The correct approach during the postoperative period is one of the keys to success in treating your pet. The stages of recovery after surgery can be divided into several periods:
The first requires constant monitoring of the animal, including the administration of medications, care of sutures, restriction of movement, etc. This period lasts in most cases 10-14 days and ends with the removal of the sutures. Then comes the second period, when control over the animal can be relaxed, but as a rule minor restrictions still remain. For example: after orthopedic operations, control over excessive movement of the animal, physiotherapeutic measures and exercises are maintained. This period lasts on average from two weeks to several months. For animals that have undergone planned low-traumatic operations (for example, castration of a male cat), this period is usually absent. And finally, the third period begins, which is characterized by the almost complete recovery of the animal after surgery. Those. an animal can lead a full life, but in some cases there are some restrictions. For example: after even a planned cesarean section, a scar remains on the uterus, which further increases the risks of a repeat cesarean section in case of repeated births. Or the likelihood of developing osteoarthritis elbow joint after surgery to remove the fragmented coronoid process, it also increases. Therefore, the owners of such patients must pay attention to even the most minor symptoms and contact their doctor in a timely manner in order to take timely measures and prevent the disease from developing to its full potential.
2. Tell us that it is not always possible to take your pet home right away; sometimes you need to leave it at the clinic. In what cases and for how long?
A long time ago, when veterinary clinics were not equipped with medical equipment that helps monitor the patient’s condition, and anesthesia was administered to the animals right in the corridor; after the operation, the animals were released asleep. The owners were told that it was necessary to monitor breathing and ensure that the tongue did not fall into the trachea. In such a situation, the owner created an imaginary feeling of involvement in what was happening and control over the situation, and the doctor sighed with relief and believed that if something happened to the animal, then in any case it was due to the owner’s oversight. In such a situation, everyone was happy with everything, both the owner and the doctor. In modern clinics the situation has changed radically. In order to minimize anesthetic risks, the animal must be left in the clinic for several hours and sometimes days. In order for the anesthesiologist to have the opportunity to qualitatively examine the patient before surgery, in some cases, carry out a series of additional research, develop a protocol for anesthesiological support that is most suitable for this particular patient. At this time, surgery and instrumentation are also prepared. Self surgery is the shortest period of time the patient is in the clinic.
Sanitation of the dog's oral cavity. The procedure takes 15-45 minutes. During anesthesia, the animal's condition is monitored using a cardiac monitor.
After surgery, the animal must be stabilized. If we are talking about simple surgical interventions, ear cropping, castration, opening of an abscess, sanitation oral cavity etc., then this period is quite short from 15 minutes to 1-2 hours.
The dog at the time of completion of rehabilitation. The animal is given oxygen therapy.
Once the animal is fully awake, it can be sent home. But if the animal has undergone surgery, for example chest cavity or brain, then such animals should remain in hospital until their condition stabilizes. This period can sometimes take from several days to several weeks. This is due to the fact that the severity of the condition of such patients can change very quickly and only timely adoption of adequate measures will lead to the patient’s recovery. Intensive therapists, not owners, should be with such animals.
3. How to prepare the house for the arrival of an animal after surgery? Should there be a toilet next to his place? Do I need to buy a “collar” or a special bandage?
If the animal has undergone surgery, the owner certainly needs to prepare the house for the post-operative period of his pet. Features of preparation depend on the specifics of the operation. For example: if an operation was performed on the oral cavity (jaw fracture, bite correction, neoplasms in the oral cavity), then it is necessary to remove all toys and objects that the dog can chew. It is also necessary to isolate other animals. If the animal has stitches, then it is advisable to have spare post-operative blankets and collars at home, since animals can tear or break them. If orthopedic surgery has been performed, then it is necessary to prepare the floor so that the animal does not slip while moving. Your doctor should tell you about all these features.
4. How does your pet usually behave after surgery? What behavior can be considered normal, and when is it better to immediately contact a veterinarian?
Normally, the animal’s behavior after surgery should not differ much from the preoperative period. Of course, for the first day or two, dogs and cats may be calmer and react less to external stimuli. But they must maintain their appetite, they must walk, recognize their owners, and go to the toilet. After metal osteosynthesis for limb fractures, animals should immediately rest on the operated paws. There should be no bleeding from the suture, only minor bloody issues on the first day. In any case, the animal’s behavior is determined not only by its general health, but also by its individual reaction to the damaging factor and stress associated with the injury. Some easily excitable animals may whine and scream even at very slight pain reactions or very balanced patients with a lower pain threshold can step on and use the limb that needs to be protected after surgery. In any case, if the owner seems that the dog or cat is behaving inappropriately, or any symptoms appear that are alarming, it is better to show it again, or call your doctor.
5. Is it possible to walk the dog immediately after the operation or should it spend several days at home?
In most cases, you can walk your dog immediately after surgery. In some cases, movement is even indicated during the postoperative period of orthopedic operations or recovery from paresis or paralysis. You just need to take into account unfavorable weather conditions. If it snows or rains, you need to consider additional protection for the seams.
6. How and with what to treat the wound yourself? Can I cope on my own or is it better to go to a clinic? In what cases should you go to the clinic?
In most cases, owners process the seams themselves; this procedure is quite simple and does not require special skills. There are a lot of preparations for treating sutures, some of them have a prolonged effect (act for several days), some have the effect of a liquid dressing (form a film that prevents the penetration of infection), some have a pronounced antibacterial effect. Therefore, postoperative prescriptions must indicate which drug and with what frequency it is necessary to treat the sutures. If discharge appears from the stitches, the stitches turn red, or signs of swelling appear, this is a reason to immediately go to the clinic and not self-medicate.
7. How to feed your pet after surgery? Are there any dietary considerations if your pet is taking medications/injections?
As a rule, the patient can be fed within a few hours after surgery. The exception is operations on the gastrointestinal tract. Then the fasting diet can last for up to several days. Sometimes animals may refuse food, which may be associated with post-traumatic pain or the patient’s severe general condition. A special feature for cats is that in such cases they must be force-fed, since with a starvation diet, even a healthy animal can develop fatty hepatosis. Starving a dog even for a few days is not a problem. There are also a number of medications that must be used before, after or during meals. Features of taking such drugs should be indicated in postoperative prescriptions.
8. Is it necessary to give your pet more attention and affection, or is it better to leave him alone during this time?
How much and what kind of attention can and should be given to each pet in different circumstances is best known only by the owner who lives with his pet side by side. There are animals that are looking for affection and support at a time when I am experiencing physical and mental discomfort, there are animals that are better not to touch, to leave alone until they come up and demand your attention. These are all nuances that owners know better than their attending physician.
