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00:00Hello mate, you understand Irish?
00:02Animals from all over the world
00:04Ah bonjour
00:06Come to see one extraordinary man
00:08Who's known as the Bionic Vet
00:11High five!
00:12Yes!
00:13Professor Noel Fitzpatrick
00:15We only get one shot at this, here we go
00:18Noel and his team offer some of the most advanced treatments available anywhere
00:23The perfect marriage of mechanics and biology
00:25This is what we have now, a brand new knee
00:28Oh wow!
00:30For some, it's a last chance
00:33It is a life or death situation because we cannot leave him like he is
00:37I just want you to do anything you can for him really
00:40Sorry
00:41As Noel continues to devise new ways of healing
00:44You're going to be Bionic, thank you so much
00:47He transforms the lives of his patients
00:50Oh that is just unbelievable
00:52He's raring to go
00:53Against all the odds
00:55Boom!
00:56One small step for a dog, one giant leap for mankind
00:59Well done
01:12I do enjoy working veterinary medicine
01:14It's definitely a major perk to have dogs and cats around the practice all day
01:20With treating a human you can obviously explain what you're doing and justify what you're doing
01:27And with a dog or a cat all they see is this person coming at them and you can't really explain what you're doing
01:33To make the patients feel safe and secure we just fuss them practically the whole time they're here
01:43Endless fuss and usually that keeps them nice and happy
01:47It would be a bit weird I think if you do that with a human patient, maybe
01:53Just a tad
01:55Just a tad
02:05Bursting through the doors of Fitzpatrick's this morning is seven month old fox red Labrador puppy Bertie
02:12Bertie Taylor
02:13Yep
02:14If you'd like to take a seat
02:16Sue has brought him in with husband Graham who is an orthopedic foot and ankle surgeon
02:23Oh no no no no no
02:26They noticed Bertie is lame in his hind leg
02:29We thought it was a trauma because he jumped off a table in the garden and landed awkwardly
02:35And he struggles to get up on his left leg because he drags it behind him
02:40Their local vet has diagnosed Bertie with a condition in his ankle called osteochondritis dissecans
02:47Which Graham is familiar with in humans
02:50Now of course we want to know what can be done other than simply clean up the joint which wouldn't last very long
02:57You know has been using implants that we haven't been all that successful within humans
03:02So hopefully it's better in dogs
03:07Now Bertie please Bertie
03:11Hi guys
03:12Hi
03:13Hello sweetheart
03:14My name is Noel
03:15What's your name?
03:16Graham
03:17I'm Sue
03:18Sue
03:19Please take a seat
03:20Hey buddy
03:21Hey buddy
03:22It's alright
03:23Come here
03:24Firstly
03:25I understand you're a human ankle surgeon
03:27I am
03:28Which is hugely ironic
03:29Do you put in total ankles?
03:30I do yeah
03:31Do you put in partial ankles?
03:32Well we don't actually
03:34Interesting
03:35That's why we're here
03:36Right
03:37Yeah yeah yeah
03:38My life's purpose is to reconverge human and animal medicine because I think it's just foolish
03:42that we use the animal as an experiment to get the implant for the human but then it doesn't
03:47come back the other way to help the dog
03:48So that's where I come in
03:49So that's where I come in
03:50All of those implants now I have available for dogs
03:53Even some more than you have because you don't yet have an effective partial resurfacing
03:57No
03:58No
03:59The left is the worst and the right is mildly affected
04:03Well it's there but it's certainly not fragmenting
04:05Yeah
04:06They told me that the left one was the one which had some contrast going beneath it is unstable
04:12The other one didn't seem to do that
04:14Okay
04:15Can we push your chairs back? Francesca let's bring him over here
04:18There we go
04:19Alright big fella
04:20Good boy
04:21You can come over here and have a look
04:23I'm not sure I want to see actually
04:25He's very squeamish
04:26Are you?
