What are Pantarsal Arthrodesis?
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.
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Pantarsal Arthrodesis Procedure in Dogs
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.
Efficacy of Pantarsal Arthrodesis in Dogs
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.
Pantarsal Arthrodesis Recovery in Dogs
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.
Cost of Pantarsal Arthrodesis in Dogs
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.
Dog Pantarsal Arthrodesis Considerations
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.
Pantarsal Arthrodesis Prevention in Dogs
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.
Pantarsal Arthrodesis Questions and Advice from Veterinary Professionals
My dog had a pantarsal arthrodesis when she was 7 months old after being hit by a car. After several months, the plate broke in her leg and was removed. Apparently when she grew, the tension from the bone broke the plate. She had an extended time casted and bandaged and wore a soft brace for awhile after that. She required water treadmill physical therapy to get her to use the leg again. She is now 4 years old. Occasionally she limps after a nap but that seems to be from stiffness rather than pain. We use the soft splint if she plays with another dog. She played with another dog today, her sister who came for a visit. She was running and made a quick turn and yelped. She is limping. We iced it immediately. Should we be worried? What kind of injury can happen with a fused ankle? Not sure if it is her foot or knee. She has let me pet the whole area with crying.
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My dog has a broken plate after 1.5 years of arthrodesis of leg. There is a small bleeding from there and the doctor suggest to take out the place and see how is the leg. Shouldnt it be replace by another plate also?
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Our 8 year old Yellow Lab suffered an achilles tendon tear last fall. An Orthopedic Veterinary Surgeon reattached her tendons after drilling into bone. After 12 weeks in hard cast, partial cast and soft cast, she appeared "good as new". She reinjured herself at which time, both Vet and Vet Surgeon confirmed complete separation of Achilles Tendon again. Her back left foot drops and flops while walking, and toes curl under as nothing is attached. She's become quite proficient at running 3-legged, but she needs consistent excercise in the form of walking to remain fit and healthy. Our Vet suggested Pantarsal Arthrodesis as an option since the last surgery failed. Would this be a good option? Would she be able to walk? run? swim? climb stairs? Would there be a danger of the apparatus breaking, as have multiple braces we have tried?
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