9. After what time can I start playing with my pet? Why should this absolutely not be done immediately after surgery?
After surgery, it is better to postpone playing with your pet for a while. Because during games, animals can get so excited that they practically stop paying attention to pain. In this case, a jump may occur blood pressure, which will lead to bleeding, or premature excessive support after orthopedic operations can lead to damage to metal structures and displacement of bone fragments. There are a number of surgical interventions in which movement must be minimized as much as possible. For example, skin grafting with free flap transfer requires complete immobilization of the operated area. Such patients should be placed in small isolated boxes, so there is simply no talk of any games.
10. Are any additional measures needed during this period if the pet is old?
Old age, as you know, is not a diagnosis. Therefore, there are no special measures in the postoperative period for older patients. The period of tissue regeneration and suture fusion may slightly lengthen, which is associated with a decrease in the regenerative abilities of the body.
11. Are there any other features of caring for an animal during the postoperative period?
In order for the postoperative period to pass as quickly and painlessly as possible, you must strictly follow the instructions of your attending physician. Under no circumstances should you self-medicate or use miracle ointments created by your neighbor’s grandmother or miracle drugs that you read about on the Internet. Find a doctor you completely trust and strictly follow all of his recommendations.
Lavrova Ksenia Andreevna doctor plastic surgeon
Nesterova Svetlana Valerievna anesthesiologist
Unfortunately, our four-legged friends sometimes they get sick and are forced to undergo operations of varying complexity. To completely cure your beloved pet, it is not enough to entrust it to a competent veterinarian. After qualified medical intervention, the owner must independently care for the sick animal properly. We'll tell you what it means a suture in a dog after surgery, how to properly care for it during the rehabilitation period.
Photo: Rehabilitation of a dog after surgery
Remember the most important things: always follow your veterinarian's advice. Strictly follow the recommendations of the doctor who performed your pet's surgery. Caring for your dog may vary from case to case, so it is possible that your to a pet For example, a special diet will be prescribed.
Do not doubt the doctor's words. And if you are still not sure about the recommendations, consult not with friends or Internet users, but with another veterinarian who is able to assess the animal’s condition, its tests, and prescribed medications.
There are also general rules caring for a sick pet.
Photo: Wounded dog Usually rehabilitation period after surgery it lasts about 10-14 days. Only after the most complex surgical intervention, special care for the animal can last up to two months. This primarily applies to older dogs, in which the recovery of the body occurs much more slowly, and complications may arise.
Some inexperienced owners recall famous saying“it will heal like on a dog” and they think that in a couple of days after a complex procedure their pet will be able to overcome high barriers and run in the morning with ease, just like before. But you shouldn't count on it. Even if your pet appears completely healthy, do not rush to return him to his usual lifestyle, as this can lead to complications. If the doctor prescribed two weeks " bed rest“- this means that these recommendations must be strictly adhered to, even if you are so “inconvenient” and it seems that your favorite is “still a big guy.”
Walks
It is better not to walk the dog for the first 24 hours after a complex operation, so as not to disturb it again. Moreover, at this time she is unlikely to want to go to the toilet, since the animal does not eat before and after the operation. Take your pet outside only if he asks, and do it very carefully.
To recover after surgery, the dog needs rest and a minimum of physical activity, but this does not mean that the pet should only be outside for 5 minutes. Give him longer walks, but don't force him to run and jump. Walk slowly, in familiar areas, and at the same time avoid the company of dogs, so that the animals, when starting a game, do not harm the sick pet.
Photo: long walks Carefully observe the dog's behavior on the street: if he shows with all his appearance that it is difficult for him to walk for a long time, do not force him to do it.
Take your pet outside for a short time, but more often. Please note: if during rehabilitation you give your pet medications with a diuretic effect, he needs to be walked at least 4-5 times a day. And, of course, you can’t scold him if, without getting outside in a timely manner, he defecates at home.
Do not force the dog to endure for a long time, as bladder pain will negatively affect the general condition of the animal and slow down the body’s recovery process.
If you have small children, be sure to warn them that the dog should not be disturbed for play. Firstly, the animal needs to be provided with peace, and secondly, a sick pet that experiences discomfort can become aggressive. To protect both the dog and children from injury and stress, it is better to ask little fidgets not to disturb the animal for at least two weeks after the operation.
If your dog has a catheter on his paw, keep it and the protective bandage clean, regularly treat the area with an antiseptic, and wrap it with plastic wrap before each walk to prevent dirt or water from getting into the catheter. Try to clean your home more often.
Photo: Dog food Follow the feeding recommendations your veterinarian gives you. Even if the new dog diet is too troublesome for you, be patient at least during the rehabilitation period. Your care will allow the dog to recover faster.
The diet may vary depending on the type of surgery. But there are also general rules. The dog should not be fed or watered for several hours after surgery. This is especially important if the surgery was abdominal cavity or the animal suffered a difficult one.
Then you need to give food in very small portions and often (3-4 times a day). In addition, food should be fresh, light and preferably liquid.
If you give it to your pet, soak it in warm water so that he does not have to chew, and also to facilitate the digestion process.
If this does not contradict the veterinarian's recommendations, you can use special canned food, but it is better if they are dietary. Foods that are unfamiliar to the dog should not be given. Many animals already have no appetite after surgery, so they are unlikely to want to try new food.
Photo: broth If you usually feed your pet natural food, give him broth for the first post-operative meal, and then feed him porridge with minced meat, cottage cheese, and kefir. Unless, of course, the veterinarian gave other recommendations.
In addition, the dog should always have access to clean drinking water. However, in the first days after surgery, it is better to slightly limit the amount of fluid consumed. And do not forget to regularly change the water to fresh water. If the animal cannot stand up on its own, carefully feed it from a syringe without a needle, because a dehydrated body will not be able to regain its strength.
Return the dog to its usual diet gradually: within a week to healing food mix in a little regular. And with each feeding, increase the portion of your usual food.
Attention! If your dog has any digestive problems, consult your doctor. Under no circumstances should you give your animal any medications without your veterinarian’s knowledge, as they may not be compatible with the medications you are using to restore your pet’s health. Don’t be lazy to consult your veterinarian once again, even if you think that you might be imagining the alarming symptoms. It is better to be safe than not to notice the deterioration.
Photo: Chlorhexidine for treating sutures in a dog after surgery To prevent the dog from licking the seams, you need to put a special blanket or Elizabethan collar on it. Postoperative sutures you need to treat it with an antiseptic 1-2 times a day. It is better if it is without alcohol, so as not to provoke additional discomfort in the animal. For example, chlorhexidine is ideal for this purpose.
