Total Knee Replacement (TKR) Procedure for Dogs
The doctors at the ACCESS Bone and Joint Center have been successfully performing total knee replacement surgeries on dogs since 2018. While it’s a less known procedure than a total hip replacement, it’s the only procedure that can restore near-normal mobility and function to dogs with debilitating end-stage knee osteoarthritis.
Knee OsteoarthritisÂ
Similar to humans, knee osteoarthritis in dogs is a degenerative, “wear-and-tear” type of arthritis that occurs when the natural cushioning between joints – cartilage – wears off. It often occurs in older dogs of medium to large size but can also affect younger pets due to developmental abnormalities, trauma, weight gain, or other conditions. Â
Total Knee Replacement procedureÂ
Total knee replacement is a surgical procedure in which the entire damaged knee joint is removed and replaced with a prosthesis designed to restore pain-free knee function.
This surgery is very similar to that carried out on humans. During surgery, the knee joint is exposed through an incision on the side of the knee. The surgeon replaces the joint surface, ensures stability, and verifies that the knee moves smoothly through a full range of motion. Â
Advantages of a Total Knee Replacement
- It closely mimics the mechanics of a normal elbow jointÂ
- It  fully restores near-normal mobility and function of the knee
- It eliminates or reduces the need for pain medicationÂ
Knee Joint Before and After Surgery
Total Knee Replacement FAQs
A total knee replacement is recommended when knee joint pain can no longer be effectively controlled with drug therapy and physical rehabilitation.
Total Knee Replacement is not recommended when infection is part of the problem or when the supporting ligament is weak or damaged and can’t support an implant. Your pet needs to be in overall good physical and neurological health. Â
The commercial knee implants are currently available for large breed dogs. However, custom implants might be an option for smaller pets. This is determined on a case-by-case basis. Â
After a total knee replacement, your pet will be able to bear weight on the operated limb immediately for walking and standing, but the activity level will need to be restricted for approximately 12 weeks. The first 6 weeks need to be stringent. There can be no running, jumping, playing, or access to stairs and a sling should be used when walking. At home physical therapy exercises, such as passive range of motion and weight shifting are highly encouraged. At the 12-week mark, most pets are cleared for a progressive return to normal activity.
Yes, patients will be hospitalized overnight following a total knee replacement procedure. In some instances, two-three nights might be necessary. Our 24×7 hospital is the best place for your pet to recover after surgery under the monitoring of our staff.
The prognosis for a total knee replacement is very good for return to near normal function.
The most significant risks associated with total knee replacement surgery are implant loosening, damage to the supporting ligaments, and infection. Most complications occur during the first few weeks after surgery and can be addressed successfully. Infection can occur up to a year after surgery (and potentially even later). The risk of loosening is also rare. Careful postoperative management can prevent damage to the supporting structures of the knee.
Medical management using NSAIDs (non-steroidal anti-inflammatory drugs) can successfully alleviate knee pain – especially when combined with activity modulation, weight control, and physical rehabilitation. Conservative management doesn’t treat osteoarthritis but rather helps manage the discomfort associated with this condition. At some point, medical management can become ineffective, at which point a total knee replacement might be recommended.
Surgical fusion of the knee (arthrodesis) might be considered. Fusion will likely remove the pain associated with the joint, but the functionality will be subpar as the knee joint will no longer bend and will be fused at a pre-defined angle. Amputation of the limb will be the last resort option for patients that no longer use their limb.
If you believe your pet might benefit from a total knee replacement, consult your primary vet or schedule a consultation with one of our orthopedic surgeons at the Bone and Joint Center.
With thousands of procedures performed, Dr. Laurent Guiot and Dr. Reunan Guillou are the leading veterinary orthopedic experts on the West Coast.