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Post-Operative Care For Cruciate Repair
Regardless of the specific type of procedure performed, surgical recoveries are very similar.
Strict exercise restriction is mandatory for the first 6-8
weeks after surgery followed by controlled exercise for an-other 6-8 weeks. Stringent exercise restriction involves:
Keep surgical site clean and dry. If swollen or oozing please clean with 70% rubbing alcohol and inform the Doctor immediately
Arthritis should be expected to develop over time with every procedure.
Most dogs function reasonably well despite these changes with or without medical therapy on an ongoing or intermittent basis.
Finally, there is a fairly high incidence of dogs that have sustained a CCL rupture on one knee, developing the same injury on the other leg within 1-2 years. Reported frequencies of second injuries range from 30-60%.
Please also check the Patellar Luxation Surgery Post-Op Rehab Schedule. Both surgeries recovery are very similar.
PHYSICAL THERAPY REGIMEN
Please must do err, err on the "do less" side of these instructions. Less physical therapy
will result in a slower return to function, but more aggressive physical therapy by a non-professional may result in failure of the procedure.
Apply an ice pack to the knee 10-15 minutes four times a day for the first 24-36 hours following surgery (if the bandage is not present). An ice slurry can be made by mixing 2 parts isopropyl alcohol to one part water in a zip lock bag and freezing. This is kept in the freezer except when in use. Use a towel between the skin and ice pack
-When swelling and redness have resolved (3 days post-op), begin application of a warm compress (a damp towel warmed in water) to the knee for 10 minutes three times a day before performing 10 slow repetitions of range of motion (ROM) exercises.
ROM Exercise--Have your pet lie on his/her good side. Grip the front of the thigh with one hand and
hold the foot with the other. Slowly push the foot up into flexion of knee and then slowly pull the foot
and push the thigh down and back into extension of the knee. Concentrate on the extension movement.
Flex and extend only to your pet’s comfort limit. Do not go to the point of creating pain or resentment.
Following ROM, apply ice packs to the surgical site for 10 minutes
-After the third day, begin slow leash walks of 3-5 minutes duration three times daily. Use a short leash during the walks outside when your dog must urinate or defecate.
Weeks 2 and 3
Apply the warm compress and continue flexion and extension of the knee as described above. Now slowly push the foot up into full flexion of all joints; hold for 5 seconds. Slowly pull the foot and push the thigh down and back into full extension of all joints; hold for 5 seconds. Repeat this motion 10 times twice daily. Again, do not go to the point of creating pain or resentment. Follow each session with 5-10 minutes of ice packs.
-Slow leash walks for 10 minutes 1 to 2 times a day is acceptable.
Weeks 4 and 5
-Sit/stand Exercise (for dogs)—Have your pet repeatedly sit and stand for 10 repetitions twice daily. Use small treats to encourage participation. Do not push down on his/her rump. Continue 4 weeks.
-Massage—your pet may stand or lie down. Perform both superficial skin massage & deeper muscle massage.
Skin massage around the knee joint involves using your hand loosely conformed to the surface of the skin; enough
pressure is applied to move the skin relative to the underlying tissues. Muscle massage of the thigh and shin involves deeper kneading and pushing of the muscles. Perform massage for 10-15 minutes twice daily for 4 weeks.
-Increase the slow leash walks to 20 minutes 1 to 2 times a day.
Weeks 6 and 7
Active exercise-Place your pet on a short leash and have him/her walk at your side. Walk outside on even/solid footing for 30 minutes once or twice daily. Continue 4 weeks, gradually increasing time and distance.
Weeks 8 – 10
-At the end of week 8, the dog should be reexamined by your veterinarian for evaluation of limb usage.
-Increase the slow leash walks to 30-40 minutes once or twice daily. The pace should be slow enough to ensure full weight-bearing on the affected limb.
-Have your dog slowly climb a flight of stairs 5-10 times twice daily.
-Jogging exercise-On a short leash, intermittently jog and walk your dog for 10 minutes twice daily. Continue 4 weeks, gradually increasing time and distance.
-Swimming is wonderful rehabilitation exercise when performed correctly. You may allow controlled swimming after week 8. Controlled swimming requires that your pet not jump or leap into the water; walking into the water until it is deep enough to swim is required. Throwing balls to fetch often results in sudden jumping and lunging, this can cause serious problems in the healing phase. Do not over extend you pet; start with short excursions (5 minutes) and increase duration and frequency gradually.
Week 11 and 12
-Light play exercise-On a long leash; encourage playing and romping with your dog for 15 minutes twice daily. Use toys for teasing and tugging. Continue 2 weeks.
-Healing should be complete and your dog can return to full activity by the 12th-16th week.
LONG TERM LIFESTYLE
Following the 12 week recovery period, there are no recommended limitations to their lifestyle. A gradual return to full function should occur, to allow for a smooth transition back to normal activity. If stiffness and lameness develop over time, intermittent use of anti-inflammatory medications can help improve limb function. Occasionally the implants that were placed in your dog’s knee will cause irritation and lameness. If necessary, these are easily removed once complete healing has occurred. It is very common (30-40% of patients) for both knees to develop cruciate ligament tears. Prevention is difficult; the most effective thing you can do toward prevention is to maintain your pet on the thin side of normal weight.