After treatment with an antiseptic, it is necessary to carefully lubricate the seams with antimicrobial and healing ointment. The drug levomekol has proven itself very well. You can find these simple and inexpensive medicines in any human pharmacy.
If the animal is prescribed any medications, they must be given strictly according to the instructions. If the schedule is not followed, treatment may not be effective and you will have to repeat it. Any deviations from the recommendations must be agreed with your doctor. Don’t hesitate to ask again and clarify: you are not a doctor, you are worried about your animal and may not figure it out the first time. The veterinarian must explain his instructions so that you can follow them.
Photo: Place to relax Provide the animal with the most comfortable conditions for recovery. Make sure that the place where the dog rests is dry, comfortable, warm, but not hot, and always without drafts.
If the house is cool, cover your pet with a blanket to prevent him from getting too cold. To prevent your pet from falling, do not arrange a bed for him on a hill.
Please note: When recovering from anesthesia, the animal will move awkwardly and its limbs will be flaccid, so make sure that it does not climb onto the sofa or chair. In this case, falling even from such a low object can be dangerous.
If your dog experiences involuntary urination or any heavy discharge after surgery, lay down a waterproof oilcloth and well-absorbent diapers. Don't worry, this is normal after anesthesia. And, of course, do not scold your pet for this.
In the first 3-4 weeks, constantly monitor the animal’s health. Daily examine his lips and gums. If their color has changed (become bluish or white), take your pet to the vet as soon as possible.
Also keep an eye out so that there is no blood in the animal's excrement. Heavy bleeding from surgical wound, inflamed appearance of the suture or bad smell from a wound is also a sign that the dog is not recovering.
Video
Watch the video: Postoperative care behind stitches on pets
Watch the video: Caring for dogs and cats after sterilization (also used for castration, laparoscopy)
Anterior rupture cruciate ligament is a common problem in various breeds of dogs leading to pelvic limb lameness due to pain and instability in the knee joint. Further, this pathology will lead to the development of a chronic inflammatory process and osteoarthritis, as a result of which the dog will lose the ability to fully use its paw.
Anterior cruciate ligament rupture often occurs in large and medium-sized dog breeds: Rottweiler, Caucasian Shepherd, Canecorso, Labrador, Boxer and others. In our veterinary practice, it is also not uncommon to encounter ruptures of the anterior cruciate ligament in small breeds of dogs, such as the Yorkshire terrier, miniature poodle, pug and chihuahua. In extremely rare cases, this pathology occurs in cats and, as a rule, has a traumatic origin.
The age of dogs can vary. This is due to the cause of this pathology, but most often dogs from 5 to 7 years old suffer from ACL rupture.
Rupture of the anterior cruciate ligament in dogs accounts for 60-70% of the total number of pathologies knee joint.
To better understand the cause of an ACL tear, the mechanism of the tear itself, and its consequences, you need to have a good understanding of the anatomy of the knee joint.
The knee joint includes the distal epiphysis femur, patella, proximal epiphyses of the tibia and fibula and, accordingly, consists of the femoral joint, joint kneecap and proximal interankle joint.
The knee joint in a dog is a complex uniaxial joint, since movement in this joint is possible in the lateral sagittal plane.
The femoral joint is formed femur and the kneecap. The lateral and medial holders of the patella originate in the ligamentous tuberosities of the femoral condyles and end on the kneecaps. The straight ligament of the patella starts from the apex of the patella and ends at the crest of the tibia.
The femoral joint is complex joint. In addition to the femur and tibia, it includes the lateral and medial menisci, which are involved in smoothing the incongruent articular surfaces. The menisci are semi-lunar in shape and each of them is connected to tibia- cranial and caudal tibiomeniscal ligaments. Lateral meniscus It also has a femoral meniscal ligament.
The lateral and medial sesamoid bones (vesalian bones) are located on the caudal side of the joint and are connected to the femoral condyles.
The proximal intertibia joint connects the head of the fibula to the lateral condyle of the tibia via the cranial and caudal ligaments of the fibular head.
The cruciate ligaments are located in the center of the joint and consist of intersecting bundles of collagen fibers.
The anterior cruciate ligament originates from the posterior portion of the lateral condyle of the femur and runs anteriorly in a ventromedial direction to the tibia and inserts in front of the intercondylar eminence of the tibia. The posterior cruciate ligament begins in the caudal ligamentous fossa of the intercondylar eminence and ends in the intercondylar fossa of the femur. The anterior cruciate ligament itself consists of longitudinally oriented collagen fibers, the purpose of which is to prevent displacement of the tibia in the cranial direction during flexion and extension of the knee joint, rotation of the tibia, and prevention of hyperextension of the knee joint.
Accordingly, when it ruptures, the dog experiences instability in the knee joint and with each step the lower leg moves in the cranial direction and normal movement of the limb becomes impossible. Instability in the knee joint very often leads to damage medial meniscus, which further aggravates the course of the disease and prognosis.
Etiology of ACL rupture in dogs
There are several causes of anterior cruciate ligament rupture, but the most common is degenerative changes the bundle itself. Due to various predisposing factors, the cruciate ligament becomes thinner, its nutrition is disrupted, the ligament becomes inelastic and any unsuccessful movement of the dog leads to its rupture.
With degenerative changes in the anterior cruciate ligament, its rupture, as a rule, occurs gradually, and clinical signs increase over time. That is, first the dog’s cruciate ligament is torn, and the dog begins to limp, then with a slight jump or playing with other dogs, it completely ruptures with clear clinical manifestations. As stated above, rupture of the anterior cruciate ligament due to degenerative changes in the ligament itself is the most common cause of rupture in dogs aged 5 to 7 years.
In dogs, more at a young age degenerative changes in the anterior cruciate ligament and its rupture can occur as a result of congenital deformities of the knee joint itself or other pathologies of the pelvic limb, for example, hip dysplasia or luxation of the patella in small breeds of dogs. As a result of improper load on the ligament, it undergoes changes and ruptures.
Rupture of the anterior cruciate ligament due to injury to the knee joint practically does not occur in veterinary practice, and if it does occur, it is usually due to severe sprain of the knee joint, for example, during a car injury.
Another cause of anterior cruciate ligament rupture is immune-mediated or infectious inflammatory arthropathy.
Predisposing factors for anterior cruciate ligament rupture may also include excessive slope of the tibial plateau or excessive caudal slope of the superior articular surface of the tibia and stenosis of the intercondylar recess of the femur.
Excessive tilting of the tibial plateau places excessive stress on the cruciate ligament and can cause it to become damaged and rupture.
