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The tarsal joint is a hind limb joint that connects the tarsal bones to the major leg bones. It exists in the back feet of a dog and restricts certain movements to control range of motion. Excessive degeneration or severe injury can destroy this joint beyond repair. A partial tarsal arthrodesis is a surgery used on a last resort basis to salvage some joint function while fusing leg and foot bones together.
Other treatments that do not affect joint function may be attempted prior to a partial tarsal arthrodesis, or they may be deemed inappropriate at the time of examination. In an arthrodesis, metal implants are surgically placed to decrease movement and relieve pain in the affected limb. An ACVS board-certified veterinary surgeon who specializes in joint surgery should be sought to perform this operation.
To identify where the weakness is in the joint, stress radiographs will be taken. Once the severity of the damage has been assessed, surgery can be planned. Blood work will be run to determine if the dog is healthy enough to undergo general anesthesia. The dog will need to be free of infection before the surgery can be performed.
The dog will need to fast for several hours before the operation. Once it has been sedated, an IV will be placed in the dog. The area of the joint will be shaved and cleaned. An incision can then be made down the leg to begin the procedure. All cartilage will need to be removed from the joint capsule. Bone will be harvested from another area and packed into the empty joint to promote healing. The joint will then be maneuvered into its permanent position. Plates, screws, pins and wires will be used to secure the bones of the joint together. The incision can then be closed using sutures.
A partial tarsal arthrodesis carries an excellent prognosis, offering more movement than a complete tarsal arthrodesis. Because of the increase in joint function, this procedure is preferred if at all possible. Many dogs experience normal or almost normal leg movement after a successful partial tarsal arthrodesis has been performed. Surgical treatment yields much better results than non-invasive treatments of severely damaged tarsal joints. Joints that are completely destroyed may require a surgical procedure called a “panarthrodesis” instead.
The dog will have to be closely monitored as it wakes up from the general anesthesia to ensure all vital functions resume properly. Pain medication can be administered at this time and may continue for several days post-surgery. A bandage will be placed over the surgical wound to help manage both swelling and bleeding. This dressing will need to be changed every one or two weeks until the site has healed.
The limb will need to be placed in a cast or attached to a splint for stabilization as it heals from the operation. The cast or splint will need to remain for at least six weeks. Exercise should slowly resume once the external support has been removed.
A partial tarsal arthrodesis can cost from $3,000 up to $6,000. The surgery is more expensive comparatively because it requires a specialist to be performed. Metal implants may need to be custom made to fit the dog's limb properly. In addition to these costs, pain medication, blood work, anesthesia, and antibiotics will also bring the overall price up. If physiotherapy is used in the recovery period, it can cost up to $75 per session.
There are certain complications that can arise after a partial tarsal arthrodesis. Infection of the surgical site can hinder proper healing of the joint. The metal implants may break, or cause severe sensitivity to the cold, both of which would require further surgery for removal. If the joint does not heal, a second bone graft may be needed.
The cast may cause pressure sores to develop. If the fixation is not rigid enough, the joint can become unstable. Some dogs may also experience death of the tissue on the base of the foot. The use of general anesthesia also comes with rare but serious risks that need to be considered before operating on the animal.
To prevent the need for a partial tarsal arthrodesis, both severe and minor injuries should be avoided. Severe injuries, often caused by vehicle accidents, can be prevented with the use of a leash whenever the dog is being walked. Minor injuries that can lead to arthritis can be avoided by discouraging jumping off of high surfaces or onto hard surfaces. Vigorous play should not be permitted in order to avoid leg injuries. Daily supplementation with glucosamine and chondroitin can help slow down the progression of degenerative arthritis so that surgical intervention is not needed.
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