Understanding the Unstable Stifle: Causes, Symptoms and Treatment Options.

Dogs are known for their agility and boundless energy, but just like humans, they can also suffer from various orthopaedic issues, one of which is an unstable stifle. The stifle joint in dogs is equivalent to the human knee joint and is crucial for their mobility. When this joint becomes unstable, it can significantly affect a dog's quality of life. In this blog, I will delve into the causes, symptoms, and treatment options for an unstable stifle joint

The stifle joint in dogs is a complex structure that comprises the femur (thigh bone), tibia (shin bone), and patella (kneecap), along with various ligaments, tendons, menisci and cartilage which covers the joint surface. The stifle joint provides stability and flexibility necessary for various activities like walking, running, and jumping.

Causes of an Unstable Canine Stifle:

1. Cruciate Ligament Tears: One of the most common causes of an unstable stifle in dogs is a torn or ruptured cranial cruciate ligament (CCL). This ligament plays a vital role in stabilizing the stifle joint, and when it tears, it leads to instability and if left unmanaged secondary osteoarthritis.

2. Patellar Luxation: This condition occurs when the dog's kneecap dislocates from its normal position, leading to instability and discomfort.

3. Traumatic Injury: Direct trauma to the stifle joint or surrounding structures can cause instability.

4. Genetics: Certain breeds are predisposed to orthopaedic issues, including stifle instability. Breeds like Labrador Retrievers, Golden Retrievers, and German Shepherds are among those commonly affected.

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Symptoms of an Unstable Canine Stifle:

• Limping or favouring one leg.

• Difficulty rising or sitting.

• Lameness, especially after exercise or physical activity.

• Swelling around the stifle joint and within the joint – a joint effusion.

• Audible popping or clicking sounds during movement – normally caused by torn menisci.

• Reluctance to bear weight on the affected limb.

Diagnosis and Treatment Options:

If you suspect your dog has an unstable stifle, it's crucial to seek veterinary attention promptly. A veterinary surgeon will perform a physical examination, which usually includes palpation of the joint to assess stability and range of motion (how well it can flex and extend).

Two tests are particularly useful in assessing Cranial Cruciate Ligament disease – the cranial drawer and the tibial thrust and these can be seen in the videos below. Additional diagnostic tests such as X-rays are often requested to evaluate the extent of the injury and plan appropriate treatment.

Treatment options for an unstable canine stifle will vary depending on the underlying cause and severity of the condition. Some common approaches include:

1. Conservative Management: Mild cases of stifle instability may respond well to conservative treatments such as rest and restricted activity, anti-inflammatory medications, physiotherapy, hydrotherapy and of course, clinical canine massage.

2. Surgery: In cases where conservative measures are ineffective or if there's significant ligament or structural damage, surgical intervention may be necessary. Procedures such as a TPLO (Tibial Plateau Leveling Osteotomy), TTA (Tibial Tuberosity Advancement) or Cranial Closing Wedge Osteotomy (CCWO) are used to manage cruciate disease. Tibial crest transplantation and deepening the trochlear groove (a groove in the femur in which the patella sits) can be performed to correct a luxating patella.

3. Rehabilitation: Physical therapy and rehabilitation exercises can aid in strengthening the muscles around the stifle joint, improving range of motion, and promoting healing post-surgery.

4. Clinical Canine Massage can be used to address areas of overcompensation, hypertonia (high toned muscles), Trigger points (hyperirritable bands of focal point tension within the muscle tissue and myofascial pain.

5. Weight management is important for managing a dog with an unstable stifle. Excess body weight places unnecessary strain upon the joints and adipose (fat) tissue releases degradational enzymes that damage the surface cartilage of a joint.
   

Conclusion:

An unstable stifle can significantly impact a dog's mobility and overall well-being. Early detection and appropriate treatment are essential for managing the condition effectively and preventing long-term complications such as osteoarthritis. By understanding the causes, symptoms, and treatment options for an unstable canine stifle, pet owners can provide the necessary care and support to help their dogs lead active and comfortable lives.

If you suspect your dog is experiencing stifle instability, don't hesitate to consult with your veterinary surgeon for guidance and personalized treatment recommendations.