Orthotic Intervention for Animal Ankle Conditions

Tarsus

Innovative Biomechanics

The canine ankle (tarsus) is a unique joint susceptible to injury and instability. Tarsal plantigrade collapse, tarsal valgus, tarsal varus, post-op arthrodesis, and neurological presentations are common orthopedic injuries that can affect your dog’s ankle joint and cause pain and lameness. The OrthoPets Tarsal Orthosis stabilizes your dog’s ankle joint by creating a 3-Point Corrective System. This advanced biomechanical support system stabilizes your dog’s tarsus joint by applying a corrective force location supporting the tarsus joint and two counter force locations that complete the dynamic mechanical environment acting within the OrthoPets Tarsal Orthosis system.

State-of-the-Art Fabrication

Your dog’s ankle brace is manufactured in our state-of-the-art manufacturing center through a digitizing process of the fiberglass impression. The impression is turned into a 3D model that is digitally sculpted to create your dog’s tarsus brace shape. The carved model is vacuum formed with advanced plastics to create the custom made brace. Once the soft medical grade foam liner, adjustable and replaceable straps and pads are added, the device is ready for delivery.

Common Injuries:

  • Achilles Complex Injury

  • Post-Op Arthrodesis

  • Medial & Lateral Collateral Injury

  • Digital Flexor Tendon(s) Injury

  • Hyper-extension Instability

  • Neurological Positioning Control

  • Failed arthrodesis

Because an orthosis is not the correct therapy for all patients, before choosing an orthosis the following points are important to keep in mind:

  1. The device MUST be put on every morning and removed every night. The device is to be used all day everyday, but must be removed at night. It is NOT like a human knee brace, worn only for sport.  The orthosis stabilizes the stifle from the outside only when ON, while surgery does so from the inside permanently.  Because of this it must be used whenever your dog will be standing and/or moving about.  The device is not used at night and your dog must not be allowed to move about at night (jump on or off bed, wander the house, go outside through a dog door, etc.).

  2. Adjustments are expected and are a normal part of the custom orthosis process. The device is custom-made for your dog.  Every effort is made to accurately fit the device and 1 complimentary adjustment is included in order to meet the requirements for an appropriate fit; you or your veterinarian can coordinate these adjustments with Pawsthetics.  Importantly, your dog is much more active at home than at the veterinary clinic.  Increased activity and activity intensity can expose fit issues requiring further adjustment.  Additional adjustments, if needed, are most commonly required in the first few months and as time goes on.   Please follow all instructions with regard to monitoring the leg and contact Pawsthetics and/or your veterinarian promptly if you have concerns.

  3. Follow-up is critical to success.  An orthosis is considered a “durable medical device.”  This means that proper use is necessary to meet therapeutic goals and to ensure its safe application over the lifetime of your dog.  In the first few months of the fitting, your veterinary team with the help of Pawsthetics will work with you in regard to device use and rehabilitation.  Annual to twice annual appointments are advised depending on age and activity of your dog.  At these appointments your doctor will thoroughly assess your dog’s orthopedic condition and evaluate the condition and fit of the device.  Recommendations will be made for continued success in the device.  If major adjustments are required, it may be necessary to ship the device to OrthoPets with a turnaround time of 2-4 business days excluding shipping time.

  4. Even with an orthosis, surgery may be required.  When the cranial cruciate ligament is torn sometimes the meniscus is also torn.  The meniscus is a comma shaped cushion on the inside of the stifle.  There are 2, one on the middle and one on the outer side of the stifle.  The middle or medial meniscus is most commonly injured and this may occur at the time of the initial cranial cruciate injury or any time later due to too much activity on an unstable joint.  A torn meniscus is very painful and if not treated it will cause continued lameness despite stabilizing the joint with surgery or an orthosis.  If this occurs, a surgical procedure called a partial medial meniscectomy is required.  It can be done by itself or with a surgical stabilization. A torn medial meniscus is diagnosed either at surgery, by MRI (rarely), ultrasound where available, or based on clinical judgment with or without use of an orthosis. 

  5. The Role of Rehabilitation.  Whether your dog undergoes surgical or orthotic intervention for stabilization of a torn cranial cruciate ligament and whether or not surgery is required for a torn medial meniscus, it will take time to recover to full, comfortable function.  If an orthosis is part of therapy most dogs adapt quickly to wearing an orthosis.  Behavioral techniques can facilitate this.  Also your dog will need to learn basic skills while wearing the device.  These include:  transitions (sitting, lying down, and getting up), stairs, getting into vehicles safely, managing on different types of surfaces (ground, carpet, hardwood floor, etc.).  Finally, orthopedic injury leads to compensatory abnormal movement and associated muscle strain and weakness.  The best way to ensure the highest level of success is to follow recommended rehabilitation schedules and techniques.  Each patient’s condition and abilities are unique and as such an individualized rehabilitation program is needed.  Your veterinarian can help find a certified rehabilitation professional (CCRT or CCRP) in your area.

  6. A proactive approach to arthritis management is the second key to long-term success.  Just as rehabilitation is important whether your dog undergoes surgical or orthotic intervention, arthritis management is key as well.  All dogs will develop arthritis after injury to the CCL regardless of the stabilization techniques chosen.  The difference is the severity and speed of development of that arthritis.  Steps taken early on and continued throughout your dog’s lifetime will make a difference in terms of regaining and maintaining comfort and an active lifestyle well into the senior years.  Your family veterinarian or a pain and mobility specialist can create an individualized, integrative arthritis management plan for your animal.

  7. Orthoses (braces) for dogs are a new solution to an old problem.  Modern medicine moves forward at a rapid pace.  It takes a lot of time and many tens of thousands of dollars to perform a controlled clinical trial to compare a new therapy to the standard therapies in common use.  As such, there is no published study directly comparing use of a stifle orthosis to surgical stabilization for CCL injury in the dog.  As the industry leader using our unique, anatomically aligned, and mechanically sound custom design, OrthoPets provides stifle orthoses for nearly 1,000 dogs per year.  This level of experience allows us to carefully select the patients best suited for a stifle orthosis; design appropriate rehabilitation protocols for best success; and troubleshoot interesting individual patient challenges.  This is not a substitute for clinical data, but is referred to as empirical (or experiential) data. This is the current state of orthoses for animals.  OrthoPets continues to work closely with university professionals to develop studies to prove and improve the use of orthotic devices in animals.