As it turned out, Cookie has a partially torn cruciate in her left knee. We’ve been through this already with Jasmine. Bad ligaments in both knees. Decisions to be made.
Back then, when Jasmine got her diagnosis, I had no idea what a cruciate ligament was, why it would get injured and what were our options.
I had to learn everything. The option that was put before us was a TPLO surgery. I looked it up. I didn’t like the TPLO. I really didn’t like the TPLO. I researched all the alternatives.
There was conservative management with or without a brace. There was prolotherapy. There were a couple of other surgery choices. And there was stem cell therapy.
We felt the stem cell treatment was the best thing to try. Anything but invasive surgery with a long recovery.
How things worked out for Jasmine
We found a vet who could do that, discussed it and decided that was what we were going to do. Life had different plans, though, and by the time we would have been able to do the treatment, the ligament got fully torn.
In the end, we opted for the traditional suture technique combined with the stem cells for both Jasmine’s knees. The post-op was long but everything worked out great and Jasmine’s knees were as good as new once again. Or as close to it as one could hope.
Being in love with Rottweilers, we knew we might face the same problem again sooner or later.
The question was, would we approach it the same way again?
Surgical options
JD is a nut and we could not see how we would be able to make it through the traditional repair post-op with him. We made up our minds that if he busted his knee(s), TPLO would indeed be the best treatment option for him. There is a different technique I personally like better, TTO, but nobody around here does that. The third option is TTA but I have mixed feelings about that one, even though they seem to have made some improvements to it.
One important criteria when choosing the type of surgery has to do with a surgeon.
The surgeon’s skill, their track record, and how comfortable they are with any given technique is at least as important as the surgical technique itself. Which, around here, really brings the options back to a single one, the TPLO.
TPLO remains the gold standard
When we adopted Cookie, our thinking was about the same – TPLO would be the best choice for her.
She too is a very active girl full of energy and enthusiasm. Going through a lengthy, vulnerable to mishaps rehab did not sounds like a good idea. So we pretty much had our minds made up what we’d do should a knee injury happen.
And then it happened.
I still don’t like TPLO
And I still really don’t like the TPLO. And the tear is only partial (at least at the moment). I found myself going through the same dilemma as the first time around. Do I really want to put Cookie through such an invasive surgery? Complications are rare but they can be pretty bad. Is there something else we could try?
Of course, should the ligament tear completely, surgery IS the best option.
Not a full tear
But this is only a partial tear. Cookie’s muscle mass is good and the knee isn’t giving her too much of a hard time … Should we just jump to chopping up bones?
Yet again, we decided to give regenerative therapy a chance.
Restoration of the ligament, of course, would be the ideal fix. Replacement of the ligament would be the second-best ideal fix. Unfortunately, replacing a ligament that needs to withstand tremendous forces isn’t so easy. There are places that do these kinds of surgeries, with reasonable success as it seems, but not around here.
Ligaments don’t like to heal because of the lack of blood supply. Without blood bringing it what is needed for healing, healing cannot take place. Could there be a way of making up for this disadvantage? Maybe … ?
Our decision
We have decided to try platelet-rich plasma (PRP) treatment for Cookie.
There was some chance that it wouldn’t work and actually get the ligament to heal. Didn’t we owe it to Cookie to give this a try before resorting to an invasive surgery? We certainly thought so.
If it didn’t work, surgery can always be done. Will it be the TPLO? Honestly, I still don’t know the answer to that. And there we thought we had it all figured out.
The postscript
The procedure went flawlessly. You can read about the procedure here.
And it worked! You can read about that here.
Related articles:
Evaluating PRP Treatment for Dogs: Platelet-Rich Plasma Treatment (PRP) for Partial Cranial Cruciate Ligament (CCL) Tears—Would I Do It Again?
Further reading:
Platelet-Rich Plasma: New Treatment Option for Dogs with Lameness