The theory of insufficient intercondylar recess has its origins in humane medicine. In humans, anterior cruciate ligament rupture can occur as a result of a collision medial surface lateral femoral condyle with cranial cruciate ligament. In dogs, this theory has reason to exist, since when studying knee joints, scientists in 1994 noted that all studied joints with torn anterior cruciate ligaments had less pronounced intercondylar grooves compared to healthy joints.
Clinical signs of ACL rupture in dogs
The most common clinical sign of anterior cruciate ligament rupture is pain when moving the knee joint. With a partial rupture, the pain syndrome may not be very pronounced and the dog will limp slightly on the affected leg. With a complete rupture, the pain syndrome is more pronounced, the dog experiences severe lameness of the supporting type, or the dog generally loses the ability to use the affected paw and keeps it in a bent state.
When the anterior cruciate ligament ruptures, swelling of the knee joint and increased local temperature may occur. This may be due to infection in the knee joint or secondary inflammation due to instability after rupture.
The presence of instability in the knee joint, this clinical sign is usually assessed by a veterinarian using tests that are performed on the knee joint. In a complete rupture that has occurred recently, the instability is usually much more pronounced and can be easily assessed by a veterinarian. Also, instability in the knee joint is well diagnosed in small breeds of dogs and can even be noticed by the dog owners themselves. Concerning large breeds dogs, then instability after approximately 3-4 weeks may be less pronounced due to the presence of chronic inflammation and peri-articular fibrosis, which complicates the diagnosis. With a partial rupture of the anterior cruciate ligament, instability in the knee joint will not be observed, but pain and lameness will be clinically observed. Swelling of the knee joint is rare.
A clicking sound may also be heard when the knee joint flexes. This clinical sign is observed when the medial meniscus is damaged, when the torn part of the meniscus can bend between the articular surfaces of the medial femoral condyle and the tibial plateau and create a characteristic sound when the knee joint is flexed. This is not uncommon in large dogs. Damage to the medial meniscus can worsen over time, when the meniscus is rubbed against the articular surfaces and becomes even more unusable. If the medial meniscus is damaged, then over time arthritic changes will be observed in such a joint, since the meniscus performs very important shock-absorbing functions in the knee joint.
Usually, with a complete rupture of the anterior cruciate ligament, at first the clinical signs will be very pronounced, but over time they begin to subside, and the dog may begin to move on the affected limb and, accordingly, this is not very good for the meniscus. Prescribing painkillers accordingly is also not permissible in order to avoid movement in an unstable joint.
As for remote clinical signs- This is atrophy of the hip muscles, arthrosis of the knee joint, not uncommon for dogs with a rupture of the anterior cruciate ligament.
Atrophy of the thigh muscles develops if the dog does not give proper load to the sore paw, while he can walk on both paws, but try to transfer his body weight to the healthy one. hind limb. Atrophy can be easily seen by comparing a healthy paw and a diseased one; a paw with a ligament rupture will appear thinner, the muscles will feel flabby and lack normal tone.
It is more difficult to determine atrophy when the anterior cruciate ligaments are torn in both legs, simply due to the impossibility of comparison, but an experienced specialist should be able to cope with this.
With arthrosis of the knee joint with rupture of the anterior cruciate ligament, when palpating and flexing the knee joint, crepitus may be felt in the joint itself, the knee joint will be increased in size, especially on the medial side, and contracture may be observed.
Diagnosis of anterior cruciate ligament rupture in dogs
A torn anterior cruciate can be diagnosed using special tests performed by a veterinarian at an appointment and special diagnostic studies.
When examining a sore joint, two special tests must be performed to diagnose anterior cruciate ligament rupture:
Sometimes it makes sense to carry out both tests under anesthesia, especially if you suspect that the rupture occurred a long time ago and there is already arthrosis in the knee joint. When diagnosing old ACL tears, tests may not be very informative and displacements during tests may be insignificant due to the presence of peri-articular fibrosis, so minimal displacement can only be noticed in a relaxed joint, so such patients are given a sedative.
If the anterior cruciate ligament is torn, these tests will be negative.
X-ray examination for anterior cruciate ligament rupture is not specific and is sufficient informative research, since the diagnosis is mostly made on the basis clinical examination joint X-ray diagnostics can be useful for detecting consequences after rupture of the anterior cruciate ligament, in particular the presence of deforming osteoarthritis. During X-ray diagnostics, the following changes will be noticeable: osteophytes will be present in the area of the patella, on the medial side of the knee joint and in the area of the sesamoid bones. The articular surfaces of the knee joint may also have defects; there may be loose fragments of cartilage and bone structures in the joint cavity.
Computed tomography of the knee joint for rupture of the anterior cruciate ligament, as well as radiographic examination insufficiently informative for this pathology. With CT we can evaluate well bone structures joint, their changes or the presence of osteophytes. Soft tissue structures such as the lateral and medial menisci and the cruciate ligament are difficult to assess.
Special attention should be paid to this diagnostic study, like knee arthroscopy.
Arthroscopic examination of the knee joint is extremely important in cases of partial rupture of the anterior cruciate ligament. This method makes a diagnosis in the absence of a positive response to the drawer test or calf compression test. Also, arthroscopic minimally invasive surgery of the knee joint is actively used in our clinic. Using it, we can assess the condition of the menisci, carry out manipulations for partial or total removal of the meniscus, remove fragments of the anterior cruciate ligament - minimally invasive!; that is, with the least surgical trauma, and then apply a technique to stabilize the knee joint.
MRI of the knee joint is a diagnostic area that is this moment is beginning to be considered as a highly informative study of the knee joint in veterinary medicine. An MRI of the knee can show damage to the meniscus, partial or complete tear of the anterior cruciate ligament, and other joint structures. Unfortunately, due to high cost equipment, not every clinic can afford to conduct such a study.
Treatment of cruciate ligament rupture in dogs
The choice of treatment for anterior cruciate ligament rupture depends on various factors, such as the dog’s body weight, the angle of the tibial plateau, the duration of the disease, etc., but in any case, everything should be aimed at eliminating pain and improving the dog’s quality of life.
There are two methods of treating a torn ACL:
Therapeutic treatment
Therapeutic treatment for anterior cruciate ligament rupture means:
Limiting the dog's mobility is walking with the animal on a leash or keeping the dog in a small enclosure where active movements are not possible. Accordingly, you need to avoid active games with the dog, various jumps, etc. Restriction of mobility should be carried out for one month, in some cases for a longer period.
Non-steroidal anti-inflammatory drugs. Drugs in this group are prescribed to eliminate pain and inflammation in the knee joint.
These NSAIDs are very widely represented on the veterinary market, but in our practice we most often use only a small range of drugs from this group.
