Dudley is a 2-year old, 64-pound mixed breed dog. Dudley initially presented to his veterinarian December 2016 for a Grade 2 patellar luxation secondary to patella alta on the left pelvic limb. When his patella luxated, he was in immense pain. Surgical correction was performed that same month. The trochlear groove was noted to be normal depth and a trochleoplasty was performed. Dudley did very well post-operatively and was using his limb with no apparent lameness within 3 days following surgery. In January, Dudley presented on emergency with severe pain of his left stifle. Radiographs revealed an avulsion of the left tibial tuberosity, just proximal to the previously placed pins.

Initial radiographs prior to the initial device

A second surgical repair was performed. Dudley was then placed in a lateral splint and remained hospitalized to reduce his post-operative activity. Three days later, Dudley was noted to be acutely painful on his left hind limb again. He had another surgery where it was noted that the tibial tuberosity had fractured vertically through the two previously placed pins. Another repair was performed. Unfortunately, radiographs performed 3 weeks later revealed a failure to the repair. Dudley remained in a splint at the point and his veterinary team reached out to OrthoPets for potential support via orthosis.

After reviewing the case with our surgical and sports medicine team at Colorado State University, it was determined that even though this was a complicated situation no matter what approach was taken and no guarantees could be made, this may have been the best chance to return comfort and mobility to Dudley.

Essentially, what OrthoPets was able to offer was similar to an orthotic design used to support post-operative patellar tendon avulsion cases. The stifle, tarsus and paw are incorporated in the device and “locked out” or non-articulating at first. As healing progresses, range of motion is slowly returned. These device configurations are very complex and require a lot of commitment from not only the clients, but also the veterinary team.

In February 2017, OrthoPets received Dudley’s case including fiberglass impression, measurements and radiographs. Due to Dudley’s multiple injuries and therapeutic goals, a special hinge called a “Camber Axis Hinge” was determined best for his device as they allow for variable ranges of flexion and/or extension to be given. The hinges were metal adding additional frontal and transverse control as well. Also, given that the entire device would be non-articulating at first, and the weight of all the componentry required, suspension would be a challenge so the device was fabricated with a neoprene suspension sleeve to increase purchase of the device to limb.

Initial Device

The owners and veterinary team continued to implement rehabilitation in Dudley’s treatment plan. By the end of March 2017, Dudley had full range of motion of this stifle and tarsus. By April 2017, no instabilities were present. Since Dudley had progressed so well, the additional componentry such as the special hinges, paw segment and tarsal cuff were not necessary. Dudley’s owners and veterinary team decided that it would be best to continue to provide support to his stifle and had a standard stifle orthosis fabricated to use as a “sports brace.”

 

Recheck radiograph prior to sports brace conversion.