What is Paatsama Stabilization?

Paatsama stabilization in dogs is a surgical procedure that is used to fix a ruptured cranial cruciate ligament. Paatsama stabilization in dogs is done by using a strip of the dog’s deep thigh muscle tissue known as the fascia lata. 

The cranial cruciate ligament is an important ligament located in a dog’s knee. If this ligament ruptures it can cause a lot of problems for the meniscus. The meniscus serves an important role for the knee joint. In order to repair a ruptured cranial cruciate ligament in dogs, the Paatsama stabilization may be used. 

The goal of the Paatsama stabilization surgery in dogs is to replace the ruptured cranial cruciate ligament with the strip of fascia lata. The tissue that replaces the ligament functions just like the cranial cruciate ligament. 

Paatsama stabilization was the first surgical treatment introduced to stabilize the stifle due to a ruptured cranial cruciate ligament. The procedure is still highly recommended today. In fact, Paatsama stabilization is usually one of the first surgical procedures recommended for a dog with a cranial cruciate ligament that is ruptured. 

In most cases, Paatsama stabilization in dogs is performed by a board certified veterinary orthopedic surgeon. 

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Paatsama Stabilization Procedure in Dogs

Dogs must have a veterinary exam before the Paatsama stabilization procedure is done. The veterinarian will check to see how severe the problem is by using several techniques. Techniques may include a physical and observational exam, imaging (MRI, x-rays), and lab work. 

The veterinarian will then refer the dog to a board certified veterinary orthopedic surgeon once the need for Paatsama stabilization is determined. The veterinary orthopedic surgeon will also want to perform an exam on the dog prior to the surgery. He or she may even want to complete their own imaging and lab work. 

On the day of the Paatsama stabilization surgery, the surgeon will administer the dog anesthesia and possibly pain management through an IV. Once under anesthesia, the veterinarian will make an incision to surgically open the knee. This gives the veterinarian a better view of the ligaments that are damaged. 

Once the damaged ligaments are identified, the veterinarian will remove them. Then the veterinary orthopedic surgeon will replace the damaged cranial cruciate ligaments. 

When the Paatsama stabilization procedure was first practiced, the damaged ligaments were often replaced with tissue from the thigh. As the procedure has advanced, more veterinarians are using monofilament nylon to replace the damaged ligaments. 

Veterinary surgeons replace the ruptured ligaments by passing the new ligament material through the lateral fabella. The lateral fabella is a small bone embedded in the tendon that makes the shape of a dog’s calf muscle. It is located at the lateral end of the femur joint. 

The material is passed through the lateral fabella to the tibial crest. The tibial crest is the anterior ridge of a dog’s tibia. After the material passes through the tibial crest, it is tied into place.

After the new “ligament” is tied into place, the surgeon will close the incision with sutures. 

The veterinary orthopedic surgeon may keep the dog for one to three days after the Paatsama stabilization surgery. This is, of course, as long as the dog’s surgical site and vital signs are normal.

After surgery, if the owner of the dog notices changes in the dog’s surgical site and/or behavior they should contact a veterinarian as soon as possible. If the dog seems to act as expected after a Paatsama stabilization surgery, a follow up should be scheduled about 2 weeks after surgery. At the dog’s follow up, the sutures at the surgical site are removed. 

Efficacy of Paatsama Stabilization in Dogs

About 85% of dogs who undergo the Paatsama stabilization procedure show a significant improvement in their condition. As long as the dog is made to follow all surgery aftercare instructions, the effects of this procedure are quite permanent. 

Some cases may not be candidates for Paatsama stabilization. As a result, other alternative treatments may be offered. These treatments may include medication, joint supplements, a customized exercise plan, and/or braces for the knee joint. 

Alternative treatments may result in a positive change in the dog’s condition. If the condition worsens, and Paatsama stabilization surgery isn’t performed, the dog may develop a severe case of arthritis. Even with the surgical procedure, the arthritis will not be resolved. 

Arthritis can be quite painful and deliberating for a dog. In order to lessen the chance of a dog developing arthritis due to a ruptured ligament, surgery is often recommended above alternative treatments. 

Paatsama Stabilization Recovery in Dogs

After a Paatsama stabilization procedure, dog owners should expect months upon months of aftercare. In some cases, aftercare may be lifelong. 

Most dogs who undergo Paatsama stabilization are required to participate in a rest period that lasts for approximately six weeks. During this time, the safest place for a dog recovering from surgery to be kept is in a small, confined area. 

Paatsama stabilization recovery in dogs involves several different options. These options may include ice pack and hot pack compressions as well as light exercise. The veterinarian may also prescribe pain medication and joint supplements following the procedure. 

Immediately after surgery, the dog will begin their recovery with ice pack compressions. Ice pack compressions are often used the first two days following surgery. During the time, an ice pack is placed on the surgical site three times a day. The ice pack is placed on the site for 10 minutes each time. The ice packs are used to help reduce swelling where the veterinarian made the incision. 

After the first two days following surgery, hot packs are applied to the knee area. Hot packs should be applied to the knee three times a day. Just like the ice packs, the hot packs should also be left on the area for 10 minutes during each session. This helps ensure that the exercise the dog needs to do to recover is not too painful. 

