ACL injury in the dog Part 4: Using custom braces (orthoses) to treat ACL injury
Last post I covered the surgical options for canine ACL (CrCL) injury. This is the most common method and the standard of care for stabilizing the knee in the average dog. However, there are a number of dogs who don’t fit the average mold and for whom surgery will not be performed for a number of legitimate reasons; fortunately, there is now a solution for externally stabilizing the knee. The OrthoPets knee brace (orthosis) is designed to limit all of the abnormal motion caused by a partially or fully torn ACL (CrCL). It can prevent forward tibial movement (so called cranial drawer motion); tibial rotation; and knee hyperextension. It just does this from the outside of the leg instead of the inside. Our patients wear their devices during periods of weight-bearing activity and many wear them morning to night in order to participate in their sports and jobs, even if those jobs are keeping the backyard squirrels in line! Many people ask us if dogs tolerate the device. In one word…YES. The devices are custom so they are built for each individual dog and comfort is as important as function. Each device is made from a fiberglass mold of the patient’s injured leg. This mold allows us to shape the device for best fit and importantly to keep the device properly suspended on the leg. The device works because it utilizes the dog’s normal muscle contraction in the thigh and calf to biomechanically unite the device with the leg. In this way the hinges of the device control all motion and thereby prevent abnormal motion. There is an odd misconception that a brace (orthosis) restricts normal motion and is static (non mobile) rather than dynamic (mobile). In a properly designed and fitted orthosis the leg can go through normal flexion and extension comfortably allowing the dog to regain strength, stability, and balance. We recommend basic orientation to teach weight-bearing and proper gaiting (walking, trotting, running) and then, as we do for surgery patients, we recommend professional rehabilitation (physical therapy) for strengthening and conditioning. Very importantly, if the meniscus (cushion inside the knee) is torn or crushed a minor surgery to remove the torn portion is necessary to allow return to weight bearing and function. For dogs that cannot have surgery a knee orthosis is the NEXT STEP in veterinary medicine. Next post I’ll introduce you to some of our ACL orthosis patients. In the meantime you can contact us at firstname.lastname@example.org or call us at 303 953 2545, for specific questions.