For small breeds of dogs we use the following medications:
- Loxicom (0.5 mg meloxicam in 1 ml) suspension.
For dogs weighing up to 5 kg. The drug is prescribed on the first day of administration, 0.4 ml per 1 kg of body weight, then 0.2 ml per 1 kg of body weight of the animal, strictly after feeding. Course up to 10 days. The drug can be used for animals from 6 weeks of age. - Previcox 57mg (firocoxib) tablets.
For dogs weighing over 3 kg. The drug is prescribed in a dosage of 5 mg per 1 kg of body weight, strictly after feeding the dog. The drug can be used from 10 weeks of age and if the dog weighs more than 3 kg.
For dogs of larger breeds, we most often use drugs such as:
- Previcox 227 mg (firocoxib) tablets.
The drug is prescribed in a dosage of 5 mg per 1 kg of body weight, strictly after feeding the dog. Also, the dosage calculation table is given above. - Rimadyl 20,50,100 mg (carprofen) tablets.
The drug is prescribed in a dosage of 4 mg per 1 kg of body weight, strictly after meals. The drug is not prescribed to dogs under 12 weeks of age.
It should be remembered that all non-steroidal anti-inflammatory drugs can cause irritation of the mucous membrane of the stomach and intestines, leading to the development of erosions and ulcers, but with correct use this happens extremely rarely. NSAIDs are also used with caution in dogs with liver or kidney disease, as they may have hepatotoxicity and nephrotoxicity. Therefore, before using the drug, it is recommended to carry out biochemical analysis blood to avoid subsequent problems.
Separately, as an independent therapeutic treatment The use of knee pads for dogs is not used. In complex therapy, for example, with insufficient limitation of mobility, this method can be useful as additional support for the knee joint when the dog moves. Most often, due to the anatomical structure of the dog’s limb, the knee pad slips off the paw or the dog itself tries to remove it, which makes this method ineffective.
In itself, the therapeutic approach to rupture of the anterior cruciate ligament is not the gold standard in the treatment of this pathology and often leads to the development of deforming osteoarthritis of the knee joint, which over time makes movement in the affected paw impossible. Therefore, in our clinic this type treatment is offered to patients who have contraindications to general anesthesia or when surgical treatment is not possible at the request of the owners.
Surgical treatment of cruciate ligament rupture in dogs
Surgical treatment for anterior cruciate ligament rupture is the most reliable method that gives the best result. Let's consider several methods of surgical treatment for rupture of the anterior cruciate ligament:
Intracapsular methods.
The goal of the intracapsular technique is to restore stability to the knee joint by replacing the ligament with a graft. In the supra-apical method of surgery, the graft consists of a straight patellar ligament, a patella wedge, a patellar tendon and fascia lata. It is placed along the course of the original cruciate ligament in the knee joint, in its normal anatomical position. Over time, the graft should take root in the knee joint, its blood circulation should be restored and over time it will resemble a healthy cruciate ligament.
All intracapsular stabilization methods have their positive sides: complete replacement of the anterior cruciate ligament. In biomechanical terms, this method has its noticeable advantages.
On the other hand, there are also negative points: after replacing a ligament, a significant load is immediately placed on it and it may not take root and rupture. Also, if a dog has a deformity of the knee joint, as a result of which degenerative changes in the cruciate ligament have occurred and it has torn, then there is no point in replacing the ligament. There are also operational technical difficulties in replacing it.
Extracapsular methods (FTS or lateral suture, muscle transposition).
Extracapsular techniques rely on stabilizing the knee joint with sutures or using soft tissue to support the knee joint.
Fabello-tibial suture or lateral suture.
Stabilizes the knee joint by forming fibrous tissue around the implant (suture). The lateral suture is placed on the lateral side of the knee joint through a double hole in the area of the tibial tuberosity. The other end of the thread is passed through the lateral fabella with a needle. Next, both ends of the thread are passed through the clip, the thread is pulled tight and the clip is clamped.
This method is good for dogs no more than 12-15 kg. The ability to support the affected limb after surgery occurs on days 7-14, and by the 12th week the lameness disappears.
Transposition of muscles.
Stabilization of the knee joint is achieved by transferring the distal end of the biceps femoris muscle and the distal end of the sartorius muscle to the crest of the tibia. As a result, the knee joint remains stable when moving, and no cranial displacement of the tibia is observed.
This method is suitable for dogs of any weight and is quite inexpensive. The ability to support the affected limb is restored after 4-6 weeks. Complete lameness can take up to 4-5 months.
U this method There are disadvantages in the long term, such as secondary damage to the medial meniscus and the development of osteoarthritis.
Also, this method requires limiting the dog’s mobility for up to 4 weeks, which is not always possible, otherwise, separation of the displaced muscles may occur.
Around joint methods (Osteotomies: TPLO, TTA, TTO). These methods are based on changing the anatomical structures of the joint for restoration.
TPLO leveling osteotomy of the tibial plateau (tibialplateaulevelingosteotomy) - surgical method, based on reducing the angle of the tibia, where the forces of movement during extension provide dynamic stabilization of the joint.
This method of treatment for rupture of the anterior cruciate ligament is one of the most reliable surgical techniques. Suitable for dogs of all weight categories with a tibial plateau angle greater than 15 degrees. The goal of TPLO is to dynamically stabilize the knee joint. The cranial displacement of the tibia in case of rupture of the anterior cruciate ligament is caused by the angle of inclination of the tibial plateau by the compression traction that occurs when the body weight is transferred to the injured limb, directed parallel to the longitudinal axis of the tibia. If the plateau angle is 5-6.5°, then there will be no displacement of the tibia in the cranial direction and the joint will be stable. Osteotomy is performed using an oscillating saw and a blade of a specially selected radius. Then, after changing the angle, the plateau is fixed relative to the tibia with a special plate for the TPLO (“clover leaf”) technique.
After this technique, dogs with a rupture of the anterior cruciate ligament have a fairly early ability to support the affected paw. After 5-7 days, dogs actively use their paws. Postoperative care does not require strict restriction of mobility; the use of antibiotics, non-steroidal anti-inflammatory drugs and suture treatment is recommended. If the menisci are damaged with this technique, arthrosis of the knee joint develops much more slowly. Like any other technique, this method has its complications, such as infection of the implant (2%), avulsion of the tibial tuberosity (4.3%), secondary damage to the meniscus (3%).
TTA advancement of the tibial tuberosity (Tibial tuberosity advancement) - the surgical method is based on the advancement of the tibial tuberosity, where, during extension, additional dynamic traction is created, directing the tibial plateau to its natural position.
