Orthopedic Surgery

Orthopedic surgeries are surgical procedures involving the skeletal system. Dr. Korosec has a keen interest in orthopedics and performs a large number of orthopedic surgeries. Jeff (5)

Stifle (knee) Surgery

  • Cruciate Ligament Surgery- one of the most common orthopedic injuries in the dog. The cruciate ligament is a major stabilizer in the knee. The goal of surgery is to eliminate pain and maintain function of the knee.  Many surgeries exist so it is very important to discuss all the options available including the risks, benefits and limitations of each. For specific information, visit our CCL Rupture & Repair page.
    • Lateral Suture Repair- some type of suture, such as nylon or braided material, is placed through or around structures to provide stability in the cruciate deficient knee. Other terms include extra-capsular repair, TightRope CCL, lateral line technique, lateral fabellotbial suture. It has limitations and may fail in larger or athletic dogs or dogs with disease in their other knee.
    • TightRope CCL- a form or Lateral Suture Repair in which a special suture called Fiber Tape is used. This is a Kevlar-like material that is used extensively in human surgery for many orthopedic applications.  This material has properties that make it stronger and less prone to failure than any other suture materials currently being used of cranial cruciate lateral suture repair.
    • TPLO (Tibial Plataue Leveling Osteotomy) – a surgery that changes the biomechanics in the knee and eliminates forward instability (major responsibility of the cruciate ligament) through its full range of motion. It can be offered to most all sizes of dogs and most surgeons recommend a TPLO or other biomechanical altering surgical technique for large dogs, athletic dogs or dogs with disease in the other knee. At this time the TPLO is considered the gold standard for treatment of cranial cruciate ligament disease. All other techniques are compared to the outcome of the TPLO surgery.
    • Meniscusectomy (removal of the meniscus) – in the dog the medial meniscus is torn in 40% to 80% of dogs that have a torn cruciate ligament. A small percentage of dogs that have had cruciate ligament surgery will go on to tear their medial meniscus.  Surgery to remove this torn meniscus is just as important as cruciate ligament surgery.  If this is not addressed at the initial surgery the dog will continue to be in pain and lame regardless on the type of cruciate ligament repair performed.
    • Meniscal Release- WE DO NOT PERFORM THIS IN OUR PRACTICE. Some surgeons release the healthy untorn medial meniscus at the time of cruciate ligament repair to reduce the risk of tearing it later after surgery.  Although this may reduce the post-operative risk of a meniscal tear it will also significantly increase osteoarthritis in the joint.
  • Patellar Luxation- common in small breeds where the knee cap slips out of its groove. It may not cause persistent or intermittent lameness to no lameness at all.   One or all of the following may be performed to keep the knee cap from slipping out.
    • Trochleoplasty- the groove in which the knee cap sits and glides is deepened.
    • Imbrication- the structures surrounding one side of the knee is tightened to prevent the knee cap from slipping out.
    • Tibial Crest Transposition (Tibial Tuberosity Transposition) – moving the attachment of the patellar tendon to keep it straight and prevent the knee cap from slipping out.

Hip surgery

  • Femoral Head and Neck Excision (FHNE) – this is a surgical procedure that removes the ball (and neck) of the “ball and socket” hip joint. It is done as a salvage procedure to alleviate pain associated with arthritis of the hip, complicated hip joint fractures, certain hip dislocations and disease.
  • Surgical Hip Reduction – most dogs that dislocate their hip will not respond to closed reduction and conservative management (popping the hip back in place and bandage or cage rest). If it is feasible and there is no evidence of hip dysplasia ((shallow hip socket) the ball and socket is surgically put back and held in place with suture and toggles.

Joint Surgery

  • OCD Joint surgery – cartilage defects in the shoulder, knee or ankle that are diagnosed in young dogs of certain breeds will benefit from surgery. If left untreated some dogs risk greater problems later as they age.
  • Arthrodesis – some joints have so much disease or a catastrophic injury that the joint needs to be fused to be functional and to eliminate pain.
  • Arthrocentesis- a method to collect joint fluid. With sedation a needle is placed into the joint to collect joint fluid.  This procedure is often done to help make a diagnosis such as infection, immune mediated disease or arthritis.
  • Joint Injections – some forms of disease respond to placing a drug directly into the joint.

Bone Surgery

  • Fracture repair – broken bones need to be put back together and held in place until they heal. External casts may work in some incomplete or stable, non-displaced fractures however surgery is often the best way to reduce (put back together)  the fracture and stabilize it (prevent movement).  Reduction and stabilization can be achieved by one or a combination of the following.
    • Intramedullary Pins and Cerclage Wires.
    • Plates and Screws.
    • External Fixators.

The decision on which orthopedic implant is used will depend on many factors such as the bone involved, the severity of the fracture, the age of the patient and the cost to the owner.

  • Limb Amputation- removal of a limb may be necessary for certain bone or joint disease or in the case of a catastrophic injury to a limb.