Knee replacement post op X-ray


The Orthopaedics service is one of the leading veterinary orthopaedic referral services for small animals.

It is led by our European and RCVS specialists, Dr Kevin ParsonsProf Sorrel Langley-Hobbs, Dr Lee Meakin and Nicolas Barthelemy alongside residents, Anna NuttMark LongleyMatt Matiasovic and Will Robinson.

This ensures that all presenting cases, whether acute trauma patients or more chronic cases, can be thoroughly and appropriately investigated with state of the art equipment and veterinary leaders in multiple disciplines, just as you would expect if one of your family were in hospital.

Feline Patella Fracture Study


'Seth' owned by Becky, head surgical nurse


If your pet is being referred to us for a problem with their bones or joints, you may have a few questions. We hope you find the information below useful. Your surgeon will also discuss any queries you might have at your consultation. Please also see our General info for Owners for more general queries. We look forward to meeting you and your pet.

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Hip Problems

What is Hip Dysplasia?

Hip dysplasia is a common developmental abnormality that affects many breeds of dogs including Retrievers, Labradors, Collies, Mastiff and German Shepherds. It often affects both hips, although one side is usually more clinically affected than the other. Hip dysplasia is also less commonly observed in small breeds and cats.

What are the signs of Hip dysplasia?

The clinical signs of hip dysplasia, lameness and pain, can be evident as early as four to six months of age.  The signs can initially be subtle such as stiffness in the morning, slowness to get up, not wanting to exercise as long or as vigorously, a change in stride of the hind legs, "bunny hopping", wanting to sit down while eating or during walks and reluctance to stand up on the hind legs.  Sometimes the only observation is an "inactive" or "laid back" puppy. In some dogs the signs may not be present until it is middle-aged or older.

How will you treat it?

Several treatment options are available for treatment of hip dysplasia. These include:

Non surgical management. This is often initially used for the management of puppies with signs of hip dysplasia. Non-surgical management is usually made up of a combination of exercise modification, body-weight management, physiotherapy, hydrotherapy and medication. Most dogs will improve with this treatment however in some cases, as the condition progresses improvements may not be maintained. Depending on the study, between 30 -70% of puppies with hip dysplasia will respond to this management regime and not need hip surgery when they are adult.

Surgical Management. There are a number of different surgical methods used to correct this condition. Your surgeon will advise you on the best option to suit your dog. One of the most common procedures Total hip replacement. We offer both cemented and cementless total hip replacements. This procedure is well established in veterinary orthopaedics and can restore dogs and cats to normal daily activity with pain free function. Traditionally the technique has been performed in large and medium sized dogs however recently size has not become a limiting factor. We can now perform total hip replacements in cats and small dogs.

Knee Problems

What is cruciate disease?

What is cruciate disease?

Cranial cruciate ligament disease is the term used to cover a variety of problems affecting this very important anatomic structure. The cranial cruciate ligament in dogs is the same as the anterior cruciate ligament in humans. The ligament is important in maintaining the position of the femur (thigh bone) relative to the tibia (shin bone). It stops over extension and rotation of the joint. The exact cause of cranial cruciate ligament injury in dogs is not known however it typically results from a long-term degeneration of the ligament. Certain breeds are predisposed to the condition including Labradors, Boxers, West highland white terriers and Newfoundland’s). Occasionally trauma is responsible for rupturing the ligament (as in humans) however this is less common than degeneration.

Typical symptoms seen include limping. This may be sudden in onset or gradual and intermittent. The condition commonly affects both knees.

How is it diagnosed?

The diagnosis of cranial cruciate ligament rupture relies on a combination of physical examination findings and diagnostic tests such as X ray, CT or MRI. Surgery or arthroscopy is used to confirm the diagnosis and examine the internal structures of the joint.

How is it treated?

A variety of surgical techniques are offered by the orthopaedic service for treating cranial cruciate ligament disease. These include tibial plateau levelling osteotomy (TPLO) and lateral suture. Your surgeon will talk to you about these, and the reasons why they might suggest a particular technique over another when you arrive for your appointment.