The essence of this technique is that if an angle of 90 degrees is achieved between the direct patellar ligament and the tibial plateau, then the cranial displacement of the tibia will not be observed, and accordingly the knee joint will be stable.
The technique is suitable for dogs of different weight categories, as well as with a tibial plateau angle of less than 15 degrees. In the postoperative period, the use of antibiotics, non-steroidal anti-inflammatory drugs and suture treatment is recommended. The advantage of the method is also the early ability to support, the disadvantage is the development of postoperative seromas (33%) and separation of the tibial tuberosity (15%). TTA is not often used in our clinic due to aspects of the high cost of implants, as well as more high degree postoperative complications compared to TPLO.
TTO (Triple Tibial Osteotomy).
The essence of this method also consists in changing the anatomy of the tibial plateau, namely, changing the angle of the plateau and extending the tuberosity using osteotomy. This technique performed on dogs whose plateau angle is less than 15 degrees. There are also a number of disadvantages, such as the traumatic nature of the operation, separation of the tibial tuberosity and severe postoperative limitation of mobility.
Prognosis for ACL rupture in dogs
The prognosis for recovery directly depends on the time of treatment after rupture of the anterior cruciate ligament.
A secondary problem after anterior cruciate ligament rupture is damage to the medial meniscus. If the dog has been walking with a tear for a long time, the meniscus injury may worsen and most often undergo surgery. posterior horn The medial meniscus is removed partially or completely. Removal of the meniscus, chronic inflammation of the knee joint, etc., leads to the development of arthrosis of the knee joint, which in the future will lead to the inability to fully use the paw.
Also, with prolonged pain in the dog’s knee joint, atrophy of the hip muscles occurs, which aggravates the rehabilitation period after surgery.
In conclusion of this article, I would like to note the main recommendation for animal owners - timely seeking help from a veterinary specialist.
Clinical case No. 1
The owners of an Alabai dog named Yuzbash contacted the State Educational Center "Pride" with complaints about lameness of the pelvic limb in their pet.
As a result of an orthopedic examination and x-ray examination, a diagnosis was made of a torn anterior cruciate ligament. This problem was solved using surgical treatment using the TPLO (Tibial plateau leveling osteotomy) technique. This modern technique, which allows you to achieve quick and effective results. This technique involves changing the angle of the tibial plateau, at which the anterior cruciate ligament loses its functional significance.
5 days have passed since the operation, and Yuzbash can already use his paw. Rehabilitation after such an operation does not require a lot of time and expense for the owners.
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Clinical case No. 2
IN veterinary center"Pride" received a poodle dog named Dorphy, who began limping on the left pelvic limb. Over time, the lameness only worsened.
Veterinary orthopedic surgeon E.S. Maslova A series of examinations (clinical examination of the animal and x-ray examination) and tests (drawer syndrome) were carried out, which made it possible to diagnose a rupture of the anterior cruciate ligament. It was decided to surgically treat the problem using the fabellotibial suture (lateral suture). This technique is performed to stabilize the knee joint when the anterior cruciate ligament is torn in small breed dogs. The technique is considered non-traumatic and dogs recover very quickly after surgery. Dorfi, having passed all preoperative examinations, was allowed to undergo surgery. The dog tolerated the anesthesia, the operation itself and the recovery period well.
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Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya
Clinical case No. 3
A dog named Kuzya (11 years old) was admitted to the State Educational Center “Pride” to the veterinarian orthopedic surgeon E.S. Maslova. with the fact that the day before at the dacha he stopped stepping on his right pelvic limb. At the appointment, using special tests and radiographic examination, medial dislocations of the patellas on both sides and a rupture of the anterior cruciate ligament on the right were diagnosed.
The causes of anterior cruciate ligament (ACL) rupture vary. In older dogs, ACL rupture occurs for two reasons: degenerative changes in the ligament and inflammatory processes in the joint. This pathology is extremely rarely traumatic in nature, and is always treated surgically.
Since Kuzi has a small body weight, they decided to fix his knee joint using a lateral or fabellotibial suture. This technique involves applying a suture made from a special polymer thread (there are special kits for lateral sutures), which prevent instability of the knee joint. The method is also relatively inexpensive and produces good results, but only for small breeds of dogs. After a preoperative examination by doctor Maslova E.S. Kuza underwent this operation successfully.
Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist Smirnova O.V.
Clinical case No. 4
A Chihuahua named Lelya (9 years old) was admitted to the Pride State Medical Center to see a veterinarian orthopedic surgeon E.S. Maslova. with lameness on the right pelvic limb. Using special tests and radiographic examination, medial patellar dislocation and right anterior cruciate ligament rupture were diagnosed. This pathology is very common in small breeds of dogs and can only be treated surgically.
Since Lelya is a miniature girl, they decided to fix her knee joint using a lateral (fabellotibial) suture. This technique involves applying a suture made of a special polymer thread, which prevents instability of the knee joint. The method is also relatively inexpensive, non-traumatic and gives good results, but only in small breeds of dogs. After a preoperative examination (blood tests and ultrasound of the heart) by orthopedic surgeon Lele, this operation was successfully performed. And after recovering from anesthesia in the hospital, she went home.
Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya
Clinical case No. 5
Labrador Uta was admitted to an orthopedic veterinarian E.S. Maslova. with the problem of pain in the left pelvic limb. After examination and a series of orthopedic tests, accompanied by x-ray diagnostics, the dog was diagnosed with crepitus in the knee joint and “drawer” syndrome. The doctor diagnosed him with a torn anterior cruciate ligament. This is a fairly common pathology among dogs. To solve the problem, surgical treatment using the TPLO technique is used. The most modern method that allows an animal to quickly begin to use its paw without the presence of a cruciate ligament. Uta was successfully operated on and went home after waking up under the supervision of his anesthesiologist and doctors in the inpatient department.
Veterinary surgeon specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist K.V. Litvinovskaya
Postoperative care- a fairly broad topic, because there are nuances postoperative management there are almost as many patients as various types operations. Let's consider some general and specific aspects of postoperative patient management.
The postoperative period can be divided into “acute” and “chronic”.
The acute postoperative period begins immediately after the patient leaves the operating room.
Although technically the operation of ovariohysterectomy is comparable to that of sterilization, the general condition of the patient is immeasurably more severe due to intoxication. With such interventions, the animal may spend several days in the hospital. (In uncomplicated cases, infusion therapy (drips) on an outpatient basis is possible, but owners should be prepared for a significant investment of time (4-9 hours).
If the condition is clinically satisfactory, a long (7-14 days) course of antibiotic therapy (injections or tablets) is prescribed. Processing and removal of seams, blanket - as indicated above.
