Post-operative care instructions
Introduction: Your pet has had a major orthopaedic operation to treat a deficiency in the function of the cranial cruciate ligament. The tibia has been reshaped by making three cuts in the bone. The bone has then been put back together again with a plate and screws. The objective of the operation is to take pressure off the cruciate.
- Painkillers 7 days
- Antibiotics for 5 days
- Cartrophen-Vet injections starting at around 5 to 7 days post-operatively and subsequent injections are given weekly for 4 weeks.
Early Post-operative Visits: The first will be 5 to 7 days after surgery for a wound check and first cartrophen. The second appointment will be 10 to 14 days after surgery for a wound check +/- suture removal and 2ndt Cartrophen injection.
Exercise: Enforced rest for the first 6 weeks following TTO surgery. This means your pet should be confined to a small room or run with non-slip flooring for the duration of this period. The only exercise allowed is short-duration (10 minutes maximum), slow walks on a leash for toileting purposes. Walking up and down flights of stairs, jumping up, or any uncontrolled activity must be avoided. Take care to avoid slipping when walking on wet or smooth surfaces. An old towel can be used as a hindquarter sling if it is placed underneath the abdomen. By doing this you can provide support and security in the early post-operative period.
Physiotherapy: After the first 2 to 3 weeks postoperatively, physiotherapy in the form of passive range-of-motion exercises can be performed. Ideally, all joints of the affected limb should receive physiotherapy 2 to 3 times a day but you should concentrate mainly on the stifle joint if time is short. During each session, a minimum of 10 flexions and extensions should be performed on each joint. After flexion and extension of the individual joints, the entire limb should be cycled through its full, pain-free range-of-motion 10 times. It is very important never to force the joints or cause pain, but gently manoeuvre the limb through a range-of-motion that is well tolerated.
Longer-term follow-up and care: At around 6 weeks post-operatively a radiograph of the stifle should be taken to assess the progress of healing. All going well, controlled exercise on a leash may begin at this time. Leash walks should be minimal at first (15 to 20 minutes twice daily), and then gradually increased after 8 weeks post-operatively. Sit /stand exercises should also begin around 6 weeks post-operatively this can be achieved during leash walking when the patient is commanded to "sit" and just before assuming the sitting position, the command to "walk-on" is given. This routine is repeated 10 or more times every walk and has the effect of building the quadriceps muscle mass, which is very important in rehabilitation following cruciate repair. There should be no unsupervised exercise, and running and jumping should be avoided during the 6 to 12 week post-operative period.
Between 8 and 12 weeks, exercise can be increased slowly to 30 to 40minutes twice daily. Deep-water swimming for 10 to 15 minutes several times a week, if possible, is excellent therapy at this stage. By 12 to 16 weeks the patient should have returned to near normal activity. However, there is a large variation in how quickly individuals return to full function following TTO surgery. If there is not near normal activity by 12 to 16 weeks postoperatively, then make an appointment for reassessment.