In this section we hope to answer the questions you have about our operations. Our veterinarians are highly skilled, and have performed this procedure successfully on countless occasions. We hope that these answers put you at ease, and allow you to see the benefits of our pioneering treatment.
96% of the dogs we’ve treated have regained the walking and running capabilities they had before the injuries. A further 2% retained slight injuries, with the final 2% being unsuccessful.
There are 2 main options for you to choose from, intracapsular and extracapsular. The intracapsular technique uses a series of grafts to repair ligament, whereas the extracapsular treatment uses sutures. Both are effective in treating your dog, and the only difference is how they’re applied.
It has a long track record, and we have audited the results of our clinical cases in 100 dogs of various breeds, sizes, and ages over 15 years. We chose skin as our preferred graft because published papers from the 60s and 70s showed it was better than nylon or fascia. No other technique replaces the ruptured cruciate ligament in the same way we do. We believe that this is essential to the restoration of normal function in the long term.
Sawing the bone without replacing the ruptured ligament isn’t something that humans would contemplate for their legs, so why think of doing it for your dog? Footballers have their cruciate ligaments repaired using tunnel and graft techniques, and they still play in the same league 10 years later. The Biomet™ website and OrthoAssociates site show how this treatment is approached for humans.
Using our chosen technique, and creating a skin graft with 2 bone tunnels costs between £1500 and £2400, depending on the size of the dog and the complexity of the case. This is an all-inclusive price including the x-rays, anaesthetics, and post-operative medication.
An extracapsular suture is likely to cost around £1000. Bone sawing or osteotomy techniques commonly cost in the region of £4000. There is an 80% chance of the other leg needing the same operation if a bone-sawing technique is used; compared to only 10% if the natural graft technique is chosen. This makes a big difference to the costs involved.
We have been frustrated for more than 30 years by the refusal of other vets to accept or recognise the value of this technique. They insist on much more radical techniques, which we do not believe are necessary. Dog owners are able to change this by insisting on being offered the graft technique as a natural solution to the problem.
Our results show that there is only a 2% chance of the operation failing. Our clients and our practice together have classified failing as an operation which has failed to restore the leg to normal function with the ability to play, walk, and run.
When the operation has failed, it is usually within 3 months of the operation. Perhaps the skin graft has not healed properly, or the graft may have failed. A dog that has been exercised too violently before the end of the strict 3-month period of ‘strict lead exercise only’ is also susceptible. This compares to published results for bone-sawing techniques where the complication rates range from 8% to 25%.
In more than 35 years of practising, we have never had a case where we have had to operate on the cartilage at the same time, and have never had to re-operate because of cartilage problems.
However, it is widely reported that 50% of cartilage problems either are already present, and that up to 28% of the time there is a need to re-operate sometime after cruciate surgery, using other techniques.
Some dogs have an audible click or clunk after rupturing their cruciate ligament, and sometimes this happens after cruciate surgery. In our experience, all clinks and clunks have disappeared after the 2 months, following surgery. It appears not to be a problem following the graft technique. Although we have not proved it, we believe that this is due to a settling down of the cartilages in the knee after surgery. The important point is that the graft enables the other structures to settle down and restabilise without further intervention.
The non-invasive nature of this procedure means that there are no adverse effects if the procedure fails. One instance was an old Yorkshire terrier, who came for cranial cruciate ligament surgery. Unfortunately, the surgery didn’t work out, but the old dog was happy to just potter around with a slight limp.
There is an option to repeat the procedure, which we have done in the past. Each time that we’ve re-applied a skin graft the process has been successful. As with the initial surgery, the procedure was non-invasive, and was much better than bone-sawing techniques that are used by other veterinarians.
We are confident in our ability to diagnose the majority of ruptured cruciate ligaments by observation and feeling the joint. Some dogs are difficult to examine, and sometimes sedation or anaesthesia is needed for them to relax. This requires skill and experience, and it’s not always easy to make this diagnosis accurately, especially when the decision on if we take the dog to surgery is critically important.
X-rays are important because of conditions which occur at the same time as a ruptured cruciate. These include the occasional presence of a bone tumour in Rottweilers, or osteoarthritis in the hips. The x- rays help in gaining a more complete understanding of the problems involved and the likely outcomes in the event of concurrent problems.
Call our veterinary practice today
if you have any further questions about the procedures, or anything else.