Surgeries to remove tumors (eg breast tumors). As a rule, in this case, a unilateral mastectomy is performed (removal of the entire ridge with capture of the lymph nodes). This is a major operation accompanied by significant tissue damage.
Patients often belong to the older age group and have a number of concomitant pathologies. Infusion therapy may be required for 1-3 days, the animal must be anesthetized (injections of opiate analgesics or NSAIDs) for the first 2-5 days, a course of antibiotics for 5-7 days.
The sutures are treated with levomekol ointment and are usually removed on the 14th day.
Quite often, with such interventions, a seroma (liquid) forms under the skin along the suture on days 4-5, which in some cases must be aspirated (“sucked out” with a needle) or even the cavity drained. If you experience symptoms of “ichor” discharge along the suture or a “water ball” “rolling” under the skin, it is better to see a surgeon.
Urethrostomy.
Most frequent indication to surgery - and the resulting blockage of the urethra. The essence of the surgical intervention is to dilate the urethra and form a new shorter one. urethra; In cats, the scrotum and penis are removed. During the operation it is installed and sutured urinary catheter, which should stand for 3-5 days until the stoma forms. The bladder is sanitized (washed) through a urinary catheter 2-3 times a day. Patients after urethrostomy usually require a long course of antibiotics, antispasmodics, hemostatic drugs and strict special diet. If acute renal failure occurs, intensive infusion therapy (drips) is required for several days and observation in a hospital.
The formed stoma must be carefully protected from licking at least until the sutures are removed (the sutures are removed on days 12-14) (put an Elizabethan collar or diaper on the animal). After the operation, a specialized diet is prescribed.
(removal of non-viable teeth, opening of oral abscesses, osteosynthesis of jaw fractures, etc.) in the postoperative period require feeding with soft, mushy food for 7-20 days and thorough treatment of the oral cavity after each meal with an antiseptic (for example, copious rinsing with chamomile decoction or Stomadex tablets). An antibiotic is usually needed.
Operations on the stomach and intestines.
After most surgical interventions performed on the organs of the digestive system (removal of foreign bodies and neoplasms from the stomach, intestines or esophagus, surgical interventions for volvulus/acute dilatation of the stomach), the patient needs a strict fasting diet for 2-4 days - no water, no food should not enter the gastrointestinal tract.
Fluids and nutrients must be given parenterally (intravenously). Since in such cases we are almost always talking about high volumes infusion therapy and the need for strictly timed administration of drugs parenteral nutrition, such animals are indicated for observation in a hospital before feeding.
After discharge, a course of antibiotic therapy, special dietary food and in the first weeks, fractional feeding regimen (5-6 times a day in small portions)
Osteosynthesis and other orthopedic operations.
Osteosynthesis- surgical intervention for fractures of varying complexity. It may involve installing an external fixation apparatus (Ilizarov apparatus in large dogs or a wire fixation apparatus in small animals), introducing a plate, screw, wire, wire cerclage, etc.
In simple cases, the owner will need to treat the sutures daily (chlorhexidine + levomekol) and limit the pet's exercise. The external fixation apparatus requires careful care (treatment of sutures and places where pins are inserted), protection with a gauze bandage until its removal (depending on the complexity of the fracture, up to 30-45 days, sometimes longer). It is mandatory to take a systemic antibiotic, in early period Injections of analgesics may be required.
For a number of orthopedic interventions, the patient is given a special soft Robert-Johnson fixation bandage for up to a month, which must be changed from time to time in the clinic.
Spine operations.
Patients with spinal injuries (fractures) or disc herniations usually require inpatient observation for the first 2-3 days. Rehabilitation period up to full recovery supporting ability can last from several days to several weeks. The owner must monitor regular urination and, if necessary, express urine or catheterize bladder. The animal must be limited in mobility (cage, carrier). The sutures are treated with levomekol ointment; a protective bandage is usually not required. Spinal patients require a course of antibiotics and steroids for 3-5 days.
To speed up rehabilitation, massage, swimming, and physiotherapy are indicated.
With severe physical overload, joint problems often occur. Experts say that the most vulnerable parts of the human body are the knees. Due to their complex anatomical structure, these joints take on most of any physical activity. It is especially fraught for them to carry out physical exercise without special training or in violation of performance technique. As a result, the knee joints become deformed. There is also a high risk of getting more serious complications(the affected leg may stop bending).
Description of the term
Arthroscopy is a special method of surgical intervention in human joints. An instrument called an arthroscope (a type of endoscope) is inserted into the cavity through a microincision. In the case of diagnosis and treatment of the knee joint, two micro-incisions are made at once:
- for surgical probe;
- for arthroscope.
Compared to traditional surgical procedures, the arthroscopy procedure has enormous advantages. There is no need to completely open the joint, exposing it. This means that the healing process and recovery after arthroscopy of the patient’s knee joint will be several times faster and easier. During such an operation, the risk of damage to connective tissues is virtually eliminated.
Stages of diagnosis by arthroscopy:
- Soft tissue incision.
- Insertion of the arthroscope.
- Examination of the knee joint through an arthroscope lens.
- Studying the video recording on the monitor transmitted by the arthroscope.
- Establishment of a specific pathology.
- If the accompanying conditions allow, arthroscopic surgery can begin immediately.
The need for surgery
The initial purpose of arthroscopy is to diagnose the internal condition of the joints of the knee, shoulder, hip, elbow and wrist. The following pathologies are most often found:
- meniscus injuries;
- partial destruction of cartilage;
- arthritis;
- cruciate ligament injury.
Once the doctor has made a specific diagnosis, a decision is made on the date of an operation called surgical arthroscopy. In some cases, immediately after diagnosis, the patient is sent to the surgical table.
Possible consequences
Arthroscopy is one of the safest operations. However, even after it some complications occur. The most common symptom after knee arthroscopy is swelling. In some cases, the leg simply does not bend from huge amount liquids.
The causes of edema vary. Most often this is due to uneven load on the sore leg during physical therapy. If even slight swelling appears in the joint area, you should immediately consult a specialist.
Sometimes the swelling is inflammatory in nature. This is fraught with infectious contamination. Therefore, if you experience unexplained swelling and pain, you should consult your doctor.
Recovery
Rehabilitation after knee arthroscopy is simple and often short-lived. If the operation was successful and no swelling occurred after it, after two to three months, with a mandatory visit to exercise therapy, the joint will return to normal.
If complications associated with various factors arise during the rehabilitation process, you should adhere to certain medical recommendations.
