This new surgical technique is called the Modified Maquet Procedure or MMP. When an MMP is done to modify the joint mechanics there is less movement of tissues during the surgery, a shorter surgery (and anesthesia) time, and we expect these patients to use the leg very soon after surgery. Although total healing time is 8 weeks, graduated leash walks are allowed beginning the day after surgery.
Cruciate disease is when a dog (and sometimes a cat) ruptures or tears the anterior cruciate ligament (sometimes called the cranial cruciate ligament) which is located in the knee (stifle) joint. The cause is typically a degenerative process and can involve trauma but sometimes they just break and we are not sure of the reason why. We do know that obesity and poor physical conditioning play a role in this disease. Researchers are looking for a possible genetic factor as well.
CCL (Cranial Cruciate Ligament)
CCL stands for Cranial Cruciate Ligament, which is called the ACL (Anterior Cruciate Ligament) in humans.
Both refer to a tough band of tissue that connects the two main bones of the knee joint. The CCL attaches the upper bone (femur) to the lower bone (tibia) and helps prevent excessive motion between these bones. A ruptured CCL is the most common orthopedic injury in dogs and results in a painful and unstable joint. If left untreated, a ruptured CCL will lead to progressive and irreversible degenerative joint disease (arthritis).
There are generally two ways a dog’s cranial cruciate ligament can rupture. The first way is similar to a sports injury in people. Like a basketball player who plants his leg aggressively and then tears his ACL, a dog’s CCL may suddenly rupture from excessive force and leave the dog with an unstable and painful knee. Alternatively, a dog can experience years of normal “wear and tear,” which can leave the ligament weak and prone to full rupture. We don’t always know why or how a ligament ruptures. Some dogs begin limping after playing aggressively in the park, while others simply step off a curb and begin limping. Obesity appears to be one of the most important predisposing factors in CCL ruptures, however, as excess weight can cause further strain on ligaments. So watch those treats!
Why does my dog need surgery? When a dog ruptures a cranial cruciate ligament, the joint becomes unstable. When he places weight on his limb, there is a shearing force on the joint. This shearing force is not just painful, but also potentially damaging to the cartilage (meniscus) in the joint. This abnormal shearing movement (called “tibial thrust”) predisposes the menisci (cartilage pads) to damage and promotes arthritic changes within the joint. These changes often become painful enough to render the limb mostly useless, especially in larger dogs. Surgically repairing a knee joint after a CCL tear provides stability to the joint and thereby reduces the rate of future arthritic change. Plus, when one CCL is ruptured, a dog will naturally transfer most of its weight to the other leg. In doing so, they inadvertently put the other CCL in danger of rupture due to overuse. If a dog has tears in both cranial cruciate ligaments, simple tasks such as rising up, walking and squatting to urinate or defecate become very difficult, and the dog’s quality of life may suffer.
The beneficial effects of laser light on tissue were first recognized almost forty years ago. Since then, there have been thousands of studies documenting the positive effects laser light has on different types of cells, tissue, and disorders. Recent advances in technology and manufacturing have made it possible to have this exciting modality available and affordable for clinicians.
Treatment protocols are unique to each patient and condition. Therefore, treatments will vary in time, complexity and cost. For some chronic patients, multiple joints will be treated during one laser treatment session. When appropriate, laser therapy can be used as a complementary adjunct to other treatment plans.
If your pet is feeling pain, has inflammation, or a wound, the laser is a sterile, pain-free, surgery-free, drug-free treatment. The laser is used to treat a variety of injuries, wounds, fractures, neurological conditions, numerous dermatological problems, and pain. Whether your pet is rehabilitating from trauma or injury, healing from wounds, or simply aging, the laser has been shown to provide relief and speed healing.
The laser light is delivered through a non-invasive handpiece to treat the affected area. Your pet will feel a gentle and soothing warmth. As the laser is administered, many pets will relax, much like you would experiencing a good massage. The almost immediate relief of pain will allow your pet to be comfortable and any anxiety that your pet initially experienced will dissipate.
The Companion therapy laser system sends photons, or packets of light energy, deep into tissue without damaging it. These photons are absorbed within the mitochondria of the cells and induce a chemical change called “photo-bio-modulation”. This light energy then inspires production of ATP in the cell. ATP is the fuel, or energy, cells need for repair and rejuvenation. Impaired or injured cells do not make this fuel at an optimal rate. Increased ATP production leads to healthier cells, healthier tissue, and healthier animals.
There are no known side effects with this treatment.
You might see a change in activity when your pet comes home. For some it might be increased activity and others may be more relaxed. This is due to the pain relief and reduction in inflammation.
There are no specific things you need to do at home, other than follow normal restrictions, dietary needs, and additional treatment protocols as you pet’s condition dictates and is outlined by your veterinarian.
Simply put, it provides relief. The fur does not need to be clipped. Eye protection will be worn by the laser operator and anyone in a close proximity to the laser probe. The eyes of the animal will be directed away from the treatment area or covered with a towel or eye wear. The clinician will move the probe over the area of treatment to assure the laser is being delivered to the area which needs improvement.
As the laser is administered, often pets will relax and enjoy, much like you would experiencing a good massage. The almost immediate relief of pain will allow your pet to be comfortable and any anxiety that your pet initially experienced will dissipate. Occasionally, angry cats will start to purr and dogs will fall asleep during their therapy session.
Just follow normal treatment protocols as outlined. You do not need to be overly cautious nor should you overdo any activities. Just business as usual.
You may see relief in the first treatment or so as pain and inflammation are reduced. For example: better mobility for joint conditions, drying and healing of dermatological issues, faster healing for wounds and incisions, or your pet just seeming more relaxed and comfortable . For some conditions, a series of treatments may be necessary before you see results due to the severity or complexity of the condition. Each pet is different, and treatments are unique for your pet’s specific needs.