We perform many different orthopedic surgeries, but the three most common are Anterior Cruciate Repair, Patellar Luxation Repair and fracture repair of any bone in the body. Most orthopedic problems are identified by the use of our high definition digital radiograph system. Joint conditions are diagnosed with different manipulations or arthroscopy to identify the cause of the joint instability or pain.
Cranial Cruciate Repair: Anterior or Cranial Cruciate ligament rupture is one of the most common orthopedic injuries that veterinarians see dogs. There are many repair techniques available to repair this injury. Dr. Hodges repairs Cranial Cruciate tears with several techniques. Leveling osteotomies are usually the best surgery for this injury. The TPLO (Tibial Plateau Leveling Osteotomy) or CBLO (Cora Based Levelingl Osteotomy) are considered the best surgeries to utilize for the correction of the steep angles of the tibial plateau, that is considered the primary reason the Cranial Cruciate Ligament tears. At Coulter Animal Hospital, we utilize both procedures. The CBLO or CORA technique ( center of rotation of angulation ) has several advantages over the other cruciate repair surgeries if dealing with a very steep tibial plateau angle or medial patellar luxation. We also utilize the Arthrex systems called SwiveLock or FASTak if more stability of the stifle is needed. This system uses a proven technique that has superior strength to other external suture techniques.
TPLO (Tibial Plateau Leveling Osteotomy) TPLO surgery involves making a curved cut in the tibia from the front to the back, much like the bottom half of a smiley face. The top section of the tibia is then rotated backward until the angle between the tibia and femur is deemed “appropriately level,” typically between 2 and 14 degrees. A metal bone plate is then used to affix the two sections of tibia in the desired positions, allowing the tibia to heal in its new configuration.
CBLO (Cora Based Levelingl Osteotomy) CBLO surgery involves making a curved cut in the tibia from the front to the back, much like the top half of a smiley face. The top section of the tibia is then rotated forward until the angle between the tibia and femur is deemed “appropriately level,” typically between 2 and 14 degrees. A metal bone plate and diagonal compression screw are then used to affix the two sections of tibia in the desired positions, allowing the tibia to heal in its new configuration.
Patella Luxation Repair: Patellar luxation is very common in small dogs. This is an inherited trait, in that the conformation of the rear legs cause this condition. Bowed legs in small breeds cause an inward pulling of the patella (knee cap) that results in the patella riding to the inside out of the femoral groove. This condition can cause arthritis if left untreated. The surgery to correct this condition involves several steps and is very successful in correcting the condition. We perform a femoral trochleoplasty, which is a deepening of the femoral groove the patella should ride in. The tibial crest which is the insertion point of the patellar ligament is transposed slightly to the outside to redirect the patella path more to the outside, so it will remain in the femoral groove. Finally, soft tissue reconstruction surrounding the knee cap to loosen the side toward which the patella is riding and tighten the opposite side called imbrication is done.
Fracture Repair: Fracture repair is performed with plating (locking screws), intramedullary pinning or external fixation devices, depending on the fracture. Every fracture must be evaluated for the best system to be used. Occasionally on the very small patient different types of splint devices must be utilized