Could you tell me more about the TPLO?
I've been performing the TPLO (Tibial Plateau Leveling Osteotomy) since 1995 and the results have far exceeded our original expectations. Better than 90% of our patients have returned to pre-injury or in some cases even BETTER than pre-injury function.
Can the TPLO be performed on dogs under 50 pounds?
Yes, the small saw and plates are available, so that the only limiting factor is the size of the animal's tibia. This means that the TPLO can now be performed on animals as small as 25 lbs.
My dog has DJD [degenerative joint disease] from an old ACL tear, will the TPLO help correct the problem?
Yes, by changing the slope of the tibial plateau we give your pet a new weight bearing surface. I have performed the surgery bilaterally on a Lab who had an untreated ACL tear for  years, and is now not lame. The TPLO is also ideal for those dogs with failed conventional ACL repairs.
Do you perform other types of knee surgery?
Yes, I perform conventional ACL repairs on small dogs and cats as well as correction of patella luxations in dogs and cats. Of course, I also repair other types of traumatic as well as non-traumatic problems within the knee joint [OCD, tumors, tendon tears, fractures, etc.].
I have a little poodle who "skips" on one of his rear leg when he runs, we think it's cute, is it a problem?
Yes, skipping off on a rear leg indicates discomfort. The most likely cause in a small dog is a medially luxating patella [dislocating kneecap], but it could be related to the hip joint. For the most part, a dog exhibits pain and discomfort by limping or going into non-weight bearing.
Could you tell me more about Medial Patella Luxations [MPL]?
The grading system I use is from 1 to 4 with 4 being worst.
Grade 1 - The kneecap is in place, can be luxated, but spontaneously returns to its normal position.
Grade 2 - The kneecap is in place, can be luxated, but stays luxated.
Grade 3 - The kneecap is always out, but can be manually replaced.
Grade 4 - The kneecap is permanently out, and cannot be manually replaced.
Should all MPLs be corrected?
I do not advise correction of Grade 1s, l do advise correction for the other grades, as keeping the patella properly aligned helps to provide stability for the knee and lessen the possibility of ligament [ACL] damage.
I have a lab with a MPL what should I do?
While lateral patella luxations are more common in large dogs, we do see MPLs in them. It must be determined that the MPL is not secondary to a problem in the hip joint [dysplasia]. The condition is then treated according to the cause.
My dog dislocated his hip, what are my options?
Usually, the first approach is a closed reduction with the application of an Ehmer or non-weight bearing sling. If this fails, then the options are: 1] Closed reduction and instillation of a Devita Pin, 2] Open reduction and internal stabilization, 3] Femoral head and neck excision arthroplasty [FHO], 4] Triple Pelvic Osteotomy [TPO], and Total Hip Replacement [THR].
I have a puppy who is 6 months old, I've been told he needs a Triple Pelvic Osteotomy, when should this be performed?
As soon as possible. We want to operate on these patients as soon as diagnosed as long as they are at least 6 months old.
What makes my dog a candidate for a TPO?
The ideal candidate is the 6 month old dog with subluxation of the femoral heads, minimal degenerative changes, and good depth to the sockets. While this is the ideal, very few patients present with these. I find the most important factors are depth of the socket and degree of arthritic [degenerative] changes. I recently operated on a 5 year old Saint Bernard with excellent socket depth and minimal DJD.
My dog was spayed and at the time of the surgery my doctor took xrays and found out that she has hip dysplasia, what should I do?
That is a tough question, the reason being that xrays can only be used to diagnose, but not prognose. I do not treat an xray, I treat the dog. Ideally, surgery is the treatment of choice if the above criteria for a TPO are met. Dogs, however, do not read their own xrays and it is very common to see dogs with severe arthritic hips who have never limped a day in their lives. One must look at the entire picture and make a decision accordingly.
If I don't have the surgery performed now will I have to put my dog down later?
Usually not, there are other surgical options or medication which can relieve discomfort.
Can you quote me your fees for the above mentioned surgeries?
I'm sorry but I do not quote fees over the internet.