Case Report: Bode the SPCA dog’s tarsal arthrodesis
Bode is a sweet dog. He was turned over to the SPCA after it was learned that he had been limping around on a dislocated tarsus (ankle) for over a month. His story spread across social media, with people from all over donating money to his cause.
Together with donations from local veterinary teams, he was able to undergo the treatment he needed – first to address his infected wound and painful abscessing teeth, then to fix the tarsus itself.
Because the tarsus had been dislocated for so long, the joint cartilage was dead. That meant there was no hope of saving the joint without leaving Bode a legacy of chronic arthritis and ongoing pain. Instead, the decision was made to perform a tarsal arthrodesis, or to fuse the joint. It would mean that Bode would always have a hitch when he walked, but that he would also be forever pain free in that joint.
These radiographs were taken when Bode was first diagnosed. The first one is a front view, and the second one is a side view of the dislocated tarsus.
For clarity, I’ve added fancy graphics. These are the same two radiographs, but with the joint surfaces highlighted. The red line traces along the end of the tibia, and the green line traces the joint surface of the talus, one of the ankle bones.
The first part of the surgery involved breaking down the extensive scar tissue that had formed after a month of no treatment. Only then could the two bones be put back together. Once that was completed, a fair amount of bone and scar tissue had to be chiselled from the tibia to make a flat surface. It is along this surface that the stabilizing implant would be placed.
Once that was done, all the joint cartilage was removed and small holes were drilled into the underlying bone to stimulate repair. A hole was also drilled in the top of the tibia and a cancellous bone graft was collected – a harvest of marrow rich in the cells needed to grow new bone – and placed in the joint spaces. Once that was complete, the stabilizing metal implant was applied.
This radiograph was taken immediately after surgery. It is a side view with a special “banana plate” applied to the tarsus with nine screws. If you look at the top of the tibia, you can see the hole through which the bone graft was collected.
Here is the same radiograph again with more fancy graphics – the purple area represents where the remnants of the old joint space used to be. The cancellous bone graft selection site is highlighted in red
For the next 8 weeks, Bode moved into the house of an SPCA representative. He wore a cast to support the implant while healing began and was under strict exercise restriction.
These last two radiographs were taken approximately eight weeks after arthrodesis surgery, and show good healing. The joint space is no longer visible. The healing bone is not yet at full strength, but it has starting to share some of the work so Bode no longer needs a cast. He is still restricted to leash walks, and isn’t out of the woods yet, but he is on his way to a full recovery.
The muscles in Bode’s leg are very weak and severely atrophied, so he has been prescribed a comprehensive rehabilitation program to speed his recovery. It will teach him that he can use the leg without pain, build muscle mass, and speed his return to an active lifestyle.
Thank-you to all those who stepped up to help this wonderful dog.