04:27With dogs yeah
04:28Come on
04:29Not with patience
04:30What?
04:31You're kidding me
04:32He can't bear anything going wrong with the dogs
04:34What?
04:35Or the children he could never be a vet
04:36What the heck?
04:37Okay puffy
04:39Very puffy joint pouch
04:40I'm just going to do it once
04:42Yeah
04:43Yeah that's a hootcher
04:44That's a hootcher
04:45Alright
04:46Alright
04:47Alright Bertie
04:48He's very sore guys
04:49Oh
04:50He's very sore
04:51It's alright buddy
04:52It's okay buddy
04:53So if you want me to consider resurfacing I need my own CT
04:59So I'd like to do that now
05:01Thank you very much
05:02Is that fine?
05:03That's fine
05:04Okay
05:05Playtime
05:06Playtime
05:07Playtime
05:08No don't need his toy
05:10Gosh you are so
05:11He's ridiculous
05:12He's so soppy isn't he?
05:14He is so soppy
05:15He's so soppy
05:16That's brilliant
05:17I love it
05:18Bertie is taken for a CT scan to establish what can be done to treat his ankle
05:25All Graham and Sue can do now is wait for his results
05:29So it's whether we can do something to give him a good few years of playing more normally and being a young dog
05:37He's a huge part of our lives even though he's only seven months old
05:41Fitzpatrick sees its fair share of cats as well as dogs
05:54Meow
05:55They may be nimble and agile but they too sometimes need Noel's help
06:00Meow
06:02Who have we got here?
06:06Jade
06:07Next to see Noel is Joe with two and a half year old domestic short head cat Jade
06:13Jade Jade Jade Jade
06:15Take a seat you're all checked in
06:17Thank you
06:18Jade has a deformed back leg which she can't use properly
06:23We had x-rays done on her leg which showed that she'd had a partially healed fracture to her knee joint
06:31And also suffer from very very bad skin condition
06:41Hi babies it's feed time
06:44Joe lives in Surrey where she set up Happy Cats Rescue five and a half years ago
06:51The aim of the rescue obviously is to find the animals loving new homes
06:56If the home doesn't work we will always take the cat back and then we will continue looking
07:02Joe also has a house full of her own cats
07:05Hi babies!
07:07My eight cats have sort of grown over the years as when we've had cats in that you fall in love with them
07:14When I started rescue I had two
07:16Yes hang on let me get the bombs now
07:19Giving her a helping hand is her 15 year old daughter Jenny
07:23I'm an only child so having cats kind of makes up for that
07:28Jade was left at the rescue centre two and a half years ago because she couldn't be rehomed
07:34At first I kind of like wasn't sure about her
07:39But when she did come out of her shell she was a really loving cat
07:43That's why I liked her
07:45She's like my best friend in a cat
07:48To be honest
07:49Unfortunately with her medical conditions we didn't find an owner that was prepared to take her on
07:57We decided we would keep her here and we would care for her with whatever she needed for the rest of her life
08:06We've got Jade's mum
08:07Jo's tried giving Jade pain relief and has already discussed amputation or fusing her knee at Fitzpatrick's
08:15But now she's decided to go for a custom total knee replacement
08:19An operation that only Noel performs
08:22Hello Jade how you doing?
08:24Alrighty
08:26Okay let's get her out, good girl
08:28Right let me just try and get a video of walking
08:29What's happening in reception right now is it busy?
08:32Oh my goodness that's very unusual
08:36Maybe it was meant to be
08:38It's never empty out there so that's a special treat for us
08:41Yes I know
08:43Okay
08:44Okay off we go
08:46Jade
08:48Come on
08:50That's it walk up by me if you can
08:53Come on
08:55Come on
08:56Keep going
08:57Keep going that's great
08:58That's perfect keep going
09:00Yeah
09:02Well as is always the case
09:06One cannot walk pussycats
09:10Right mum we're going to take her through
09:12Is that fine?
