Immediate physical therapy in dogs with rupture of the cranial cruciate ligament submitted to extracapsular surgical stabilization

Abstract

The study evaluated the influence of immediate physical therapy on the functional recovery of hind limbs of dogs with experimental cranial cruciate ligament rupture which underwent surgical extracapsular stabilization as well as to verify its interference in joint stability. Eight dogs were randomly divided into two groups: GI (control) (n=4) and GII (physical therapy) (n=4). The dogs in GII underwent the following therapeutic treatments in the postoperative period: cryotherapy, passive joint movement, massage, passive straightening, neuromuscular electrical stimulation, hydrotherapy (bath and aquatic mat) and therapeutic exercises. We performed evaluations of the thigh circumference, goniometry, X-ray, and knee stability (drawer test). Results did not demonstrate a significant difference between the groups nor between different post-operative times. Regarding gait analysis, we found that the 4 dogs in GI remained in degree 3 of lameness 45 and 90 days postoperatively. However, in GII, one dog remained in degree 3 45 and 90 days after surgery; one dog changed from degree 3 to 4 90 days after surgery and the other 2 dogs changed from degree 3 to 5 90 days after surgery. It is possible to conclude that dogs with CCL rupture that undergo immediate physical therapy demonstrate better results in regards to functional gait recovery. The therapeutic modalities used in the immediate postoperative period did not cause instability of the operated knee. Further studies are needed with a larger number of dogs to indicate the immediate physical therapy in dogs with CCL ligament rupture which underwent extracapsular stabilization.Keywords: dog, knee, surgery, physiotherapy, trauma RESUMO Avaliou-se a influência da fisioterapia imediata na recuperação funcional do membro pélvico de cães com ruptura experimental do ligamento cruzado cranial (LCC) submetidos à estabilização cirúrgica extracapsular e verificou-se sua interferência na estabilidade articular. Foram utilizados oito cães distribuídos, aleatoriamente, em GI ou controle (n=4) e GII ou fisioterapia (n=4). Nos cães do GII, as modalidades terapêuticas empregadas no pós-operatório foram crioterapia

Cranial Cruciate Ligament Rupture in Dogs: Review on Biomechanics, Etiopathogenetic Factors and Rehabilitation

“…The strengthening of the periarticular muscles, especially in dogs who are more reluctant to exercise, can also be obtained by neuromuscular electrical stimulation (NMES); this technique is simultaneously effective in reducing edema and pain and in promoting joint mobility [ 183 ]. In a 2008 study, Pellizzari and collaborators demonstrated that NMES can increase the thigh circumference in dogs suffering from atrophy following knee immobilization [ 199 ], confirming the previous results obtained by Johnson and collaborators in 1997 [ 164 , 200 ]. To provide greater stability to the hindlimbs during normal daily activities and to prevent improper movement of the stifle joint, rehabilitation programs also include exercises aimed at strengthening the core muscles.…”

“…Rehabilitation can play a pivotal role in restoring the functionality of the injured limb [ 162 , 163 , 164 , 165 , 166 , 167 ]. Regardless of the therapeutic option, the objectives of the rehabilitation protocols are pain management, recovery of normal joint kinematics, periarticular and core muscles strengthening, and correction of proprioceptive deficits [ 156 , 158 , 159 , 162 , 166 , 168 , 169 , 170 , 171 , 172 , 173 ].…”

Effects of early postoperative rehabilitation with physiotherapy in the cranial cruciate ligament ruptured dogs stabilized with extra capsular technique

“…Moreover, after the 90 th day post-operative radiographic scores didn't differ significantly from preoperative values which imply that the joints after surgery were stable and no severe osteoarthritis was observed which supports the findings of Jerre (2009). Lameness Score and weight bearing score: The results of lameness and weight bearing are in accordance with Berte et al (2012) who observed improvement in gait in case of physiotherapy group as compared to non physiotherapy group who concluded that the dogs with CCL rupture that undergo immediate physical therapy demonstrate better results in regards to functional gait recovery. Marsolais et al (2002) also observed significant difference in limb function (peak vertical force and vertical impulse) among the physiotherapy group and exercise restricted group.…”

“…Thigh girth: The increase in muscle mass had been seen in the physiotherapy group as compared to non physiotherapy group might be due to improved gait and similar findings have been reported by Johnson et al (1997) who suggested that improvement in gait, weight bearing lameness and a decrease in bony changes. Berte et al (2012) all supports that the neuromuscular electrical stimulation and exercise might assist in the prevention of the atrophy by disuse of the operated limb.…”

“…Similar findings have been reported by Marsolais et al (2002) between the physiotherapy group and non physiotherapy dogs were dogs the with physiotherapy benefit from postoperative rehabilitation and suggested that the rehabilitation should be considered part of the postoperative management of these patients. Berte et al (2012) concluded that dogs with CCL rupture that undergo physical therapy immediately after surgical extracapsular stabilization demonstrated better results regarding functional gait recovery. Furthermore, therapeutic modalities used in the immediate post-operative period did not cause instability of the operated knee, which was also observed in the present study.…”