Mayfair Animal Hospital      

Orthopedic Surgery

Orthopedic medicine and surgery refers to anything that involves bones, ligaments, tendons and muscles. At Mayfair Animal Hospital, we can handle a variety of orthopedic issues for your pets. Unusual or complex cases may be referred out to board-certified orthopedic surgeons in the area. Dr. Santilli has a special interest in orthopedics and handles the majority of these cases at Mayfair Animal Hospital.

Orthopedic issues we can address here include:

• Cranial Cruciate Disease: The most common knee injury in the dog is rupture of the Cranial Cruciate Ligament (CCL), also frequently referred to as the Anterior Cruciate Ligament (ACL). ACL damage is also known as Anterior Cruciate Rupture (ACR) or Cranial Cruciate Rupture (CCR). This injury can occur at any age and in any breed, but most frequently occurs in middle aged, overweight, medium- to large-breed dogs. This ligament frequently can suffer a partial tear, leading to slight instability and lameness of the knee. If this damage goes untreated, it most commonly leads to a complete rupture,  possibly damaging the medial meniscus of the knee. This, in turn, will lead to osteoarthritis of the knee and discomfort for your pet. Complete rupture of the CCL results in front-to-back instability, commonly called tibial thrust, and internal rotation of the lower leg. Untreated legs usually become very arthritic and painful from the instability. Definitive diagnosis is made via physical exam and radiographs of the affected knee.
  
  

• Luxating Patella: Patellar luxation is when the knee cap “pops out” or dislocates from the femoral groove. Small-breed dogs such as Poodles, Yorkshire Terriers and Chihuahuas are most commonly affected, but it can happen in any size dog and, rarely, in cats. Most pets with luxating patellas are born with the condition, but it can occasionally be caused by trauma. It typically results in intermittent hind leg lameness which progresses slowly over months to years. Diagnosis is made by examination of the knee joint identifying patellar luxation, and radiographs of the affected knee. Sometimes sedation or anesthesia is required to make a definitive diagnosis. Radiographs are utilized to support a suspicion of patellar luxation and to rule out other causes of hind leg lameness. Initial treatment is usually rest and anti-inflammatory medications. Some small breed dogs do very well with rest and anti-inflammatory medication. However, many small breed dogs and most medium and large breed dogs require surgery to resolve lameness and correct the luxating patella. As a general rule, if a pet remains lame, or again becomes lame, after two to four weeks of initial treatment, surgery will eventually be necessary.

• Fractures: A fracture refers to any break in a bone, regardless of the severity or whether it is a complete break or not. Virtually all bones are susceptible to fracture, but in dogs, fractures of the long weight-bearing bones (humerus, radius, femur and tibia) and pelvis are most common. With most fractures there is also damage to the surrounding soft tissues. The majority of fractures in dogs are caused by trauma sustained by motor vehicle accidents. Occasionally they will occur because of an underlying bone disease such as a bone tumor or from repetitive stress applied to a certain bone, as in a fatigue fracture in a racing greyhound. To repair a fracture, the ends of the bone must be opposed and the continuity of the bone restored as close to normal as possible. This can be done closed - that is, without exposing the bones - by using traction and manipulation, trying not to disturb the natural healing processes already underway, and then splinting or casting to keep the bone in place while it heals. More commonly, it is done open - surgically exposing the bones by separating and, if necessary, cutting through muscle – to visualize the fracture and to put it back together with pins, screws, or other surgical implants.
  

• Amputations: Occasionally, a bone is so badly broken that repair is not possible and the limb must be amputated. Diseases such as bone cancer may also require amputations. Severe nerve damage or infection in a limb may also lead to amputation. Animals usually adapt very quickly to the loss of a limb, learning how to balance themselves on their remaining three legs. Often they are able to return to running and jumping as if they still had four legs.

• Femoral Head Ostectomy (FHO): For pets suffering from hip dysplasia or other abnormalities of the hip, and for those owners who cannot afford the cost of a total hip replacement, an FHO may be a good choice. An FHO offers an alternative to relieve the severe pain often associated with a debilitating arthritic or traumatized hip. This procedure eliminates the “bone-to-bone” contact that causes pain. Femoral head ostectomy removes the “ball” of the femur that normally fits in the socket of the pelvic bone. The resulting false joint is supported by the large muscle mass around the hip. Generally, a 70-80% return to normal function and a pain-free active life can be expected.