Do all dogs with laxity in the knee require surgery?
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(link to the beginning of Article)Keep reading to see that there is a conservative solution to this painful condition. First, right off of the bat I can tell you that neither Chiropractic style treatments or my technique, NMR-T help cruciate injuries directly. Over the years I attempted using Infrared Laser therapy to help these cases with little success. Cruciate injuries are sprains, not dissimilar to sprained ankles in humans in one respect, manipulation of the joint is very much contraindicated. In the human patient the standard for a sprained ankle or sprained knee for that matter is RICE therapy. That is, Rest, Ice, Compression, and Elevation of the injured joint. Unfortunately dogs won't sit still for such therapy. Additionally because of the anatomic angulation of the knee when standing the cranial cruciate ligament is under constant strain and stress. When a human stands with the knees straight the cruciate ligaments for the most part are not under tension. Dogs don't stand or walk with their knees straight and that's the rub. Consequently, surgery was believed to be the only remedy, inasmuch as the cranial cruciate ligament sprain would continue to be exacerbated to a greater or lesser extent by simply walking, trotting or galloping.
One other factor that was evident in the vast majority of cases was that a preexisting condition predated the cruciate ligament injury. In nearly all cases I examined over the years there were spinal issues that in my opinion had a direct bearing on why the patient was susceptible to this injury in the first place. In humans when a pinched, compressed, or injured nerve is suspected, doctors can perform an NCV test, or Nerve Conduction Velocity test. This measures how fast an electrical impulse moves along the nerve. If the test demonstrates a latency or slowness of the impulse, doctors can surmise that the nerve being tested is injured or compromised in some way. It has therefore been my contention that irritation or pressure on one or more of the lumbar nerve roots (or the spinal cord itself) is a prerequisite to making your companion more susceptible to a cruciate injury. How you might ask? Simply, in the execution of movement of the hind legs, in running for example, there is a reciprocal interplay between the flexor and extensor muscles that move the knee joint during activities like trotting or galloping. To understand this better let us explore what happens when an athlete "pulls a hamstring." Perhaps you have experienced this unpleasant injury. The mechanism is quite simple. If there is latency in the nerves exiting from the lower lumbar spine caused by compression of the nerve roots, the hamstring muscles become slow to respond to the nerve signals that tell them to completely relax as the powerful quadriceps muscles contract strongly to bring the leg forward for the next stride. Consequently the portion of the hamstring muscles that are still contracted to a greater or lesser extent and slow to release are no match for the powerful extensor muscles and they are literally torn. I have surmised for a long time that this is also the mechanism responsible for anterior cruciate injuries in dogs.
Currently, I am having great success with reducing caudal-cranial (headward) laxity of the cruciate ligament in dogs as measured by ongoing and repeated orthopedic testing, specifically Tibial Thrust and Drawer tests, in dogs that did not exhibit gross laxity and pronounced crepitus that indicated compete rupture on initial examination. The procedure involves resolving the nerve impingement using NMR-T, with concurrent and intense Light Therapy using the Petlight System and protocol. Since adopting this protocol I have only lost one patient to surgery that I initially accepted as a patient after indicating that they were a potential candidate on initial examination.