Medial Patellar Luxation (MPL)


Many small breeds are predisposed genetically to a condition called medial patellar luxation (MPL). This refers to the kneecap sliding out of its normal position over to the inside of the leg. Initially, dogs will display sporadic lameness without pain, but over time the issue may worsen with chronic lameness, arthritis, or pain developing. In about half of affected dogs, both knees will be impacted.


Surgery provides excellent results in correcting MPL. Several steps are taken by your dog's orthopedic surgeon: moving the insertion of the kneecap ligament on the tibia; deepening the femoral groove that the kneecap rests in; tightening the joint capsule which had been stretched by the luxating patella; and possibly placing an implant on the inside of the knee.


Recovery is usually very rapid and the prognosis is excellent in most cases.




Tibial Plateau Leveling Osteotomy (TPLO


TPLO (Tibial Plateau Leveling Osteotomy) is a surgical procedure used to treat cranial (or anterior) cruciate ligament (ACL, CCL) rupture in the knee joints of dogs. The surgery is an extremely effective long-term solution for this injury. It is primarily performed in medium, large and giant breed dogs.


Performed by our board certified orthopedic surgeon, the surgery involves changing the angle of the top of the shin bone (the tibia! plateau)by cutting the bone, rotating it, and stabilizing it in a new 'level' position with plates and screws. This eliminates the need for the ACL ligament and returns stability to the joint immediately.


Most dogs will be weight bearing within a few days after surgery though it is imperative that strict exercise restrictions are implemented for a 6-8 week period.


Ulnar Ostectomy


Some young, growing puppies develop front leg lameness due to one of the two bones in forearm (ulna) growing faster than the other (radius). This leads to uneven positioning in the elbow joint, leading to abnormal wear, pain and lameness as well as limb deformity (bowing).


Once diagnosis is confirmed with x-ray and possibly CT scan, surgical correction (ulnar ostectomy) is needed. Under general anesthesia, a wedge of the longer bone (ulna) is removed, and the two ulnar segments are aligned by pinning together.


A 3-4 month period of strict activity restrictions is needed post op to prevent issues with bone healing properly.


Prognosis is very good for puppies seven months or younger to return to normal. Older dogs have a more guarded prognosis.



Femoral Head Ostectomy


Femoral head ostectomy (FHO), is a surgery performed to restore pain free mobility to a diseased or damaged hip, by removing the head and neck of the femur (thighbone). Without the usual ball/socket hip joint, the body creates a 'false joint'. It is generally recommended for dogs under 50# (some larger dogs may qualify) and cats.


The FHO removes the bone-on-bone contact to restore pain free mobility. The most common indications are: fractures of the hip, dislocations of hip, severe arthritis of hip, and Legg-Perthes disease of hip in small breeds.


After an FHO, activity restrictions for the first few days will be needed, then gradual increases in activity will be prescribed after one week in most cases. Prognosis is usually good to excellent for return to normal or near-normal function.