ACL: 11 months post Surgery and it retears?

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ACL: 11 months post Surgery and it retears?

Postby DarkMoon » Mon Oct 31, 2011 9:59 am

Ok, Nubs had Traditional Surgery on his torn ACL 11 months ago, it has never been quite right, but he seemed to adapted well to it. Vet said all was fine, that everything looked good, nothing to worry about.

Thursday night, after Nubs was out with the puppy playing, he wasn't putting any weight on the leg he had surgery on. He's over done it a few times where it would bother him, but by the next morning he was just fine. It's now Monday and he's still not putting any real weight on that leg. It's just like when he tore it the first time.

Every site I've read said by 8 weeks, the dog should be able to return to an active life. Nothing about the snapping of the steel strip that replaced the ACL.

So two questions:

1. Has anyone had this happen?
2. If the surgery was done correctly in the first place, would this have happened?

I expected him to tear his other ACL, but no, it's the SAME ONE that he had surgery done on! :po:
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Re: ACL: 11 months post Surgery and it retears?

Postby dogs4jen » Mon Oct 31, 2011 12:00 pm

I have heard about people who had to have it redone. Your timeline is awfully short, I was told no playing/running for twelve weeks, not eight. I think we had just started the short amount of exercise every day at eight weeks, or maybe it was six. Roscoe did manage to sneak outside a couple of times and go after his tennis balls and I was terrified that the fishing line would be loosened and we would have to have it re-done, but he was ok. I'm sorry you are going through this again, I would be :po:
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Re: ACL: 11 months post Surgery and it retears?

Postby dogs4jen » Mon Oct 31, 2011 12:03 pm

And 11 months later, that is pretty strange, you would think he would have plenty of scar tissue and muscle built up to support his knee.
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Re: ACL: 11 months post Surgery and it retears?

Postby mtlu » Mon Oct 31, 2011 12:50 pm

Molly did not have the traditional repairs done on her knees but when I was researching the various CCL repair options, I remember seeing that it is possible for dogs to reinjure their knees again with pretty much all of the repair options. I don't think it's a matter of the steel (or whatever "line" they replace the ligament with) being placed coreectly or incorrectly but like dogs4jen pointed out, the subsequent buildup of scar tissue around the where the ligament used to be is what "heals" the joint – whatever line is put in just acts as a stabilizer while the healing/scar tissue takes place and is not the replacement for the ligament.

I also think that 8 weeks is a little fast to resume "normal" activity on any of the repairs but my experience w/Molly was longer than that due to TPLO cutting into bone. It takes 8 weeks for the bone to heal but even if I subtract that time from her total recovery period, we still did not let her off leash for more like three or four months after the bone healed in order to make sure that her muscles had built back up properly.

I don't think any of the repair options are without complications: with Molly's first surgery, we had a weird round of what the surgeon diagnosed as "patellar tendonitis" within that 8-week bone-healing window; and with her second surgery, we had a mystery sprain about 8 months post-op. Both times, we had x-rays done to check hardware placement in her knees and the second time, we also had spinal x-rays done because she showed a pain response that looked indicative of a spinal issue (she was fine though, no pinching in the spine and no signs of early arthritis showing up around the repaired joints).

I'm hoping that Nubs just has a sprain, which is entirely possible and often looks the same as an injured ligament.
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Re: ACL: 11 months post Surgery and it retears?

Postby Misskiwi67 » Mon Oct 31, 2011 1:42 pm

He may have torn the suture implant (thats the major downside of traditional repair, they can break), he may have damaged his meniscus, or he may have an entirely new problem. I'd have him checked out for sure...
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Re: ACL: 11 months post Surgery and it retears?

Postby DarkMoon » Mon Oct 31, 2011 7:46 pm

Oh he was on rest for 4 months before I let him to any real activity, and I just started over the past month working him again, little runs, flirt pole a little, and his springpole. I just figured 11 months, he should be fine. So annoying.

He has a Vet appt. tomorrow morning. His knee is swollen today but he's back walking on it. Something is messed up in there.
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Re: ACL: 11 months post Surgery and it retears?

