Laurie's Blogs.

Dear Laurie,

I wondered if I could pick your brain??

Next week my colleague and I will have a dog referred to us immediately following a total knee replacement. These operations are not carried out in the UK very often, and I was wondering if you had experience of dealing with a dog after this type of operation?

The vet has asked for a Physiotherapy Plan from us, and I was just wondering what sort of things you would include in this, and what timescales you would apply.

Thank you very much in anticipation.

Kind regards

S 

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Hi S,

You know, I've not seen a TKR in a dog before... none of our locals vets are doing them as far as I know.  However I have treated them in people.

I'd draft it like this... but I'll let you fill in the blanks:

Early Stage: i.e. first 2 - 3 weeks.

Manage swelling - i.e. ice, effleurage, modalities, grade 1 - 2 mobs

Manage pain - i.e. ice, modalities, grade 1 - 2 mobs

Prevent loss of ROM

Promote healing - i.e. modalities

Advise on home management - i.e. safe flooring, do's & don'ts

Encourage early / safe weight bearing / weight shifting - i.e. figure of 8 walking, cookie exercises

Mid Stage: from week 3 - 6 

Attain full ROM - i.e. sit practice

Strengthening - i.e. water treadmill, land treadmill, hill walking, cavalettis...

Proprioception - i.e. use of wobble board, balance exercises, backing up

Treat secondary issues - i.e. myofascial trigger points, tight muscles, spine issues

Late Stage: week 6 and on...

Advanced strengthening - i.e. steep hill walking, tug of war, sit to stand facing up hill, step-ups, 3-leg squats...

Advanced proprioception - i.e. balance exercises on balls / uneven surfaces, Walk on a narrow plank, balance on a narrow plank.

I hope this helps a little... I don't have a protocol, but I have always taught in a way to try to make people think and figure it out, so they can approach anything thrown at them.  If you think Goal first, then you can come up with what achieves that goal as your second step.

Best of luck!

Cheers,

Laurie