Dog with orthotics

The Stifle Device is our most common device. It can be used for a number of conditions affecting the stifle such as:

  • Cranial and caudal cruciate ligament injury
  • Medial and lateral collateral ligament injury
  • Patellar tendon avulsion
  • Hyper-extension instability
  • Genu varus / valgus

Is the Stifle Orthosis The Right Solution For Your Dog?

Injury to the cranial cruciate ligament (CCL, also called the ACL) is the most common orthopedic injury in the dog. This injury is due to a partial or complete tear of a ligament inside the stifle (knee).  The resulting instability leads to pain and arthritis.  Stabilisation is recommended for best short and long-term function, quality of life, and comfort.   Stabilisation is traditionally done surgically either with a joint realignment surgery (TPLO or TTA) or with a pseudo-ligament surgically placed outside the joint (tight rope or lateral suture).  These procedures are considered the standard of care, in general.  In the past 7 years, the use of custom orthosis (brace) has become available as an alternative to surgery when surgery is not appropriate for any reason.  These reasons may include other health issues, unacceptable surgical or anaesthesia risk, advanced age, and financial constraints, among others. Because an orthosis is not the correct therapy for all patients, before choosing an orthosis the following points are important to keep in mind:

  • The device MUST be put on every morning and removed every night.  The device is to be used all day everyday.  It is NOT like human knee brace, worn only for sport.  The orthosis stabilises 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.).
  • Wearing in period: A typical stifle device requires an initial wearing in period of 2-4 weeks, to allow the skin to become accustomed. After this, the device can be worn all day like a pair of shoes, and needs to be removed overnight.
  • 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 2 follow up appointments are recommended within the first month of fitting, in order to meet the requirements for an appropriate fit.  These appointments are at the Orthopets Melbourne clinic at Dogs In Motion(fitting day and one additional appointment). If this is not possible due to your location, then  phone / internet appointments can be arranged. Importantly, your dog is much more active at home than at the veterinary clinic.  Increased activity and activity intensity can expose fitting 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 us and your veterinarian promptly if you have concerns.
  • Orthotics for dogs is a new solution to an old problem.  Modern medicine moves forward at a rapid pace.  It takes a lot of time and many 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 stabilisation for CCL injury in the dog.  As the industry leader using our unique, anatomically aligned, and mechanically sound custom design, we at OrthoPets provide 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 orthotics for animals.  OrthoPets and our own medical director in the USA, Dr. Patsy Mich, continue to work closely with university professionals to develop studies to prove and improve the use of orthotics in animals.
  • 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 fitting your veterinary team with the help of your OrthoPets case manager will work with you coaching with 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 OrthoPets case manager 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 and may include adjustments or part replacement as needed.
  • 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 stabilising the joint with surgery or an orthosis.  If this occurs, a surgical procedure called a partial medial menisectomy is required.  It can be done by itself or with a surgical stabilisation (see first paragraph). 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.  If your veterinarian suspects a meniscus tear please talk to them about your options.
  • Rehabilitation, the first key for success. Whether your dog undergoes surgical or orthosis stabilisation for a torn cranial cruciate ligament and whether or not surgery is required for a torn medial meniscus, it will take time to recover full, comfortable function.  The best way to ensure the highest level of success is to follow the recommended rehabilitation schedule and techniques.  Each patient’s condition and abilities are unique and as such an individualised rehabilitation program is needed.  Your physiotherapist at Dogs In Motion Canine Rehabilitation Centre will design a tarsus device specific plan for your dog. If you are not located nearby, we can put you in touch with an animal physiotherapist / rehabilitation therapist in your area
  • 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 orthosis stabilisation, arthritis management is key as well.  All dogs will develop arthritis after injury to the CCL regardless of the stabilisation 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 pet's veterinarian and animal physiotherapist can create an individualised, integrative arthritis management plan for your dog.
  •  The Process: In order to make a device that fits your pet’s leg perfectly, a fibreglass impression must be made of the limb. Make sure you read through the instructions and watch the casting video first prior to commencing If the cast is not made correctly, we will ask you to repeat it, to avoid unnecessary adjustments having to be made down the track. Some measurement forms will also need to be completed by your pet’s vet. The fiberglass impression and forms need to be sent to Orthopets Australia for final checking. If the cast needs to be repeated, or additional information is required, we will contact you and let you know.If the cast has been made correctly and we receive all the additional information, we will then contact you for payment prior to shipping to the USA. Once the cast reaches the USA, it will be manufactured and returned to us here at Orthopets Australia, before being sent on to you, or fitted in our clinic. This process typically takes 3 weeks. If you require a rush service there is an additional fee. This generally reduces the whole process down to 2 weeks.
  • Pricing: These are prescriptive devices so fees will vary from case to case. Please contact us for a quote.
  •  Payment: Payment of the total fee is required prior to shipping the cast impression to the USA. Once the cast impression reaches the USA and your individual orthosis / prosthesis design is decided, we will contact you if any additional small fee is required. Payment can be made by credit card, EFTPOS or direct debit.
  •  Questions: Please don’t hesitate to contact us if you have any questions.

To Complete Your Order Please Complete The Following:

If you would like to make an appointment in our clinic to have your dog assessed and cast for an OrthoPets custom device, please call us for an appointment on 03 9553 0896.

You do NOT need to complete any forms or watch the video prior to this appointment but we will need a medical history from your pet's vet.

If you cant come to our clinic due to distance, you will need to download and complete all the forms below and have your pet's vet or animal physiotherapist complete the cast impression and measurements of the limb.

 

Step 1: Download, print and complete this referral pack

Step 2: Pet's vet or animal physiotherapist to watch the video below, and follow the Stifle Fibreglass Casting Impression Instructions

 

You will require an Orthopets cast impression kit in order to make the cast. To order your fibreglass casting impression kit please visit our store.