Traumatic Patellar Tendon Rupture

[lehughes]

Hi Laurie

I hope you are fine, and I look forward to seeing you in April at the STARR conference!

Yesterday I was referred an 8 year old small münsterländer (size of a border collie) with traumatic patella tendon rupture. He had surgery yesterday and was casted for 7 days. Would you suggest a brace/orthotic where I can set the flexion angle? I have no experience with pat.tendon rupture in dogs. What would you recommend?

If you like you can post the case at the forum too!

Thank you for your help.

Regards from Switzerland,

Yvonne

[lehughes]

Hello Yvonne!

Nice to hear from you. I will look forward to visiting in April!

I have never seen anything like what you describe either! It sounds crazy!!

I would think that it is ROM that you will need to gain… when able to. From what I’ve experienced with pinned tendons, you don’t really push for stretching / tensing it until about the 8 week mark, when the attachment should be solidified. Up until then, any mid range activity would be good.
Which will be tricky for a patellar tendon… after the 8 weeks, you will have a very stiff leg.
All in all, I think that the dog will likely self limit stretching it too far and will likely side-sit or stick the leg out… so you might not have to worry about a brace.
But the owner will need to keep the dog very calm.
I had a biceps tendon re-pinning case last year, and keeping that dog calm was the hardest thing.
We did UWT and the owner did leash walks… and she managed fine. But it was hard for such an active dog.
Your job will be hardest at 8 weeks when you have to regain the flexion.

I hope this helps!

Cheers,

Laurie

[David Lane]

In the past for this situation, I have used a rigid orthotic with a tamarack hinge locked out for the 1st 8 weeks then increasing ROM for the 9-16th week. Over that initial 8 week period, on a daily basis, the brace was removed with the dog in lateral recumbency and relaxed (if dog won't relax and might explosively and suddenly struggle, then I would consider trazadone), so that the stifle can be put through an ROM up to the point of tension on the patellar tendon but not beyond.

Slow progression of increasing ROM and tension on the patellar tendon after that 8 week mark as with any tendon issue.