Torn cranial cruciate repair at Santa Fe Veterinary Clinic performed by Dr. Blake Robberson (DVM)

Here at Santa Fe Vet Clinic, Dr. Blake Robberson can repair a torn cruciate ligament with a surgical procedure called a Modified Maquet Procedure (MMP). Below is more information about the surgery if you think your dog is a candidate for MMP surgery.

What is MMP surgery for dogs?

The Modified Maquet Procedure is a procedure used in surgery to repair a ruptured or torn cranial cruciate ligament (CCL) in your dog’s knee joint.

MMP surgery helps compensate for the dog’s injured cruciate ligament (CCL) by redirecting the impact of the quadriceps muscles. This procedure takes advantage of the strong patellar tendon to bring the tibia back to a normal location. A titanium Orthofoam wedge implant provides stability as well as promotes healing and accelerated bone growth. This wedge improves the tension on the patellar tendon to make up for the torn cruciate ligament.

Why would my dog need MMP Surgery?

The MMP surgery is used to treat pain and immobility while also preventing crippling arthritis due to the injured cruciate ligament. Without surgery, dogs will continue to limp and have painful mobility issues even if they do not express it.

 A limping dog is a dog in pain, even if they don’t yelp every step.

There is also potential of a meniscal injury/tear if the torn CCL is left untreated. The meniscus is the “cushions” between the femur and the tibia. Severe arthritis of the knee will occur if not treated. Pain meds/ NSAID are a temporary “band aid” that may help your animal feel some relief, but keeping your pet on pain meds for long durations is not recommended for their health long term.

How will I know if my dog tore their CCL?

A torn CCL can happen immediately in dogs after jumping, twisting, running, or other sudden trauma to the knee. It also can gradually happen over time and will continue to get worse with excessive activity.

The following signs can indicate your dog has an injured CCL:

*All a sudden your dog is limping on its hind leg. A dog that is “toe touching” (barely putting any weight on its leg) on its hind leg is a classic presentation of a dog with a torn CCL.

*Your dog is limping for a long duration (Weeks to months) of time with little to no improvement.

*Lameness in hind leg or legs

*Your dog’s gait (the way they walk) changes

 

Are there multiple options for fixing a torn CCL?

There are a couple different procedures that will fix a torn CCL. One of them is called a tibial plateau leveling osteotomy or TPLO for short.  A TPLO surgery involves cutting, rotating and changing the position of the tibia bone. Bone plates and screws hold the bone graft in place.

There are a few reasons why your veterinarian may recommend MMP surgery over TPLO surgery for your dog. Although every case is different, the MMP surgery is typically far less invasive than TPLO. It also gets your dog back to normal function around the same percentage as the TPLO. As a result, MMP recovery time is fast, and patients do very well.

MMP Recovery

As with all dog knee injuries, your dog needs plenty of rest and limited physical activity during MMP recovery. Make sure your dog does not have access to stairs. Prevent them from running and jumping (even inside your home). Sometimes crating them is best if the dreaded mail man will provoke them to charge the door.

Walk your dog on a leash (to prevent running, jumping and reinjury) for the first two-three weeks post-surgery.

Within 2 days: Your dog should be able to bear some weight on the post-operative leg while walking. Sometimes they can bear full weight. Ensure your dog is walking slowly enough to put weight on the limb.

After 14 days: The sutures are removed or are dissolving (depending on the type of suture used). Take your dog on multiple slow 20-minute leash walks. Your pet should be using the operated limb with increased confidence. Some lameness of the limb could still be noticeable.

After 4 weeks: Your dog should be walking strongly on the operated limb. 20-minute leash walks are crucial during this time. Increasing the duration of walks is encouraged to help strengthen the limb.

After 4-6 weeks: Your dog will come back into the clinic for X-rays to confirm everything is healing according to plan. After this visit, activity levels are likely to gradually increase back to normal depending on the recommendation of Dr. Robberson and X-ray results.

After 8-10 weeks: Your pet should be back to normal activity with little to no activity restrictions after gradually introducing off-leash walks. Some stiffness of operated limb may be noticeable after intense exercise, which is normal.

After 6 months: Your pet should be able to run free and not display lameness. There might still be stiffness when first getting up or after playing rough. However, you should expect to see persisting stiffness after rest and lameness to decrease and in most cases disappear.

 MMP Surgery Cost

If your dog is a candidate for MMP surgery. Dr. Robberson will provide a quote at the time of your consultation. The weight and size of each patient impact the quote; the appropriate size Orthofoam wedge and staple(s) are ordered specifically for your dog. Also, large dogs require more anesthetic medications than smaller dogs because these medications given are based on the weight of each patient.

I think my dog has a torn CCL. What do I do next?

Call the clinic at 405-341-5634. You will be made an appointment for you and your pet to come see Dr. Robberson. At the time of your appointment the assistant will ask you about the history of your pet’s limping/ lameness of limb, followed by Dr. Robberson coming and personally speaking with you while also examining your pet. X-rays will be completed of the problematic limb. After Dr. Robberson examines your pet and looks at the X-rays, he will then be able to determine if your pet is a candidate for MMP surgery. If your pet is a candidate for MMP surgery, Dr. Robberson will give you a quote for your pet’s surgery and scheduling a day for the surgery will follow.

Please Note: *Some patients may require sedation to allow us to get the best radiographic images of your pet’s limb. Same day sedation may not always be possible, if your pet needs sedation you may be asked to bring them back on a different day to allow us the time to perform X-rays*