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Thread: ACL Tears

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    Senior Member Bill Davis's Avatar
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    Default ACL Tears

    What the prognoses on an ACL tear for a 2 y/o hard charger?
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    Senior Member Howard N's Avatar
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    TPLO + Rehab and he'll be very close to the same dog in 4 months.
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    Senior Member Misty Marsh's Avatar
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    I agree with Howard! Quality re-hab is the key.
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    Quote Originally Posted by Howard N View Post
    TPLO + Rehab and he'll be very close to the same dog in 4 months.

    yeah but only if you get Dr. Cal Cadmus to work on the dog...not the one we used to work on Star when she tore hers
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    Senior Member EdA's Avatar
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    Quote Originally Posted by Howard N View Post
    TPLO + Rehab and he'll be very close to the same dog in 4 months.
    And very likely to tear the opposite side within 18-24 months

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    Senior Member Misty Marsh's Avatar
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    Quote Originally Posted by EdA View Post
    And very likely to tear the opposite side within 18-24 months
    Are there not factors that may not make this a fact? Things like the genetic tibial plateau angle and the quality of the re-hab, thus less emphasis on the uneffected knee?
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    Senior Member Maxs Mom's Avatar
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    Quote Originally Posted by Misty Marsh View Post
    Are there not factors that may not make this a fact? Things like the genetic tibial plateau angle and the quality of the re-hab, thus less emphasis on the uneffected knee?
    I was told when my dog tore her second knee, that it is the strain knee number two goes through while number 1 is healing. I mean if the knee tore do to running around, chances are the other knee has some issues too. However if your dog takes a specific blow to the knee, that causes the CCL to tear, that could be a totally different story.

    My dogs knee went when she was t-boned by my lab, but she was older when it happened so it may have just been "the icing on the cake" so to speak. I will say though after TPLO #2 she never limped again for the rest of her life. She was almost 8.5 when she had her first knee done, 9.5 when #2 was done, died at the age of 12.5 to cancer. She lost a step, but not sure that was not just age related. I have a friend who had her GSD done, one side several years ago, he just completed his agility MACH.
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    Quote Originally Posted by EdA View Post
    And very likely to tear the opposite side within 18-24 months
    A small but well done study shows that giving Fish Oil after CCL repair should decrease the odds of blowing the good knee.

    Here's an abstact of the article that shows the biochemistry behind the protective abilities of giving fish Oil after CCL surgery.

    For clarity, "AA", and the "MMP's" and "uPA" are the bad guys "TIMP" is a good guy
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Fish oil decreases matrix metalloproteinases in knee synovia of dogs with inflammatory joint disease.Hansen RA, Harris MA, Pluhar GE, Motta T, Brevard S, Ogilvie GK, Fettman MJ, Allen KG.
    Department of Health Promotion and Human Performance, Weber State University, Ogden, UT 84408, USA.

    This study was designed to determine whether dietary fish oil affects the expression and activity of matrix metalloproteinases (MMP), tissue inhibitors of MMP-2 (TIMP-2) and urokinase plasminogen activator (uPA) in synovial fluid from dogs with spontaneously occurring stifle (knee) instability in a single hind limb resulting from acute cranial cruciate ligament (CCL) injury. Two groups of 12 dogs were fed diets from 1 week prior to surgery on the affected knee to 56 days post-surgery. The fish oil and control diets provided 90 and 4.5 mg, respectively, of combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)/kg body weight per day. Plasma and synovial fluid, from both surgical and nonsurgical knee joints, were obtained at start of the diet (-7), surgery day (0) and 7, 14, 28 and 56 days post-surgery. Plasma total EPA and DHA were significantly increased, and plasma total arachidonic acid (AA) was significantly decreased by the fish oil diet. In synovial fluid from the nonsurgical knee, fish oil treatment significantly decreased proMMP-2 expression at Days 7 and 14, and proMMP-9 expression at Day 56, and uPA activity at 28 days and significantly increased TIMP-2 expression at Days 7 and 28. There were no differences in MMP expression or activity, TIMP-2 expression and uPA activity in the surgical joint synovial fluid at any time throughout the study. These results suggest that dietary fish oil may exert beneficial effects on synovial fluid MMP and TIMP-2 equilibrium in the uninjured stifle of dogs with unilateral CCL injury.



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    Senior Member Obabikon's Avatar
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    Quote Originally Posted by EdA View Post
    And very likely to tear the opposite side within 18-24 months
    Is this a direct result of the first injury, or a symptom of a genetic predisposition that caused the first injury?

    If it's strictly genetic, let me run this past you....

    I assume that dogs with no particular predisposition to ACL tears can (and do) tear an ACL if they tweak their knee badly enough. Nothing's unbreakable, right?

    That said, is there any way of determining if a dog tore its ACL because the ACL was genetically inferior, or if it was just hurt badly?

    I'm awaiting x-rays, but my vet told me the other day that my dog almost definitely tore its ACL (at least partially), and I'm wondering how likely a second tear will be.

    If it matters, I talked to my dog's breeder a few minutes ago, and to his knowlegde, neither of the parents or littermates have torn ACLs.

  10. #10
    Senior Member EdA's Avatar
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    Everything I will tell you is purely anecdotal and unsupported by controlled double blind scientic study but these are observations from 40 years treating and training athletic dogs and discussions with the surgeon(s) who has done thousands of TPLO since 1993 or 1994 when I urged them to learn the procedure.

    CCL tears were not unheard of but beginning in the late 80s seemed to increase in incidence until today when it seems almost epidemic.

    Most tears were in adult dogs middle age and older, I never saw a juvenile tear until the mid to late 90s, by juvenile I mean dogs 5-10 months old.

    We used to tell clients that after the first tear dogs had a 30% chance of tearing the opposite side. Now it is closer to 50% and young dogs +\-2 years who tear them have an even higher incidence of tearing the opposite side. This has nothing to do with the repair of the first tear or overloading the normal leg, rather the factors which contributed to the first tear exist in the normal stifle.

    If we could identify those factors it would help or possibly prevent the high incidence of CCL tears in performance Labradors.

    Some theories include genetic predisposition (slope of the tibial plateau, narrow intercondylar notch, small or weak ligaments). Some believe that the precursor is an immune mediated joint inflammation which weakens the ligament.

    The good news for us all is that CCL tears are the most consistently repairable joint injuries in the dog thanks to the very innovative late Dr. Barclay Slocums tibial plateau leveling osteotomy which has been performed successfully on hundreds of thousands or perhaps more than one million dogs world wide over the past 2 decades.

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