09:13Yeah
09:14The cause of Jade's limp is clear from the CT scans taken during her last visit
09:21If we look at it in 3D
09:23We can see the kneecaps permanently out here
09:25Yeah
09:27It's very challenging from a surgical perspective
09:30Because you can see that the femur is dramatically twisted
09:33Yeah
09:34Like so
09:36My biggest concern is the quadriceps muscle here is so short
09:39When muscles been tight for a long period of time if you don't stretch them
09:42It's very hard to acutely stretch
09:44And during the op I have to acutely stretch
09:47I can't wait 6 months
09:49It's got to be done
09:50Is there a reason why you did not consider full limb amputation?
09:54Because she's young and I think she deserves a chance to keep her leg
09:59Okay
10:01Jade is settled in
10:03Oh she legs close
10:05Ready for surgery later today
10:08Thank you
10:09We're trying to do the best we can
10:10Thank you
10:11Thank you
10:12Thank you
10:13We're trying to do the best we can
10:14Give me all the kisses
10:15Give me all the kisses
10:17Give me all the kisses
10:19Oh my God
10:20Why are they so pretty?
10:22Why are they so pretty?
10:24Bertie, the seven-month-old fox-red Labrador puppy has had CT scans to assess what can be done to alleviate his painful ankle
10:42to alleviate his painful ankle I love red Labradors I'm gonna say that I'm Fox
10:49red now I'm not ginger or Fox reds these are the CT scans right here there's a
11:03massive hole on the left side it's a critical size defect the other side
11:10unfortunately is affected but to a lesser extent if we look at the the lesion it's
11:18the same but smaller so you're here in time but only just yeah I absolutely do
11:27not think the fragment removal is going to be of any use whatsoever so we either
11:30go down the route of tablets until you get a bit older and fuse it but with two
11:36ankles fused you'll have a stilted dog forever or crack on as soon as we can
11:42and put a resurfacing in there at such an early age the bouncy pup is facing not
11:50one but two ankle operations by all means think about it
11:54deliver that I don't think we need to think about it right so I'll ask the
11:57engineers to look at the CTs tonight I'll come back to you with an answer tomorrow
12:01on time frame okay good boy both of his legs are affected the left's a lot worse
12:09so basically gonna have a sort of partial joint replacement in each because
12:14without it he'll not only be in pain he'll get arthritis quite quickly anyway
12:19it's just upsetting because you can't explain to him what's happening whereas
12:23with a patient you can do that and I find that quite difficult emotionally
12:41it's early evening Jade the rescue cat is being prepared for her total knee replacement her implant
12:48has been 3d printed based on her CT scans but operating on Jade won't be
12:54routine due to her deformed leg so in real life the kneecap should be
13:01somewhere up here on the front of the knee but instead it's over here on the
13:04side of the knee
13:07Noel's first challenge is to cut out the deformed joint and prepare the fragile
13:12bone for the implants
13:16so I've made sure that I can flex the ankle and line up the front of this
13:22implant so it's exactly perpendicular to the tibia and exactly parallel to the
13:28ankle if the implant isn't straight then Jade's kneecap could continue to
13:33dislocate okay I think that looks pretty good now we'll prepare the femur you can
13:43see here where we've shaped the stem in a curve to fit the very curved femur when
13:47we push it in
13:49so this is very difficult to sculpt because the femur is bent both on the
13:54outside and the inside so the marrow cavity is also bent
13:59finally Noel needs to relocate the kneecap into the groove and connect the tiny femur and
14:10tibia implants with a specially hinged plastic bushing you can see here that the knee can flex
14:18extend and also rotate
14:24so physiotherapy is going to be critical to success we've no idea yet how Jade is going to use this knee
14:31the function will be entirely dependent on whether the quadriceps muscle can loosen up enough to flex
14:38this morning's patient is also looking to know to fix a painful knee Joe's brought in her four-year-old
15:03springer spaniel Sophie just take a seat they're not going to be long thank you very much we're here
15:13because when she was a pup she had luxating patellas so basically it's the kneecap slipping
