The preferred treatment option for CCL disease at Gilding Veterinary Orthopaedics is TPLO. Recent studies have shown this technique to be superior to other treatment options for CCL disease. Locking plate technology makes recovery from this surgery rapid and with minimal complications. TTA and lateral suture can also be offered in appropriate cases where budget restrictions might preclude TPLO.
Using an Arthrex Synergy High Definition system to give outstanding intra-articular images which can be saved in digital copy for future reference. Common indications for use are in the diagnosis of thoracic limb lameness (particularly elbow and shoulder conditions) and in diagnosing partial CCL tears or meniscal injuries in the stifle.
Both locking and standard DCP plate technology as well as External Skeletal Fixation (Linear, Circular and Hybrid) to manage even the most complicated long bone and spinal fractures. We employ minimally invasive percutaneous fixation (MIPO) in appropriate cases to ensure rapid return to pain-free function.
Tibial tuberosity transposition, wedge recession sulcoplasty, medial release and lateral imbrication are all employed to treat this common multifactorial orthopaedic complaint. Distal femoral osteotomy is used in selected cases with severe distal femoral varus. Patella groove replacement can be used in some cases of severe patella-femoral joint arthritis or in cases where the trochlear is poorly developed.
Following arthroscopic diagnosis of medial compartment disease, Ulna osteotomies (PAUL) or Canine Unicompartmental Elbow Replacement (CUE) can be employed for the treatment of severe elbow arthritis secondary to advanced medial compartment disease. These techniques can help ameliorate the chronic pain that these dogs suffer from, which is often refractory to medical management.
Total hip replacement is a very effective treatment for the chronically painful arthritic hip joint secondary to hip dysplasia. It can be performed in dogs as young as 10 months old. The Kyon cementless system can be used for dogs >14 kg. Biomedtrix cemented (micro and nano systems) are used for small breed dogs and cats. Due to the increased need for high standards of theatre sterility, this procedure can only be performed at clinics with appropriate facilities. An alternative surgical venue is available for THR cases that cannot be performed in the first opinion setting.
Joint resurfacing techniques (Synacart and OATS) for large cartilage lesions seen in some cases of shoulder OCD and in most cases of stifle and humeral OCD, which tend to respond less favourably to simple cartilage flap removal. These resurfacing techniques provide a durable smooth articulation and may help to reduce the development of painful secondary degenerative joint disease.
For some end stage cases of osteoarthritis or catastrophic soft tissue damage, the only salvage option for pain-free function is arthrodesis. This works particularly well in the carpus and tarsus, moderately well in the shoulder and can be an option in rare cases of the end stage elbow where total elbow replacement has been discounted for various reasons. We can perform all of the above arthrodesis with custom made plates as needed.
The use of Bone Marrow Derived Stem Cells (BMAC) or adipose derived stem cells and platelet rich plasma (PRP) can be used to treat a range of soft tissue injuries in the shoulder and stifle and in some cases of refractory arthritis.
Laminectomy (mini/hemi) and ventral slot for Hansen Type 1 disc removal in the T spine and C spine respectively. Spinal distraction fusion techniques for Hansen Type 2 disc protrusions when indicated. The need for advanced imaging such as CT and MRI combined with prolonged intensive nursing care that is required for success in spinal cases limits this service to hospitals with appropriate imaging and nursing set up.