After suffering from lameness in his right leg, a 10-year-old English Springer Spaniel has returned to living a happy, healthy life with the help of Arthrex Vet Systems innovation, including a tibial plateau leveling osteotomy (TPLO) plate and a TightRope® implant for the InternalBrace™ procedure.
“Dylan is such a character and makes us smile every day,” said Sheena Hawkins, Dylan’s owner. “He is sweet and energetic and loves to play fetch and swim in the ocean. So, a few months ago when he started having trouble walking, we knew something wasn’t right and needed to seek help.”
Dylan experienced a cruciate ligament rupture in his right hind leg while running with his canine friends at a local day care for dogs in late 2020. This injury caused him to walk with a noticeable limp. To alleviate the problem, Dylan’s primary care veterinarian successfully performed a cranial closing wedge ostectomy; however, the issue in his right leg persisted. In February 2021, Dylan was referred to Pat Ridge, BVSc CVR CSAS MRCVS, and owner of Ridge Referrals in South Devon, England.
“The initial surgery went well, and the affected area appeared to be healing properly,” said Dr. Ridge. “After taking some follow-up x-rays and fully assessing Dylan, we were able to determine his subsequent problem was due to an internal pivot shift, which was impacting his ability to walk correctly.”
Dr. Ridge proceeded by scoping Dylan’s knee to ensure there was no further meniscal injury. He then removed the plates and screws from Dylan’s previous procedure, recut the tibia and rotated the plateau to 2°. Using a standard 3.5 mm stainless steel Arthrex TPLO plate, he stabilized it to span the previously placed drill holes. After positioning a second locking compression plate caudally to protect the tibial diaphysis from any risk of fissure fracture, Dr. Ridge provided “belt and braces” stabilization of the osteotomy. Finally, he performed an InternalBrace procedure and used a single TightRope implant, which includes a standard FiberTape® construct and buttons for fixation, to prevent the pivot shift.
After the successful procedure, Dylan was prescribed six weeks of at-home rest. Dr. Ridge noted several features about the Arthrex TPLO plate that are particularly beneficial.
“Putting K-wires through the holes in the plate to affix it onto the bone’s surface was absolutely critical because we needed to ensure the exact location in order to span the previous screw holes. The fact that the design of the plate is slightly different, it has a sloped back-head profile, allowed me to feel confident we were going to get good screw purchase in the head of the plate,” he said. “Also, having the laser lines that allow you to predict where you are going to put the plate in relation to the osteotomy was very useful in planning for the procedure. I knew where the landmarks on the bone would be, I knew exactly where the cuts would go, I knew the plate would fit exactly as I hoped, and it did.”
Dr. Ridge has used TightRope since 2009 for various cases. As the implant for the InternalBrace procedure, he said TightRope provides “immediate stabilization of the stifle in all planes. Being able to combine both an isometric stabilization to address internal tibial subluxation and a TPLO to dynamically stabilize in a craniocaudal plane provides excellent results in selected cases, as demonstrated with Dylan.”
Now seven months post-op, Dylan walks normally and comfortably, without lameness or the pivot shift. X-rays show positive signs of bone healing and stable implants.
“When animals like Dylan come back a few weeks after an operation and are walking normally and getting back to their typical lives, that’s the best thing in the world as far as I am concerned. That’s the primary reason why I set up my practice in the first place,” said Dr. Ridge. “I’m grateful for the innovation of Arthrex to support successful outcomes for my patients.”
Sheena said Dylan is back to most of his regular activities and living life to the fullest.
“The Arthrex procedure has enabled Dylan to return to his energetic, fast-paced, wonderful self again,” she said. “Dylan is part of my family life, and we look forward to many more happy years together.”
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