15:19in and out of the joint it's not staying in Joe lives 400 miles away in Cheshire I live on my own
15:31with my three dogs and hope Sophie and Indy Indy is currently nicknamed Dobby because she keeps
15:38stealing salts oh I love the springer spaniel breed due to Sophie's condition she's not been able to
15:53join in the games they are a lovely family unit and they include me in that as well which is nice
16:01I know some people don't seem to understand that bond between people and and dogs sometimes but for
16:10me it's a very profound bond Indy where's it gone and I do have to remind myself that they are dogs
16:18not children the others are still doing that sort of running around and just clearly loving life that's
16:26why it's so sad with Sophie a little bit is because she's so tied down Sophie's had three surgeries
16:35already so far and time away from me has made her even more clingy but certainly if we ever go back
16:42to the vets she'll sit on my knee and and cuddle in just wanting reassurance Sophie's operations were
16:50for a slipping kneecap and a cruciate ligament rupture on the same knee but both failed to hold the
16:56kneecap in place and she's also had surgery on her right elbow I can't see what else they can do
17:03um sorry I see it as her last chance to get it right I feel like I've tried to do my utmost with
17:18the physio and the hydro and doing it at home and it just hasn't worked so I think it's just wanting a
17:25final surgical solution so it's 30 months and I just want her to be okay Jo's local vet has sent
17:36Noel Sophie's medical history with x-ray pictures of her disease joints okay please take a seat you on
17:44your own yes I am you're a doctor oh what kind of a psychology I definitely need you yeah right you're hired
17:54okay so which leg is she got a luxating patel on when I extend it easy comes out and then it's
18:09completely out I want to put it back in it's in yes yes tough situation isn't it despite her multiple
18:21surgeries Sophie's kneecap is still dislocating the elbows concern me as well because they're pretty
18:28significantly affected by osteoarthritis can you tell that from the x-ray yeah on the right side
18:34especially but also on the left side in terms of the left knee we wouldn't do anything at the moment
18:42it's static with regard to the right knee this kneecap was slipping that way and that way what you want to
18:50do is you want to try and stop the kneecap coming out sideways you've exhausted all reasonable
18:55possibilities of deepening the groove and you've exhausted all reasonable possibilities of moving
19:00the front of the kneecap attachment over if the alignment was okay then there will be ways to
19:07address it one would be to put on artificial ridges to stop it slipping out and the other question is
19:16whether we perform arthroscopy on the elbows at the same time or not okay for me you are her last hope
19:23in relation to her back leg at least I wasn't expecting the front legs today but you know I'd be grateful for
19:30them to be done I certainly think we should check it I hate the thought that she is in pain
19:44leaving her behind was hard but she needs surgery and that's that okay there you go I just wanted to
19:53be a better I suppose at the end of the day after taking radiographs and CT scans Noel uses an arthroscopic
20:02camera to look inside Sophie's joints he will try and save Sophie's right hind knee joint it's just the
20:13ridges on either side are not high enough to keep the kneecap in now that's the problem instead of
20:22removing the whole joint Noel will design an implant that will aim to keep the kneecap in place next he
20:31moves on to Sophie's front legs you can see that there's raw bone here with no cartilage on it that's
20:40not good so that's rubbing Noel will have to operate so what I'm going to do is I'm going to cut the
20:48ulna the top part kicks down and back and then it heals itself without any stabilization so no pin
20:54no plate required luckily no won't have to operate on Sophie's other front leg for now there we go the
21:05illness free to move it's obviously not going to cure the arthritis but it should certainly help to
21:14decrease pain in the elbow as a result of rubbing it'll take about eight to twelve weeks for this
21:19to heal properly during that time we'll be making the new ridges for the knee so the timing is just
21:27about right Sophie can go home in a couple of days to recover but she'll have to wait for a custom
