Pantarsal Arthrodesis in Dogs

Arthrodesis is the fusing of low motion joints, performed when injury or deterioration in these joints causes disorder and pain to your dog. Pantarsal arthrodesis is achieved with the surgical application of bone material in the joints and metal plates to the surfaces of the tibiotarsal, proximal and distal intertarsal and tarsometatarsal joints. These joints have limited or no range of motion and fusing them does not prevent your dog from walking or moving about, but relieves pain in the damaged joint. The insertion of surgically implanted metal plates to fuse the joint may be used when trauma to the bones or soft tissue of the joint has occurred, or degenerative disease such as osteoarthritis occurs. The resulting fixation of the joint to resolve the condition can be an alternative to limb amputation. Pantarsal arthrodesis in dogs is performed under general anesthetic by your veterinarian with the use of appropriate surgical plates to fixate the tarsal joints.

Fixation of surgical plates may be external or internal to the joint, depending on the type of damage or disease, and what method will be most effective. A variety of different size plates are available and the correct size needs to be selected in order for fixation to be successful. Radiographs taken prior to surgery will be used to plan the surgical procedure and to address the approach and plates to be used. 

Prior to surgery, you will be required to fast your dog so as not to cause complications with the administration of general anesthetic. Your dog will be sedated, given intravenous anesthetic and then intubated and anesthesia maintained by gas. The area to be incised on the tibia and tarsal joints is shaved and antiseptically cleaned prior to incision. Surgical drapes are used to maintain a sterile surgical site. An incision is made from the tibial area to the metatarsal joint. Subcutaneous tissues are cut away to expose muscles and ligaments that are then moved aside with the use of retractors. Joint capsules are destroyed or repairs made to bone and soft tissue as required. Bone grafts are used to fill joint spaces and achieve bone fusion. Specialized surgical plates are affixed with surgical screws to the tibia, tarsus, and metatarsus as required to fix the joint. Incisions are closed and a splint bandage may be used to support the leg and joint. Your dog will be assisted while they recover from anesthetic and administered supportive care as necessary. 

Pantarsal arthrodesis, achieved with surgical intervention and implantation of plates, is usually effective at fusing the joint and relieving pain in the hindlimb of dogs. When pantarsal arthrodesis is not successful, it may be due to poorly sized or fitted plates or plates loosening or breaking, resulting in fusion not being achieved. This procedure can be a successful alternative to limb amputation.

After pantarsal arthrodesis surgery, your dog's activity should be restricted for three to four weeks. A splint bandage may be used during this time if deemed necessary to immobilize the hind leg while healing of the surgical site occurs. Sutures will need to be removed in 10 to 14 days if nonabsorbable sutures or staples were used. Your veterinarian may prescribe pain killers and antiinflammatories, which should be administered as directed. If risk of infection is suspected, antibiotics may also be prescribed. Inspect the surgical incision routinely to ensure that wound rupture or infection is not occurring and address with your veterinarian if this should occur. You may need to use an e-collar to prevent your dog from interfering with bandaging or sutured incision site.

The cost of pantarsal arthrodesis in dogs varies depending on the cost of living in your area. Pricing will be reflective of radiographs, anesthetic, procedure, and medications required during recovery. The price of this procedure can range from $1,000 to $5,000. Specialized surgical plates and customization may also contribute to variations in cost.

Complications from disease present, general anesthetic, and infection are risks inherent in this procedure which can be mitigated with appropriate supportive care.

Proper size selection and necessary plate customization to ensure adequate fit for your dog’s tarsal area are critical to the success of the procedure. Plates that are too small can break, and plates that are too large may not provide adequate structural support to the bone.

Osteoarthritis, which is a common cause of the requirement for joint arthrodesis, may not be preventable. However, injuries that may contribute to osteoarthritis or trauma that could directly result in the requirement for pantarsal arthrodesis can be mitigated. Ensuring your dog’s environment is safe from hazards and that they are not left unsupervised or loose outside will greatly reduce the likelihood they will be involved in household accidents, motor vehicle accidents or fights with other animals resulting in injury to the tarsal joints. In addition, early intervention when osteoarthritis presents may allow for treatment that can prevent surgical intervention being necessary.