Jabber underwent TPLO surgery on Friday, March 2, in Charleston, SC. We were very nervous about subjecting him to a long operation, but we felt it was necessary. I am happy to report that the operation was successful! Here's how it went:
Just before surgery, Jabber was sedated, intubated, and then his knee was x-rayed to determine the slope of the tibial plateau. Jabber's slope was 23°. A normal slope would measure 18 to 20°. Jabber's steeper angulation was a contributing factor to the rupture of his cruciate ligament, but according to his surgeon, Dr. Paul Shealy, it was probably not the sole cause. (There can be many factors leading to cruciate failure in older dogs.)
In the operating room, Dr. Shealy opened Jabber's knee. He found that Jabber's meniscus was badly torn. The meniscus is a C-shaped piece of fibrocartilage. It acts as a cushion between the femur and the tibia. After the cruciate ligament ruptured last December, Jabber's bones were "jumping around" whenever Jabber used his knee. The uncontrolled movement tore up the meniscus. Typically, when the meniscus is damaged, the torn cartilage begins to move in an abnormal fashion inside the joint, resulting in a lot of pain. Before the operation, we assumed Jabber's pain was primarily due to arthritis. During surgery Dr. Shealy observed that Jabber's arthritis is not very bad. He thinks most of Jabber's discomfort arose from the damaged meniscus. Dr. Shealy removed most of the meniscus to eliminate the painful rubbing. He then began the TPLO (Tibial Plateau Leveling Osteotomy). First he made a special cut near the top of the tibia, releasing the tibial head. The tibia was now in two pieces. He then rotated the tibial head, changing the pre-surgery angle of 23° to a more stable 5°. (This eliminates the need for a cruciate ligament and results in an extremely stable knee joint.) Dr. Shealy then attached a metal plate to hold the two sections of tibia in the proper position. Normally it takes two to three months for the repositioned bones to knit together to form one stable bone.
Jabber will spend this week having limited physical therapy at Dr. Shealy's excellent Treatment Center. I will visit Jabber and document his early recovery. He'll come home on Friday or Saturday.
From then on, he will be severely restricted while his bones start to heal. (He'll be crated and/or sequestered in my studio and Merlin will not be allowed to play with him, no matter how much he asks.) At the end of three weeks, Jabber will go back to Charleston for two weeks of intensive physical therapy. He will live at the clinic and undergo daily hydrotherapy, bioelectric stimulation and therapeutic ultrasound along with regular passive motion exercises to strengthen his leg and promote healing. Afterwards, he will come home and continue his recovery. After the bone and surrounding tissues are completely healed, Jabber should be able to lead a completely normal life. He'll be able to run and jump and do whatever he wants without pain! although he will have to be careful walking through metal detectors.
Next week we'll take a look at Jabber's leg (his incision!) and we'll see how he's doing. In the weeks that follow we will return to our regular DaDane of DaWeek format, with occasional updates on Jabber's progress. I want to thank everyone who wrote last week to send good wishes for Jabber's surgery. Your words of concern and encouragement were so very appreciated. We received messages not only from around the United States, but also England, Germany, Australia, South Africa, New Zealand, Faroe Island, and even India. I want to give special thanks to Jabber's surgeon, Dr. Paul Shealy. He is an accomplished surgeon who is very dedicated to healing animals, large and small.
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