Monthly Archives: January 2016

Surgery Patient of the Month- January- Bilateral Cruciate Ligament Rupture

Congratulations Keifer on being our January Surgery Patient of the month! Keifer , a 10-year-old  mixed breed dog, was presented to the West Hills surgery service for evaluation of a two-day history of reluctance to walk and hind limb pain.Keifer

Two weeks prior, Keifer was diagnosed with an acute right anterior cruciate ligament (ACL) rupture at an Emergency Hospital. A few days later, he suddenly showed lameness of his left hind limb. Dr. Hirshenson, our ACVS board certified su…rgeon, examined

Keifer, and diagnosed him with cruciate ligament tears of both hind limbs. A cruciate ligament tear is diagnosed via palpation of instability in the knee joint. The instability causes intense inflammation and pain, manifesting as lameness.

Cruciate ligament rupture is the most common orthopedic disease in dogs, occurring secondary to chronic degeneration of the ligament over time. The weakened ligament can suddenly fragment, causing acute lameness.

A dog with a ruptured cruciate ligament in one knee is likely to develop a tear on the opposing limb 50% of the time, and 25% of these dogs may develop another tear within the same year.  A smaller proportion, like Keifer, will develop tears in both limbs in a much shorter time frame. While dogs with only one limb affected can ambulate by bearing weight on the opposing back limb, dogs with bilateral cruciate ligament tears can be rendered immobile from pain in the most severe cases.

The treatment of choice for cruciate disease in dogs is surgical repair. Dogs with bilateral tears typically have surgery on one limb, followed by the other 2-3 months later. These dogs experience eventual return to a normal level of physical activity; however this can take upwards of 4-6 months or more when the surgeries were separated. Dr. Hirshenson is one of a small number of surgeons, who has extensive experience repairing both knees during a single surgery and offers this option for appropriate cases.

The pros to simultaneously repairing both sides are that the patient experiences a single anesthesia and hospitalization and a more rapid return to their normal physical activity. The con is the increased physical rehabilitation required in the immediate post-operative period.

Keifer’s owner was willing to take on the extra post-operative care and pursued bilateral surgery. Keifer immediately started physical rehabilitation exercises after surgery, and his owner continued therapy at home.

Just three short weeks after surgery Keifer was walking well on his own, and was cleared to resume his normal activities, including running and playing after 10 weeks.

Through the dedication of his owner and the staff at West Hills, along with Keifer’s toughness and determination, he was able to get back onto all four feet with flying colors. Way to go Keifer!