Meniscal Release in Dogs

The 'meniscus' is a piece of connective tissue that sits within a dog's knee, dividing the femur (the thighbone) and the tibia (the shinbone). There are in fact two menisci within the joint, which act to cushion the bones of the leg and prevent them from rubbing against one another, which would severely impair the dog's range of movement. However, certain health conditions can result in the menisci becoming caught upon protrusions from the tibia within the knee joint. This can cause abrasion of the cartilage to take place over time, resulting in thinning, hardening, or even tearing of the tissue as a result. In order to prevent this from happening, the vet may choose to divide the meniscus to free it from becoming caught on the protrusions of the tibia.

The vet will firstly sanitize the area that they will be operating on by shaving and applying disinfectant to the knee after the dog has been put under a general anesthetic. They will then make an incision lengthways along the back of the leg to reveal the rear of the knee joint. The next step is to carefully move aside the connective tissue and muscle that surrounds the joint in order to reveal the caudal horn, which should sit on the right hand side of the lower half of the joint. This connective tissue will then be severed using a scalpel and allowed to move untethered. At this point, the surgeon may also take the opportunity to visually inspect the other tissues of the knee joint for signs of damage or wear. Finally, the ligaments and muscles that support the knee will be put back in place and the skin will be sutured shut and disinfected. The procedure is comparatively brief compared to other joint surgeries, usually taking less than an hour to complete.

There is much debate as to the effectiveness of the procedure, with many vets arguing that dividing the cartilage (and thus leaving a gap in its area of coverage) will result in osteoarthritis developing in the dog as time goes on. Instead, they would recommend performing surgery to remove damaged parts of the meniscus and accompanying this with extensive physiotherapy to strengthen the knee joint. However, the dog should exhibit a noticeable reduction in pain and discomfort after the procedure and should be able to resume a good level of activity if the proper aftercare guidelines are followed.

After the operation is complete, the dog will need regular doses of painkillers in order to prevent them experiencing undue discomfort in the joint. They may also require antibiotics depending on their particular case. Both of these will typically be delivered in the form of pills crushed into the dog's food, though liquid alternatives are available. The vet will no doubt advise dog owners to keep the animal restricted to light exercise only in the weeks after the surgery, as heavy activity can cause the incision to re-open, potentially harming the animal. Furthermore, follow-up appointments may be needed in order to appraise the dog's rate of recovery and deliver any additional treatment (i.e. physiotherapy) that may be deemed necessary. The majority of dogs will have fully healed within three weeks, though larger breeds may take longer, owning to the increased strain placed on their joints.

When compared to many forms of joint surgery, a meniscal release is relatively simple, as it does not require specialist instruments or implants to perform, though it does require a high degree of precision. However, factors such as the age of the dog or additional health problems may raise the cost of the procedure somewhat. The majority of owners can expect to pay between $1,000 and $1,500 for surgery to release the meniscus in a single knee. Alternative treatment methods, meanwhile, are far less expensive. Physiotherapy can cost just a few hundred dollars per month, whilst painkillers and anti-inflammatory medication can cost far less.

There is disagreement in the veterinary community as to the usefulness and long-term safety of the meniscal release operation. Whilst the surgery itself is safe enough, it is the effects that come afterwards that have worried many vets. Chiefly, it is contended that without the meniscus in place to fully divide the tibia and femur, the two bones will over time start to rub together and induce osteoarthritis. This is a condition wherein the bones in a joint come into contact and cause pain, swelling and a loss of range of motion. To prevent this, the dog will require significant physiotherapy in order to strengthen the joint. This physiotherapy, it is argued, could be done without the attendant surgery, giving the caudal horn of the meniscus a chance to recover and leaving the joint intact.

In order to head off the need for surgery to be performed on a dog's knee joint, owners can take several important actions. The first is to make sure the dog gets regular, good quality exercise, as this will build the animal's musculature and strengthen the support structures of its joints. Secondly, addressing joint injuries promptly and getting the necessary physiotherapy conducted will stop complications down the line, such as impingement of connective tissue and arthritis.