Radiofrequency-induced thermal capsulorraphy
Posted: Mon Nov 26, 2018 7:47 am
I have a patient coming this week having had a RITC done two weeks ago. As the suregoen I work with doesn't perform these (because he doesn't like this technique for MSIs) I have never rehabbed one before and need some advice.
1 I know this is a somewhat debated technique and that some surgeons really like it and others don't. Any opinions on wether or not this is a good tehnique or not, and wether or not it carries a good prognosis? What I'm most conserned about in this patient is that I examined it before the surgery (owner came to see me because no one had managed to figure out what was wrong with his dog) and when I tested for MSI I felt a clunk which was present every time the shoulder was placed in abduction. When I measured the abduction angle I stopped at 58 degrees because I didn't want to cause the patient any pain, but I think that the abduction angle was significantly more than that as I didn't feel that I was getting close to the end-range. I'm thinking that in this case a different surgical techinque would have been optimal anyway due to severity...
2 Owner has sent me the information he got from the surgeon and it says that he could most likely start off leash excercise at 8-10 weeks after surgery. I'm thinking that this is far too early. Particularly as this is a hunting dog used for hare-hunting and if they are let loose they tend to run for 1-2 hours if they end up following an animal. My thought is that 4-5 months is more realistic and then after a period of more activity spesific retraining. Any opinions? In the litterature I've been reading hobbles are recommended for 12 weeks and then gradually removed over a period of time so if that's the case I'm thinking that off leash after 8-10 weeks could be detrimental.
3 In the litterature I've read it says that modalities aimed at reducing inflammation should not be used. However it doesn't say for how long after the surgery. The owner was recommended frequent laser treatments from the clinic that did the surgery. At which point would it be safe to start lasering the shoulderjoint?
Luckily the vet who performed the surgery wrote that the owner should follow the advice of the rehab-professional, so if I want to do things differently than outlined that would probably be fine as long as I manage to clearly explain to the owner why I want to do things differently (I think the off leash part will be most difficult because owners, and partiularly hunting-dog owners, are always sooo eager to start off leash training). The dog was operated in a different part of the country and they've not planned for any follow up appointments there so the follow up will probably be done with one of our vets and me. I would be really greatful for any advice on how to approach this patient. Thanks in advance
Best
Sunniva
1 I know this is a somewhat debated technique and that some surgeons really like it and others don't. Any opinions on wether or not this is a good tehnique or not, and wether or not it carries a good prognosis? What I'm most conserned about in this patient is that I examined it before the surgery (owner came to see me because no one had managed to figure out what was wrong with his dog) and when I tested for MSI I felt a clunk which was present every time the shoulder was placed in abduction. When I measured the abduction angle I stopped at 58 degrees because I didn't want to cause the patient any pain, but I think that the abduction angle was significantly more than that as I didn't feel that I was getting close to the end-range. I'm thinking that in this case a different surgical techinque would have been optimal anyway due to severity...
2 Owner has sent me the information he got from the surgeon and it says that he could most likely start off leash excercise at 8-10 weeks after surgery. I'm thinking that this is far too early. Particularly as this is a hunting dog used for hare-hunting and if they are let loose they tend to run for 1-2 hours if they end up following an animal. My thought is that 4-5 months is more realistic and then after a period of more activity spesific retraining. Any opinions? In the litterature I've been reading hobbles are recommended for 12 weeks and then gradually removed over a period of time so if that's the case I'm thinking that off leash after 8-10 weeks could be detrimental.
3 In the litterature I've read it says that modalities aimed at reducing inflammation should not be used. However it doesn't say for how long after the surgery. The owner was recommended frequent laser treatments from the clinic that did the surgery. At which point would it be safe to start lasering the shoulderjoint?
Luckily the vet who performed the surgery wrote that the owner should follow the advice of the rehab-professional, so if I want to do things differently than outlined that would probably be fine as long as I manage to clearly explain to the owner why I want to do things differently (I think the off leash part will be most difficult because owners, and partiularly hunting-dog owners, are always sooo eager to start off leash training). The dog was operated in a different part of the country and they've not planned for any follow up appointments there so the follow up will probably be done with one of our vets and me. I would be really greatful for any advice on how to approach this patient. Thanks in advance
Best
Sunniva