Lola, English Staffy, 12 weeks post MMP for torn ACL
What are Anterior Cruciate Ligament (ACL) tears?
This is a partial or complete tear of the ligament that runs from the back of the femur to the front of the tibia in the stifle (knee). It is painful and leads to immediate lameness in the affected leg, as it is less painful with less weight born through the affected stifle, hence the obvious limping/lameness. The vast majority of these that we see are secondary to either rotational activities (fetching) or being overweight (the joint structures are worked much harder when the body is carrying excess mass beyond design), or both.
Complete ACL tears can be diagnosed quite simply by testing for movement of the tibia relative to the femur (anterior draw sign) that should not be there. X-rays are often taken by many hospitals, often under anaesthetic, of the stifles and hips. We feel these are unnecessary in the vast majority of cases and markedly increase the cost to owners. Where there is no stifle instability and no pain in the hip or hock or back, then the problem is almost always still in the stifle joint. These are usually minor/partial ACL tears and rest (cage or tied up), weight loss where appropriate, and walking, over two to four weeks, can lead to more than half of these never requiring surgery.
There are many methods of treating torn ACL’s. We use a technique called MMP – Modified Maquet Procedure – which involves placing a titanium wedge into the tibial crest, forcing the tibia to stay in its correct location, thus preventing anterior draw sign during walking/running. Developed approximately 10 years ago, this procedure is a cost effect method of treating ACL tears. It is just as effective as Tibial Plateau Levelling Osteotomy (TPLO) - the 'gold standard' - by 12 weeks post-surgery. This technique has been performed more than 45,000 times around the world and we perform more than 100 of these surgeries every year at present.
Cost of the procedure
ACL stabilisation is usually priced anywhere from $2,500 - $5,000, depending on the surgical method chosen and where it is performed. MMP is often priced at as much as $3,500. We offer this method at $1,400 - $1,700 currently. Our margins are a lot less than what others charge - but where many hospitals perform 10 - 20 of these are year, we perform up to 150. So, whilst our margins are thin, we still make as much or more than other hospitals and at the same time, provide cost savings for our clients. A second benefit... we do a lot of them, so we are very good at it!
Recovery and aftercare
Patients can be walked from day one after surgery and this is encouraged. We see the best results where clients put in the most effort after surgery. Patients are encouraged to be walked multiple times per day after surgery, with walk lengths increasing each week from 3 - 5 minutes to 20 - 30 minutes by four to six weeks post-surgery. The vast majority of cases are 80 - 90% normal just four weeks after surgery. Some patients are less lame the day after surgery than before they had surgery! By eight to ten weeks after surgery, we are starting to have the patient spend time off lead, with full off lead by twelve weeks after surgery.
Ernesto, German Shorthaired Pointer, 24 hours post MMP for torn ACL
Bella, 8 year old German Retriever, 4 weeks post MMP for torn ACL
Ivy Bensley, Labrador, 5 weeks post MMP for torn ACL
Ernesto, German Shorthaired Pointer, 12 Weeks post MMP for torn ACL
Skin incision over medial lh stifle
Saw guide in place
Placement of titanium wedge
Placement of bone pin
Drilling holes for staple
Securing staple in place
Wedge and staple and pin in place
Closure of skin
Meet Dr. Scot Plummer
Dr. Plummer has been passionate about caring for animals since his childhood, and graduated with Honours in a Bachelor of Veterinary Science from the University of Queensland. South Eastern Animal Hospital allows him to provide your pets with the care they deserve - at a price point that is more affordable.