applied open or closed, and combined with many other techniques making them extremely versatile.\t\n<div class=\"su-spacer\" style=\"height:10px\"><\/div>\nInternal fixation describes the use of pins and wire, plate and screws. Plates and screws can be used for a variety of different fragments, but offer exceptionally stable fixation and in some cases the ability to squeeze or compress the ends of the bone fragments together. Such repairs can ensure an animal can be up and using a fractured limb as soon as possible. \n  <\/span><span class=\"collapseomatic arrowright\" id=\"id69ee4743decdf\"  tabindex=\"0\" title=\"\"    ><\/span><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-542","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Orthopedic Surgery - Referral Caledonvet<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/caledonvet.com\/referral\/orthopedic-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Orthopedic Surgery - 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