Inpatient procedures
During surgical arthroscopy, the patient is given anesthesia. Depending on the duration and complexity of the operation, it can be either local or general.
In the first case, the patient is sent home within a few hours along with a detailed recommendation from an orthopedic doctor, a referral for exercise therapy and a list of corrective menus for the coming days. During the rehabilitation period, it is not recommended to eat too much salt or drink liquid at night. It is strictly forbidden to drink alcohol, because it toxic effects only increase the risk of swelling.
In the second case, the patient after the operation is transferred to intensive care unit. After the anesthesia wears off, the patient is prepared for discharge with typical recommendations.
When swelling occurs, experts prescribe various diuretics that help remove excess water from the body. To eliminate pain, drugs based on analgesics are recommended.
During the rehabilitation period, patients may be prescribed the following restorative procedures:
- massage;
- electrical stimulation.
Self-rehabilitation
After knee surgery, you need to give your body some rest. Special attention should be given to the sore leg. The development of the knee joint should occur gradually without overload. Minimize hiking, use a stick or cane for a while. Do not overexert yourself during exercise therapy. If swelling occurs, be sure to apply ice wrapped in a soft, thick cloth. The procedure must be repeated 3-4 times a day.
Give your leg a two-hour day rest every day. To do this, take a horizontal position and place your sore leg on a soft pillow. It is important that the leg is above the level of the heart. This ensures proper blood flow and relaxes the limb.
There are also therapeutic exercises for developing the knee joint. To do this, you need to take a horizontal position on a hard surface and raise/lower your leg, while the knee should not bend. Manipulations should be carried out 15–20 times every 2–3 hours. After 2–3 months, you can increase the load and switch to an exercise bike.
If possible, wrap your leg elastic bandage. This minimizes the risk of swelling.
Question answer
Quite often, the patient has a lot of questions that he tries to answer for himself. However, it is worth remembering that health must be protected and you cannot rely on chance. Here we will try to answer some frequently asked questions. But this is not a substitute for a full consultation with a specialist.
Question: When executing home gymnastics are in pain. Is it worth continuing?
Answer: Rehabilitation exercises should not be painful. The most you will feel is a slight discomfort associated with micro-incisions. If you feel pain, you should stop exercising immediately and consult a doctor.
Question: While taking a bath, the wound got wet. What to do?
Answer: In the postoperative period, doctors recommend tying the leg with polyethylene during hygiene procedures. If the wound gets wet, you should consult a doctor and immediately clean the wound and change the dressing. Delay is fraught infectious diseases and inflammation.
Question: Do I need to see a doctor after arthroscopy?
Answer: After such an operation, the doctor makes appointments for the patient within 10–15 days. After this, the patient engages in his rehabilitation independently at home. If he has no complaints, there is no need to visit a doctor.
Question: Do I need to wear post-operative orthoses?
Answer: There is no need to wear orthoses (special fixing structures) without a doctor’s prescription. But if the doctor examined the joint and found that muscular system is too weak, then supporting and fixing orthoses will be prescribed to you without fail.
Arthroscopy was previously used only for the diagnosis and treatment of professional athletes. Now this practice is available to any patient. Knee arthroscopy – simple and effective procedure. However, without making efforts to independently rehabilitate and proper recovery, it will be very difficult to avoid swelling, severe pain and other complications.
How to restore and develop the meniscus after surgery?
The layer of cartilage in the knee joint, located between the surfaces of the femur and tibia, is called the meniscus. It functions as a shock absorber and stabilizer, but under certain types of load, especially during sports, it may rupture. This injury is one of the most common and accounts for about 75% of all closed damage knee joint.
Restoring the meniscus after a tear is possible using stitching with a special thread. If this cannot be done, then it is removed. In some cases, synthetic prostheses are implanted, which take on the functions of the meniscus.
Rehabilitation after surgery consists of physical therapy and physiotherapy; the duration of this recovery period depends on the nature of the injury.
Rehabilitation set of exercises
If resection of the meniscus (its complete or partial removal) was performed arthroscopically*, then the restoration complex can begin 1-7 days after the operation.
* That is, using special video equipment through two punctures on the sides of the knee joint.
If the injury caused damage to the ligaments or removal of the meniscus was performed open method, That physical therapy will have to be postponed, because at first the knee needs rest. The same situation is observed in the case of suturing the edges of the meniscus, which need to heal before putting weight on the knee again. This period can take up to 5-7 weeks after surgery, depending on individual characteristics.
Early recovery
The main goals of early rehabilitation after surgery include:
- normalization of blood circulation in the damaged joint and elimination of inflammation;
- strengthening the thigh muscles to stabilize the knee;
- prevention of contracture (limitation of range of motion).
Physical therapy should be carried out in different body positions:
- sitting, passively extending the operated leg, placing a cushion under the heel;
- standing on a healthy limb;
- lying down, tensing your thigh muscles for 5-10 seconds.
All these exercises can only be performed with the permission of the attending physician in the absence of effusion (inflammatory fluid) and blood in the joint after surgery.
Late recovery
The objectives of late rehabilitation are:
For this, exercises in the gym and in the pool are most effective. Cycling and walking are very beneficial. Do not forget that the first few weeks after meniscus resection, it is not advisable to squat and run.
Examples of exercises
Physiotherapy
Physiotherapy in the postoperative period is aimed at improving blood circulation and metabolism in the knee joint, as well as accelerating regeneration processes. Massage, laser therapy, magnetic therapy and electrical muscle stimulation are effective for these purposes.
Massage should be performed when there is swelling and limited mobility of the knee. For greater effectiveness, it is advisable to teach the patient self-massage, which he will perform several times a day. It is not recommended to massage the joint itself in the early postoperative period. To perform other physical procedures, you will need to visit the clinic.
Surgical repair of meniscus
The meniscus plays an important role in normal operation knee joint, therefore during the operation it is not completely removed, but they try to preserve maximum amount intact tissue. There are two main methods for surgically restoring the meniscus after injury:
- Suture application, which is performed in cases linear discontinuity, if no more than a week has passed since the damage. It makes sense to apply it only in an area of good blood supply. Otherwise, the tissue will never heal and after some time it will rupture again.
- Replacement of the meniscus with the help of special polymer plates is used quite rarely, usually with extensive destruction and removal of most of the cartilage tissue. In addition, there is the possibility of transplanting fresh frozen donor tissue.
In conclusion, it is worth recalling that if you have suffered a knee injury, you need to contact an experienced traumatologist. The doctor will determine the nature of the damage and conduct necessary treatment. Performance simple exercises for rehabilitation and restoration of meniscus function after surgery will very soon allow you to forget about the unpleasant incident and return to your previous active life.
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