Post op care – MMP cruciate surgery

The Procedure

A triangular titanium implant has been placed inside the tibia (shin bone) after a saw was used to make a cut (osteotomy). The implant is held in place with a pin and wires and the bone will grow through it and incorporate it in to the bone. The dynamics of the joint have been changed so that it is stable during weight bearing even though the cruciate ligament is not functioning properly. The bone is broken and will take 6 weeks to heal.

The Medication

  • Loxicom – is an anti-inflammatory pain killer. It is usually prescribed for 4 weeks following the surgery. Stop if vomiting or diarrhea is experienced and call for advice.
  • Noroclav or Cephacare – are antibiotics usually prescribed for 7 – 10 days following the procedure.
  • Other pain relief may be prescribed as necessary

Post op

  • Eating, drinking and urination should have been seen by the morning after surgery
  • Defaecation may be delayed for several days post-op
  • Cold compresses can be used on the wound for the first 72 hours. Ten minutes on and ten minutes off, if tolerated, throughout the day.
  • A course of laser therapy may be prescribed to reduce pain/swelling and improve healing.

Exercise

  • Strict restriction and supervision of activity is required
  • Preventing running and jumping is essential for at least 6 weeks (consider using stair gates and ramps)
  • Consider using a crate / cage to control activity when unsupervised
  • 1 – 10 days – 5 minutes lead exercise 3 times daily
  • 10 – 20 days – 10 minutes lead exercise 3 times daily
  • 20 + days – 15 minutes lead exercise 3 times daily
  • Failure to follow these points may result in serious consequences including further surgery

Physiotherapy / Hydrotherapy

  • Early gentle walking on the lead is helpful
  • Flexing and extending the leg through its normal range of motion several times a day is also of benefit
  • An appointment with a qualified physiotherapist may be recommended
  • Hydrotherapy is extremely beneficial from 4 weeks post op to improve flexibility and build muscle

Follow – up appointments

  • 2-3 days to check the wound
  • 14 days to remove sutures
  • 6 – 8 weeks for post-operative x-rays

What The Future Holds…

  • There is a 50% chance that the other cruciate ligament will develop instability later in life
  • 5-10% of cases may develop a cartilage tear (meniscus) weeks or months after the surgery. This would require a second smaller procedure to remove the torn cartilage.
  • Degenerative joint disease (arthritis) will continue to develop and require managing, usually in the following order:
    • Weight control
    • Regular gentle / moderate intensity exercise
    • Veterinary strength joint supplements
    • Hydrotherapy / Physiotherapy
    • Anti-inflammatory drugs