Total knee replacement (TKR) surgery is a rarely conducted major procedure with possible complications. TKR surgery is primarily performed in medium and large dogs.
Candidates for surgery are dogs with persistently painful knees (stifles) that are not responding satisfactorily to medical management. Signs of knee pain include lameness, stiffness, difficulty rising, difficulty jumping, restlessness and reluctance to exercise and play.
The most common cause of knee joint pain is osteoarthritis associated with rupture of the cranial cruciate ligament (CCL). Dogs with knee osteoarthritis, no matter how severe, are not candidates for TKR surgery if signs of pain and lameness are mild and readily controlled by conservative measures such as physiotherapy and hydrotherapy.
Joint replacements are amongst the most challenging operations performed by veterinary orthopaedic surgeons. The operation is performed through an incision directly over the front of the knee. Careful preparation of the two bones that make up the knee is necessary prior to placement of the relevant prostheses. The two artificial components are then brought together and the stability of the knee checked. X-Rays are obtained at the end of the operation to check the position of the prostheses.
Aftercare following TKR surgery is very important with rehabilitation taking many months. Exercise must be very restricted for the first few weeks until the joint capsule and other soft tissues heal. This is the period when dislocation of the prostheses is most likely.
Exercise is primarily for toileting purposes. It must be on a lead or harness to prevent strenuous activity. At other times confinement to a pen or a small room in the house is necessary with avoidance of jumping and climbing. After a few weeks, exercise may be gradually increased in a controlled manner (still on a lead). Physiotherapy and hydrotherapy are important aspects of postoperative care.
Rehabilitation is a process which aims to maximise patient mobility and wellbeing, returning them to their usual way of life following illness, injury or surgery. We restore pets to normal function (or as close as is possible), efficiently and safely using a wide variety of physiotherapeutic techniques.
Injury and even surgery can disrupt the body’s equilibrium in all sorts of direct and indirect ways. Even a pet’s own protective responses such as the inflammatory process can overwhelm and inhibit healing so one objective of rehabilitation is to reduce this level of inflammation. During rehabilitation, we also aim to boost the circulatory system, improve muscle function, increase range of motion within joints, and stimulate innate pain-relieving mechanisms.
With a committed and planned rehabilitation programme, pets can recover more quickly, realise better outcomes and avoid much pain and discomfort.
The best rehabilitation programmes consider the whole pet, not just the area of injury; we target and improve multiple systems throughout the body without forgetting the invaluable healing effects of boosting mental wellbeing too. From the wound healing properties of laser treatment, and the muscle strengthening of hydrotherapy, to the circulation boosting effects of massage, we will devise a rehabilitation programme to match a pet’s specific requirements.
The content on this page is for advice and information only and does not represent veterinary guidance or direction. Please always consult a veterinary surgeon if you are worries about your dog.