Is my dog likely to recover?

Generally dogs with cruciate ligament or meniscal injury respond well to surgery. Development of osteoarthritis in affected knee joints is inevitable. This can result in on-going stiffness and a persistent lameness. Most cases however recovery well from surgery and return to normal or very near normal function.​In cases where arthritis progresses (either as a result of cruciate ligament rupture or other conditions of the knee) and lameness and pain is persistent a total knee replacement is an option

What is patellar luxation?

What is patellar luxation?

The patellar is the ‘knee-cap’. It normally slides in a grove at the end of the femur (thigh bone) when the knee extends and flexes. Dogs and cats both can suffer from patellar luxation. This is where the knee cap slips out of the groove in which it normally slides. The knee cap can move either to the inside of the knee or to the outside of the knee. Patellar luxation occurs frequently in dogs and occasionally in cats. Both small (e.g. Chihuahuas, Yorkshire terriers) and large breed dogs (such as Staffordshire Bull Terriers and Labradors) can be affected.
There are a number of reasons why the patellar can luxate. Genetics play a role but in some cases trauma may be the underlying cause. 

How is it diagnosed?

Patellar luxation is diagnosed by a combination of clinical signs (e.g. an intermittent skipping or a crouched gait), physical examination findings and X-rays. Typically we grade patellar luxation from grade 1 to 4. Grade 4 patellar luxation is the most severe grade.

How is it treated?

Treatment typically involves surgery as erosion of the patella and trochlear (the ridge which normally keeps the patella in the groove) can occur and progress. This can lead to arthritis. Surgery may not be recommended if an animal does not show any clinical signs of the condition. Following surgery patients will need to be rested and X rays taken after six weeks to assess healing.

Is my dog likely to recover?

The prognosis for patellar luxation is generally good however animals will develop arthritis. This often does not cause lameness.


What is a total knee replacement?

X-Ray of arthritic knee jointX-Ray after surgery showing new knee

Total knee replacement (TKR) surgery is a major surgical procedure. Reasons for performing the procedure include severe arthritis or a traumatic knee injury leading to ongoing pain and lameness. Prior to performing the procedure it is important to consider all options as it is a major operation and there is no ‘going back’.

As with all major surgery there can be risks associated with the procedure therefore the pros and the cons need to be considered. These will all be discussed thoroughly at the time of consultation.












Sam's Story

Total Knee Replacement

Total Knee Replacement

Sam a 7 year old Pointer underwent a BioMedtrix Total Knee Replacement 

Sam was presented to the Small Animal Orthopaedic Department with severe lameness in his left pelvic limb due to osteoarthritis in his knee joint following an articular fracture which happened years before. Sam had pronounced muscle wastage in this limb, was unable to exercise for any appreciable length of time and would often be non-weight bearing on the limb for periods during the day.

Total knee replacement was performed in February 2012 at which time a cemented tibial component and cementless femoral component were placed. The video footage shows Sam 12 months after surgery at which point his lameness was much improved, him being able to exercise for extended period without the need for continuous pain relieving medication. 






Elbow Problems

Maisie's story

An x-ray of an elbow replacement

TATE Elbow replacement

Maisie is a two year old Labradoodle who presented to the orthopaedic department with chronic left thoracic limb lameness due to elbow osteoarthritis secondary to medial coronoid process disease. Maisie had radiographs of her elbow that demonstrated marked osteoarthritis. Arthroscopy of the joint confirmed full thickness cartilage loss in both medial and lateral joint compartments. Subsequently the decision was made for Maisie to have a BioMedtrix TATE elbow replacement surgery that was performed in January 2012.

Maisie has made excellent progress following surgery and the video footage shows her running around with minimal lameness approximately 18 months following surgery. She currently does not require any pain medication whereas prior to surgery she required on-going pain relief medication.