Posterior Capsulorrhaphy in Dogs

Posterior capsulorrhaphy is a surgical technique performed to provide support to the stifle in your dog. The stifle is the equivalent of the knee in humans, and connects the femur (thigh bone) to the tibia (shin bone). It is naturally supported by a cruciate ligament which is a structure of ligaments that cross and hold the stifle joint in place. Failure of this ligament or other surrounding tissues to support the stifle adequately will result in discomfort and severe lameness in your dog, which must be addressed. Several surgical techniques are available to your veterinarian depending on the nature of injury or dysfunction in the joint. Capsulorrhaphy specifically involves incision into the joint capsule or repair of a tear in the joint capsule to affect and limit articulation and prevent further dislocations from occurring. This procedure is performed under general anesthetic by a qualified veterinary surgeon with orthopedic training.

Your dog will be required to fast prior to surgery. The dog will be sedated, an intravenous line will be set up, and anesthetic administered by IV, followed by the insertion of a breathing tube and gaseous general anesthetic. Your dog's vital signs will be carefully monitored while under general anaesthetic. The area above the stifle where incision or incisions are to be made will be clipped and cleaned and isolated with surgical drapes. An incision is made over the stifle to expose the stifle joint. Vessels, muscle tissues and ligaments are moved aside to expose the joint capsule. A medial arthrotomy, incision into the joint, is performed to explore the joint capsule. Tears are repaired if present. Adjacent muscles may be transected, advanced and sutured to provide more support and limit articulation resulting in dislocations. The joint is then approached laterally and a small incision made in the posterolateral joint capsule, this incision is sutured to tighten the joint capsule and tendons and tissues are folded over the patellar tendon and sutured while the joint is extended. This limits the ability of the joint to over rotate in future. The incisions into the joint capsules and the advancement of adjacent supporting structures provides medial and lateral support to the stifle in future. Incisions are sutured and your dog is put into recovery from anaesthetic where they will be monitored and provided support as needed.

Posterior capsulorrhaphy is one of a number of orthopedic surgical procedures that can be used to provide support in your dog's stifle. The efficacy and choice of procedure depends on the type of injury and radiographs performed, which will help your veterinarian determine the most effective approach. Posterior capsulorrhaphy may be used in conjunction with other procedures to tighten the structures around the joint capsule and provide better support, preventing further injury in the future. This type of procedure is usually associated with good outcome but success is dependent on the extent of injury and other factors, such as your dog's weight and physical condition.

Medications such as analgesics, anti-inflammatories and antibiotics should be administered as prescribed post surgery. The incision will need to be monitored to check for wound rupture or signs of infection. An e-collar to prevent your dog from interfering with the surgical wound may be required. 

Limiting activity post-surgery is very important to allow the repaired stifle and surrounding structures time to heal. Premature stress could cause the repair and advanced tendons and muscles to fail. Your dog may require cage rest post-surgery for several days, and have activity restricted for several weeks. Your dog should be kept on a leash when outside, and modifications made in the home, such as providing secure footing with carpets and inaccessibility to stairs or furniture they may jump on.

Physical rehabilitation may be recommended to improve your dog's recovery; your veterinarian can recommend a practitioner and an appropriate regime.

The cost of posterior capsulorrhaphy, including the cost of radiographs for diagnosis and planning, medications, anesthetic, procedure and hospitalization ranges from $1,000 to $5,000. In addition, a specialized orthopedic veterinary surgeon with training and experience can contribute to the cost of this procedure. The cost of living in your area and special or expert resources used also contribute to variations in cost.

If activity is not restricted post-surgery, failure of the tissue advancements and joint repair can occur. Surgical considerations include risks of anesthesia complications and infection. Checking to ensure your dog is healthy prior to surgery, administration of antibiotics prophylactically, and careful monitoring of your dog post-surgery mitigate these risks significantly.

Some lameness and restriction of movement can occur post surgically; results vary from individual to individual.

Regular veterinary care, adequate exercise in a safe environment with secure footing, and a healthy diet will reduce the likelihood of stifle joint disorder occurring. Obesity is a major contributing factor to stifle joint failure and maintaining a healthy weight in your pet will reduce the risk of posterior capsulorrhaphy being required in your dog. Preventing injury that could result in dislocation mitigates the likelihood of stifle injury occurring that requires surgical intervention.  Monitoring and restricting your dog when outside can prevent motor vehicle accidents and injury from incidents with other animals. Slips and falls are also a contributor and ensuring your dog's household and outside environment are free from hazards that could cause these is recommended.