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Dog Knee Brace for Torn Ligaments

 

If your dog is suffering from an anterior cruciate ligament tear, you may be wondering whether the use of a dog knee brace for torn ligaments may turn out being helpful in your dog’s recovery.  The use of knee braces for dog ligament tears are often a subject of controversy, there are those who advocate its use and those who seem to think they cause more trouble than anything else. Following is some information about the use of dog knee braces for torn ligaments.

Picture of dog cruciate ligament

A Word About Torn Ligaments

In order to better understand how dog knee braces work, evaluating what happens when a dog tears a knee ligament can be helpful. A dog’s knee joint is kept stable courtesy of two ligaments connecting the dog’s femur and tibia.

These two ligaments criss-cross each other, just like the letter “x,” (see picture) hence, the term “cruciate” which derives from the word “cross.” These ligaments are respectively known as the anterior cruciate ligament (ACL) and the cranial cruciate ligament (CCL).

In particular, the ACL is the ligament that’s infamous for rupturing more often in dogs. Because the ACL stabilizes the dog’s knee joint ( keeping the tibia from slipping forward), when it breaks it’s known for producing a lack of stability that is recognized by the vet when he or she performs the “drawer test.

Toe touching in a dog with a knee ligament tear

Function of Dog Knee Braces 

The lack of instability in the joint which happens when a dog tears a ligament, is known for causing discomfort and pain in dogs when they are moving. The tibia’s repeated slipping forward  movement often ends up damaging the cartilage lining of the joint  This is where the use of a brace comes into place. A dog knee brace’s main function (when manufactured correctly) would be to provide support and stability to the dog’s knee joint.

The use of a brace may be temporary or prolonged. A temporary example would include dogs suffering from bilateral tears. In this case, a custom brace may be used prior to surgery to provide stability to the leg that won’t undergo surgery or afterwards as the dog is recovering. A prolonged use example would instead include the use of the brace for dogs who are not candidates for surgery.

Some people also opt to use a brace  in the opposite knee  to help prevent injury to that knee (many dogs tear the other knee months later due to it bearing most weight during the injury).

Regardless of their use, braces, as mentioned, are often a subject of controversy. Some people swear by them while others (even vets!) provide negative feedback. It would be interesting at this point to see what surveys on the use of dog knee braces for ACL tear have to say.




What Surveys Say 

A survey was published in the Journal of the American Veterinary Medical Association which focused on client satisfaction using braces to treat cranial cruciate ligament tears versus having  dogs treated  with surgery through  a procedure known as tibial plateau leveling osteotomy (TPLO). The survey results provided interesting findings.

According to the survey, owners of dogs who had undergone TPLO had a significantly higher satisfaction rate versus those who had their dogs were a brace. When asked whether they would choose the selected treatment plan again (brace or TPLO) respondents in both groups respectively reported they would choose the selected treatment again.

Most importantly, 5 percent of owners of dogs who underwent TPLO reported complications from the surgery, while 46 percent of owners of dogs wearing braces reported complications. What kind of complications can wearing a dog knee brace cause? Following are some of them.

Skin Problems from Dog Knee Brace

Skin problems were what most owners of dogs wearing the brace reported as a complication in the survey mentioned above.  This seems to happen even though some braces are custom-made for that particular dog.

Looking back at the survey results, it was found that 46 percent of dog owners reported that their dogs developed skin lesions from use of the brace, out of which 32 percent required medical attention.

How do skin lesions develop in dogs wearing a brace? It can happen that an ill-fitting brace may cause friction to the skin when it rubs against the brace, causing wounds, as explained in the quote below.

“While braces that are not custom-made are more affordable and easily acquired, they do not support the stifle or eliminate instability. Furthermore, if the brace is not designed to fit a specific patient, rubbing of the skin against the brace can lead to skin wounds.”~Brittany Jean Carr, DVM, and David L. Dycus, DVM, DACVS

Negative Impact on Legs

The survey also showed some numbers when it comes to lameness in affected dogs. A large number of owners of dogs treated surgically (98 percent) reported seeing little or no lameness in dogs during recovery times after TPLO surgery. In the dog knee brace group instead, 88 percent reporting seeing little or no lameness after using the brace.

Other potential problems include loss of muscle mass. According to veterinarian Dr. Andy, this is likely to occur when preventing normal use of the leg, which leads to the muscles shrinking from not being utilized.




Possible Non-Acceptance

This is not really a complication, but something worthy of considering when thinking about using a brace: not all dogs will readily accept it. Yes, many dogs may eventually get used to wearing a brace over time, especially if time is spent in creating positive associations with wearing it (just like with a muzzle!) but some dogs may be reluctant to wearing it. There are often many straps and clips and fasteners and dog may not stand still long enough to have it fit and may grow impatient.

This is not just an issue of psychological acceptance, but there’s a physical component too. If the dog is not comfortable wearing the brace, then he will change his gait and at that point, the orthotic device is no longer beneficial, warns Dr. David Dycus, a veterinary surgeon.

Looking back at the survey results, 7 percent of dog owners reported that the dog never got to tolerate wearing the orthotic device. This intolerance may stem though from issues with proper fit or skin issues.

“While further study is still needed to assess the kinetic and kinematic effect of custom stifle orthotics, this study demonstrates that custom canine stifle orthotics allow for improved weight bearing on objective gait analysis and satisfaction in terms of function by validated client survey. “~B.J. Carr et al, Veterinary Evidence

The Bottom Line

While several dog owners may be satisfied from the use of a knee brace for a dog’s torn ACL, it’s important to keep in mind potential complications such as persistent limping, skin lesions,  intolerance and the need for subsequent surgery. On top of that, multiple device adjustments and wear and tear from repeated use should be factored in when considering costs. Therefore, it’s important to weigh the pros and cons especially considering that a dog’s knee brace can easily cost anywhere between $500 and $1,000.

 References:
  • Hart JL, May KD, Kieves NR, et al. Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs. J Am Vet Med Assoc 2016;249(4):391-398.
  • DVM360: To Brace or not to brace?
  • DVM360: Brace yourself: Client satisfaction with orthotics vs. TPLO for cranial cruciate ligament injuries
  • Today’s Veterinary Practice: Practice to Practice, Canine Orthopedic Devices
  • Carr BJ, Canapp Jr. SO, Meilleur S, et al. The use of canine stifle orthotics for cranial cruciate ligament insufficiency. Veterinary Evidence Online 2016

Photo Credits:

    • Knie_hund_beschriftet.jpg: Florian Scheuerer, derivative work: Rexmania Creative Commons Attribution-Share Alike 3.0 Unported, 2.5 Generic, 2.0 Generic and 1.0 Generic license.


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