Keyword: Canine, TPLO, Stance Analyzer, CCL, photobiomodulation, laser therapy
Author(s): Dr. Mark Barton BVMS MRCVS, Emily Ashdown RVN, A Dip Phys, ISFMCert, CSMC, MRAMP, MIAAT, AHPR.
Signalment: Canine, 7 years old, F/S, Labrador Retriever, “Jaffa”.
History: Partial CCL rupture in the LEFT pelvic limb approached conservatively for 3 years with physiotherapy including Photobiomodulation (PBM), hydrotherapy, & pharmaceutical pain management (Tramadol). A complete CCL rupture was diagnosed on January 2, 2021. TPLO surgery was performed on January 20, Tramadol was used PRN post operatively. Due to reduced renal figures, NSAIDS were avoided.
Pre-surgical Diagnostics: Initial Stance readings taken pre and post PBM therapy. Those results were LF 33/ RF 34/ LH 3/ RH 30 (Normal= 30/30/20/20)
Post-Op Treatments: PBMt was delivered once a week for two weeks before physio assessment was able to take place.
10 days post-op Physical Exam: Overall good ROM was noted through the left stifle with some mild swelling and slight pain response in full extension. Discomfort on palpation and minor spasms were noted in the spinal segments L5-L7.
Photobiomodulation Therapy: Companion CTX-15 –
Settings: The patient was treated with 2100 total Joules (7J/cm2) delivered to the L stifle and 2300 total joules (8J/cm2) to the lumbar spine in contact with the LARGE contact treatment head.
Frequency of Treatment: After physiotherapy assessment, patient was treated twice weekly, reducing to once weekly at 4 weeks post-op and then once every 2-3 weeks over the next 8-week period.
Progress at 3 weeks Post-Op: Over the next 21 days, the patient became more weight bearing on the LH limb. Mild spasm continued in the thoracic & lumbar spine, PBMt and Tramadol were continued. Stance readings improved to LF 31/ RF 35/ LH 14/ RH 20 Progress at 8 weeks Post-Op: Good ROM noted through the LEFT stifle. Very slight hesitation in full extension but no other discomfort noted. General posture and spinal discomfort much improved. Stance readings improved to LF 36/ RF 29/ LH 16/ RH 18. PBMt session frequency decreased to every 2 weeks.
Conclusions: PBMt was a key part of Jaffa’s pain control & rehabilitation allowing for a quicker return to weight bearing and activity after surgery. The Companion Stance Analyzer was crucial in obtaining objective data post operatively. The frequency of treatment sessions were reduced at a pace that was suited to the patient & obtaining these objective measures also enabled us to move through the rehabilitation program at an adequate level, introducing strength exercises only when an appropriate level of weight bearing was achieved.