Light exercise that involves extending the knee joint should be done after each hot pack session. The light exercise session should last at least 10 minutes. Once the exercise session is complete, an ice pack is placed on the surgical site. The ice pack should be left on the area for at least five minutes. If possible, leaving the ice pack for 10 minutes is preferred. 

Dog owners should continue the hot pack and exercise protocol as recommended by their vet until the dog is able to put weight on the knee again. As well as following up the exercise routine with an ice pack, it’s also important, during the exercises, to focus on other joints as well. 

Unless complications are noted, a dog will typically have a follow-up appointment around 14 days following the surgery. During this follow up exam, as long as the surgical site is in good condition, any sutures present are removed. The veterinarian may also perform imaging again. This is to ensure that the surgical site is healing properly. 

After Paatsama stabilization, the first three months are the most difficult. During this time, activities such as off leash activity are restricted. It is recommended that dogs only take short, on-leash walks of 10 minutes or less twice daily.

Following the first 3 months after surgery, most dogs are able to gradually increase their exercise. If no issues arise, dogs may start to extended leash walking to 20 to 30 minutes. But, off leash activity is not recommended until after the fourth month following the Paatsama stabilization. 

Running and jumping are often not encouraged following the Paatsama stabilization surgery. The same is true for any kind of rough play. Although some dogs are able to continue running and jumping as soon as 12 weeks following surgery. 

Swimming that takes place in deep water is a top recommendation for exercising after the surgery. This is usually recommended around eight weeks after surgery. 

Dog owners may see improvement in their dogs as soon as two weeks following the surgery. The lameness your dog may have previously experienced should decrease around eight weeks following surgery.

Significant improvement following Paatsama stabilization in dogs is usually noticeable around the sixth month following the surgery. In fact, by month six your dog should be using the limb in almost a normal fashion. 

Many veterinarians recommend making an appointment if your dog shows little to no improvement within 16 weeks following surgery. 

Cost of Paatsama Stabilization in Dogs

The cost of the Paatsama stabilization procedure is dependent on the severity of the case. Cost will also vary depending on where you live and where the surgery is performed.

In order to calculate the total cost of the Paatsama stabilization surgery, you’ll want to factor in treatment prior to and following surgery. 

Prior to the procedure, the dog must visit a veterinarian and a board certified veterinary orthopedic surgeon. Veterinarian visits may range anywhere from $50 to  $150 or more. A visit to a veterinary orthopedic surgeon may cost as much as $300 just for the examination. 

Most dogs undergoing a Paatsama stabilization require imaging and lab work. Recommended imaging may include MRI and x-rays. The price of imaging usually ranges between $80 and $400. In fact, the price of the lab work is often in the same range. It’s important to keep in mind that the veterinarian and the orthopedic surgeon may both require separate lab work and imaging. 

The cost of the Paatsama stabilization procedure itself, including anesthesia, pain management, and vital sign monitoring, often runs as high as $3,000 or more. Depending on where the procedure is done, follow up visits, medications, and imaging may or may not be included in that final price. 

If aftercare visits and medications are not included in the final price, you’ll want to factor in these costs. Medication is usually prescribed to go home with the dog directly after surgery. The cost of the medication may range anywhere between $10 and $50.

After the surgery, most dogs return to the veterinary clinic within two weeks. The visit will consist of an exam and may also include imaging, which, once again, may cost as much as $400 or more.

Alternative treatments to Paatsama stabilization, in the beginning, are less expensive than the surgery itself. But, deciding to not surgically fix the problem may end up costing much more in the long run. 

Dog Paatsama Stabilization Considerations

There’s one huge benefit of Paatsama stabilization in dogs. Most dogs, over 80%, will have quite an improvement in using the affected limb. Rupturing a cruciate ligament is also quite painful for dogs. The surgery, combined with proper aftercare, helps decrease this pain. 

Performing a Paatsama stabilization is also beneficial if it is performed prior to the dog developing arthritis. If this is done, it will lessen the chance of the dog developing arthritis down the road. Unfortunately, the surgery will not fix the arthritis if it was already present. 

While it is rare, there are risks associated with the Paatsama stabilization surgery. Risks include surgical site infection, reaction to the material used to replace the ligament, or possible entrapment of nerves around the surgical site. 

The veterinarian performing the surgery may not find any damage to the meniscal cartilage during the procedure. Damage to the meniscal cartilage may show up later down the road. As a result, a second surgery may be required. 

Paatsama Stabilization Prevention in Dogs

Injuries to the cranial cruciate ligament are becoming more and more common within the veterinary community. Thankfully, most injuries that result in the need for a Paatsama stabilization are preventable. 

Most injuries that are in relation to the cranial cruciate ligament are due to the tibia rotating excessively. It is often seen after dogs participate in activities such as running, jumping, and/or rough playing. 

Other factors may also contribute to a dog needing the Paatsama stabilization procedure. These factors include dislocation of the kneecap, immune mediated disease, and obesity. 

Assisting in the prevention of Paatsama stabilization in dogs is possible. In order to help prevent the need for the surgery, dog owners need to ensure that their dog is fed a balanced diet. In addition to a balanced diet, regular exercise should also be provided. 

Dog owners can also help prevent the need for Paatsama stabilization by closely monitoring their dog. They should ensure that their dog isn’t participating in exercise that is too strenuous. Play time should also be monitored. The chance of an injury to the ligament will hopefully decline with proper monitoring.