Postby suzanne » Mon Oct 31, 2011 9:52 pm

Misskiwi67 wrote:He may have torn the suture implant (thats the major downside of traditional repair, they can break), he may have damaged his meniscus, or he may have an entirely new problem. I'd have him checked out for sure...



This.

The traditional surgery seems to be the most successful on older/inactive dogs.

We've been doing the TTA at our clinic and unless the dog is in shape but not overly active I don't recommend that surgery either. We've had 3 failures now, two hardware failures on two VERY overweight dogs, and one failure on an overly active lab. I think for the TTA to be really successful the conditions of the dogs has to be just so and the owners need to have good follow through.

TPLO is the best way to go in my experience. People who support the TTA claim they have less failures than the TPLO but every dog that I know that has had the TPLO has had a good recovery.
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Re: ACL: 11 months post Surgery and it retears?

Postby Red » Mon Oct 31, 2011 10:47 pm

suzanne wrote:TPLO is the best way to go in my experience. People who support the TTA claim they have less failures than the TPLO but every dog that I know that has had the TPLO has had a good recovery.


Same opinion here.My older girl Ice, who I just lost to heart tumor, did fantastic after it. Smooth recovery, full range of movement after it. I wish I could have afford it for my latest foster (it is $5000 plus here in CA, for a good orthopedic surgeon in Los Angeles) but she had to get the traditional repair with the sutures and I can only hope she will be okey.
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Re: ACL: 11 months post Surgery and it retears?

Postby Kingsgurl » Tue Nov 01, 2011 12:46 am

suzanne wrote:
Misskiwi67 wrote:He may have torn the suture implant (thats the major downside of traditional repair, they can break), he may have damaged his meniscus, or he may have an entirely new problem. I'd have him checked out for sure...



This.

The traditional surgery seems to be the most successful on older/inactive dogs.

We've been doing the TTA at our clinic and unless the dog is in shape but not overly active I don't recommend that surgery either. We've had 3 failures now, two hardware failures on two VERY overweight dogs, and one failure on an overly active lab. I think for the TTA to be really successful the conditions of the dogs has to be just so and the owners need to have good follow through.

TPLO is the best way to go in my experience. People who support the TTA claim they have less failures than the TPLO but every dog that I know that has had the TPLO has had a good recovery.


Martin had both his knees done at the same time with the traditional repair (he already had torn both meniscus as well, so that was cleaned up at the same time) He was very young at the time and has had no problems at all. He is pretty active, but he is a smaller dog than most pit bulls out there now at 50 pounds and the surgeon (who usually does TPLO) was super fantastic in going over (and over, lol) the pros and cons of each surgery and how HE fit them (angles, movement, etc.) She said on Pit Bulls, she USUALLY prefers TPLO, as they tend to have a sideways twist to the knee under normal locomotion.
I feel so bad for you, I know how nerve wracking it is and hope it's just a small set back.
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Re: ACL: 11 months post Surgery and it retears?

Postby DogNerd » Fri Nov 04, 2011 7:42 pm

He may have torn the suture implant (thats the major downside of traditional repair, they can break), he may have damaged his meniscus, or he may have an entirely new problem. I'd have him checked out for sure...


tearing the suture after 11 months should not be an issue as it is scar tissue which stabilizes the knee and not the suture material. The suture material is only intended to stabilize for long enough that scar tissue builds up. This seems to be a common misconception even among vets and part of why a TPLO is unnecessarily recommended for a lot of dogs. My active 60 lb dog had a traditional repair done on one knee several years ago, returned to agility without issue and a couple years later had the other knee done. There were no signs of arthritis in the original knee when he was ex-rayed after blowing the second knee. His recovery was slower on the second knee for some reason but he is now at full activity without issues over a year later. No more agility but that was my choice for other reasons. He jogs with me and runs and plays and is an active almost-nine year old. I am really glad I didn't do a TPLO on him.

All that said, hopefully this is just some sort of minor setback with Nubs or an easily resolved unrelated issue!
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