I have a client with a 4 year old rescue Golden Doodle. He is a little over a weight 7/9 (100#)but is a large boned dog.With a partial torn cruciate. Owner would like to try and avoid surgery until they retire in about 2 years.
Owners are interested in a stifle brace and doing conservative management. Along with rehab exercises and laser.
Do you feel the brace will be beneficial? If so do you have a manufacturer you recommend? Would it be better just to rehab him and not get a brace.
Thank you,
Korey Kennedy, LVT, CCRP
When to use a stifle brace?
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David Lane
- Posts: 164
- Joined: Mon Oct 24, 2016 10:51 pm
Re: When to use a stifle brace?
A few point form thoughts:
• kinematic studies have shown that a stifle brace allows improved weight bearing relative to no treatment, but not as much as surgery does - kinda part way between the two
• another study found that although braces did not allow the same improvement in function that surgery does, owners that selected braces instead of surgery were still largely happy with their decision
On a more subjective level, I tell clients the following:
• Braces work best for partial tears, and not at all when there is a meniscal tear
• The goal of a brace is to gain improvement for low key exercise (eg leash walks); it will not provide enough stability to allow the dog to rip around in the woods without consequence
• Braces need to be coupled with a weight loss and hindlimb strengthening program
With this case:
• I’ve used hero braces a lot, and a few other companies as well. I’ve not experienced one that is superior to the others
• If this is a hyper 4yo, then I am skeptical of the benefits of bracing, and would suggest surgery if it is at all possible. A partial CrCL tear in a mellow dog that doesn’t really need a lot of activity anyway, may do well with a brace plus rehab
• Brace or no brace, if they can’t prevent flare ups or stiffness of the knee after activity, then there is a good chance that in 2 years time there will be advanced stifle OA which will impede a return to full activity, even with surgery
• If they want to go the conservative route, I would encourage getting a brace at least for the short term. Depending on how the weight loss and fitness training goes, it may not be needed as much in the long term
• kinematic studies have shown that a stifle brace allows improved weight bearing relative to no treatment, but not as much as surgery does - kinda part way between the two
• another study found that although braces did not allow the same improvement in function that surgery does, owners that selected braces instead of surgery were still largely happy with their decision
On a more subjective level, I tell clients the following:
• Braces work best for partial tears, and not at all when there is a meniscal tear
• The goal of a brace is to gain improvement for low key exercise (eg leash walks); it will not provide enough stability to allow the dog to rip around in the woods without consequence
• Braces need to be coupled with a weight loss and hindlimb strengthening program
With this case:
• I’ve used hero braces a lot, and a few other companies as well. I’ve not experienced one that is superior to the others
• If this is a hyper 4yo, then I am skeptical of the benefits of bracing, and would suggest surgery if it is at all possible. A partial CrCL tear in a mellow dog that doesn’t really need a lot of activity anyway, may do well with a brace plus rehab
• Brace or no brace, if they can’t prevent flare ups or stiffness of the knee after activity, then there is a good chance that in 2 years time there will be advanced stifle OA which will impede a return to full activity, even with surgery
• If they want to go the conservative route, I would encourage getting a brace at least for the short term. Depending on how the weight loss and fitness training goes, it may not be needed as much in the long term
David Lane DVM
ACVSMR, CVA, CVSMT, CCRP
ACVSMR, CVA, CVSMT, CCRP
Re: When to use a stifle brace?
I would agree with David on just about all points.
With a young dog active, it's tough. With an older and/or more placid dog, it can be great.
All in all, rehab is key!
I also like Hero braces... and check out the Discount section, because FourLeg Members can get a discount!
We've used them on plenty of full tears with great success. I tell the owners to plan of 'life in a brace' no matter what for a full year. At that time, there seems to be sufficient fibrosus to help stabilize the joint.
And keeping the meniscus intact is key for minimizing OA development.
All the best!
Laurie
With a young dog active, it's tough. With an older and/or more placid dog, it can be great.
All in all, rehab is key!
I also like Hero braces... and check out the Discount section, because FourLeg Members can get a discount!
We've used them on plenty of full tears with great success. I tell the owners to plan of 'life in a brace' no matter what for a full year. At that time, there seems to be sufficient fibrosus to help stabilize the joint.
And keeping the meniscus intact is key for minimizing OA development.
All the best!
Laurie
LAURIE EDGE-HUGHES
Re: When to use a stifle brace?
Oh! And check out the video for bracing, and the articles for a Rehab Protocol for Use of a Stifle Brace.
Laurie
Laurie
LAURIE EDGE-HUGHES
Re: When to use a stifle brace?
We have also worked with Hero brace and have had a great experience with them.