Some of our orthopedic surgeries include complex fracture repair, cruciate surgery, TPLO, lateral suture, angular limb deformities, complex hip surgery, elbow and shoulder surgery, arthroscopy of all joints, Sliding Humeral Osteotomy (SHO) and Canine Unicompartmental Elbow (CUE).
Arthroscopy utilizes a small, highly magnified camera (arthroscope) placed through a key-hole incision to allow for minimally invasive evaluation and treatment of conditions of the joints. At CARE, we are excited to offer the very latest technology at our surgeons’ fingertips. The Arthrex SynergyHD3 System (Make this a highlight link) is revolutionizing arthroscopy with its ability to estimate cartilage erosion depth, (technology that has not yet been released in human medicine) as well as instantly transmit high definition video and pictures to owners and their family veterinarian. Not only is CARE the only Specialty Hospital in the Maryland-Virginia-DC area to offer this technology, we are the very first private Veterinary Specialty Hospital in the country to own this caliber of equipment. Our combination of surgical and pain management expertise, along with our advanced equipment, means many arthroscopic procedures are performed on an outpatient basis. Please contact CARE to find out how we may help your pet utilizing the most advanced and minimally invasive surgery possible.
Common conditions treated with arthroscopy:
- Fragmented coronoid process
- Elbow incongruency
- Incomplete humeral condyle ossification
- Cranial cruciate ligament disease
- Meniscal tears
- Medial shoulder instability (rotator cuff injuries)
- Biceps tendon disease
- Articular fractures
- Fracture fragment removal
CRANIAL CRUCIATE LIGAMENT (CCL)
What is a Cruciate Ligament?
There are 2 ligaments in the stifle (knee) that are called the cruciate ligaments because they cross each other. One runs from the back of the femur (thigh bone) to the front of the tibia (shin bone). This one is called the cranial cruciate ligament. The other one runs from the front of the femur to the back of the tibia and is called the caudal cruciate ligament. Cruciate ligaments are important for the hinge joint function of the stifle joint. They help to keep the stifle aligned and the cranial cruciate ligament especially prevents internal rotation of the stifle, forward displacement of the tibia, and hyperextension.
DEGENERATIVE JOINT DISEASE (DJD)
What is degenerative joint disease?
DJD is more commonly known as arthritis. This is a progressive, non-infectious condition of the weight-bearing joints. Normal, healthy joint cartilage is smooth, white and translucent. It consists of cartilage cells, protein, water, and collagen that forms a sponge-like middle. In the early stages of arthritis, the cartilage becomes yellow, opaque, and softens to create a rough joint surface. As the disease progresses, the soft areas become worn and expose the hard bone underneath, causing remodeling. This progression leads to osteophytes (bone spurs) in the joint and a decreased blood supply that inhibits cartilage repair. DJD can be caused by aging changes in a joint or by a mechanical instability. Mechanical instabilities are most often the result of joint abnormalities (such as hip or elbow dysplasia), trauma, or wear from a ruptured anterior cruciate ligament, luxating patella, or osteochondritis dissecans (OCD).
FEMORAL HEAD AND NECK OSTECTOMY (FHO/FHNE)
What is a Femoral Head and Neck Ostectomy?
The hip is a ball and socket joint, with the femoral head (the upper part of the leg) being the ball and the acetabulum (a portion of the pelvis) comprising the socket. Femoral head and neck ostectomy is a surgical procedure in which we remove the ball portion and the attachment (neck) portion from the rest of the femur, which in essence removes the hip joint. The body forms a ‘new hip’ in the months following surgery. But unlike the normal contact of bone and cartilage, the new hip is a collection of scar tissue with additional support from the surrounding muscles and joint capsule.
FHO is a surgical treatment for hip disorders such as a fractured hip, hip dysplasia, hip luxation, and Legg-Calve-Perthes Disease in small dogs (less than 50 lbs) and cats. These animals are usually too small for the smallest hip replacement available for animals.
MEDIAL PATELLAR LUXATION (MPL)
What is a Medial Patellar Luxation?
Medial patellar luxation is a condition in which the kneecap (patella) pops out of its groove. It can pop to the inside of the knee or the outside of the knee making the knee quite unstable. This condition is often diagnosed in small breed dogs, frequently effecting both rear legs and can be either traumatic or congenital. Congenital MPL is far more common and is most often the cause of MPL in small dog breeds and in cats. In large breeds, MPL can be due to a congenital problem but can also occur secondary to trauma. MPL occurs most commonly in breeds such as Yorkshire Terriers, Maltese, Papillion, Miniature Poodles, but also can be seen in Labrador Retrievers, Great Pyrenees, and other large breeds.
The condition is usually first detected in 6-12 month old puppies and the condition can worsen over time from a mild and only occasionally popping patella to a chronically luxated patella that cannot be put back into the femoral groove anymore. This is called a Grade 4 medial patellar luxation.
OSTEOCHONDRITIS DISSECANS (OCD)
What is Osteochondritis Dissecans?
Osteochondritis Dissecans is an abnormality in development of bone from cartilage. As a result, within joints such as the shoulder, elbow, knee, and ankle (hock), a flap of cartilage can develop causing lameness. The shoulder and elbow are more commonly affected. The development of OCD is secondary to multiple factors including diet, growth rate, genetics, trauma, hormonal imbalance and joint architecture.
TRIPLE PELVIC OSTEOTOMY (TPO)
What is a hip Dysplasia?
Early hip dysplasia (HD) is seen as an increased laxity (looseness) of the hip joint. The late form of HD is characterized by degenerative joint disease (arthritis). Early signs can be diagnosed before 6 months of age, while the late stage is often apparent as soon as 1 year of age.
TIBIAL PLATEAU LEVELING OSTEOTOMY (TPLO)
What is a Tibial Plateau Leveling Osteotomy?
A TPLO is a method to repair a cranial cruciate ligament (CCL) rupture in a dog. A CCL tear in the dog is similar to an ACL tear in people. It can be an abrupt tear during trauma or some other strenuous activity as often occurs in people. However, it can also be a slow deterioration of the ligament over weeks or months, potentially affecting both knees (also known as stifles). Following a CCL tear, the limp is usually quite severe. While some improvement may occur with time, surgery is the best method of treatment for a dog with a CCL tear.
Over the past 30 years, numerous surgical techniques have been developed. The TPLO method has been a very popular surgical repair for the past several years. The TPLO is usually the best option for large breed dogs but is also a good option for moderate and small breeds, especially if a full return to an active lifestyle is desired. For the TPLO surgery, we change the angle of the tibia (the bone below the stifle), so the ligament is no longer needed, unlike the human procedure where the ligament is repaired.