21:36implant to be made to repair her slipping kneecap Sue has brought in seven-month-old Labrador puppy
22:01Bertie Bertie her son Johnny has come to help although he too has struggled to restrain Bertie
22:10I think the frustration got hold of Bertie this morning and picked him up to stroke him and he's
22:15gouged my nose out here and the last four months or so we've had him on the lead a lot and he's just
22:22had a lot of pent-up energy Bertie's gonna have his first of two operations he's having resurfacing of
22:29his ankle joint on his left leg very nervous oh dear yeah he's very boisterous isn't he he's very
22:51boisterous here's some tissue there you go right okay so you know what I'm doing today I'm going to
22:58put a custom ridge onto his ankle joint or we'll we'll give him some sedatives to help him to cope
23:04yeah I think that's our main worry is we're not quite sure how he's yeah it's everybody's main worry
23:10because he's so boisterous as you can see I'm sorry about that okay guys God bless see you later bye bye
23:21hopefully when he's had the surgery then he'll get back to being a lovely puppy that can actually
23:29get rid of his energy and then he won't be quite so bad first Noel will access the joint by temporarily
23:43removing a piece of tibia bone next he opens the ankle and prepares the diseased surface to place in the
23:50new custom implant finally he'll fix the ligament attached to the piece of tibia back into position
23:57securing it with special eyelet pins and wire as we open up the ankle so we can see here where the big
24:12hole is and unfortunately that big hole of raw bone has already rubbed away a bit on the other side here
24:18we're just going to sculpt the correct shape in order to put our implant in
24:25so we want this to fit just right
24:32okay so that's the metal ridge in place now we fill the hole what we're going to do now is going to pop it back up into the joint like so
24:42the hope is we can give a functional healthy pain-free joint for a long time and then we'll do the other side in six weeks
24:51jade the rescue cat has been recovering at the practice for nine days after her total knee
25:11replacement but she's still got a long way to go she'll need intensive physiotherapy and laser treatment
25:18daily to stretch her contracted muscles
25:21hello how are you
25:23good
25:25joe has returned with her daughter jenny for a visit
25:29jade's adores my daughter and she's missed her like crazy
25:35she loves her cuddles with you as well doesn't she
25:38yeah i've missed her a lot
25:40hello friends there we go come on bubba
25:44so as you can see there is an effort to use the leg now
25:48yeah
25:49but it's still too straight
25:50okay so what we're encouraging every day is this
25:54like so yeah so she's got to put that down you see that
25:58pick her up there
25:59she's wanting to pull it forward but she can't flex it
26:05come on beautiful
26:07i'm still concerned whether we're going to get uh function or not into that quadriceps because it's
26:13been deformed for so long
26:15she's been with us 18 months and it's just been slowly getting worse
26:21yeah well you're not going to reverse 18 months in two weeks
26:24of course we're not now i appreciate that and i said to you from day one it will take as long as it takes
26:30okay bub here you go well done good
26:35it's definitely hard leaving her behind but we know we're on the road to getting her
26:40better and fixed and hopefully using that leg again properly
26:45so we're going to be waiting now with baited breath for updates
26:51see you later ladies we'll see you again
27:07lively labrador pup bertie has been at the practice for a week
27:11after having his first partial ankle replacement
27:16take your seat i'll let him know you're here
27:19sue has returned to pick him up with her other son james to give her a hand
27:24very excited here i'm a bit worried he's going to go mad
27:29hopefully he won't scratch us like he scratched johnny
27:35this is your new ankle ridge replacement um as you can see the objective of the operation is to
27:41replace the entire defect with this cap the cap is a super smooth surface that will rub forever
27:48on the opposing surface of the tibia super clear yeah good post-operative confinement is the main thing
27:57so no running no jumping no slipping no sliding if the family managed to keep bertie calm hi bertie
28:04and everything goes to plan he will have his right ankle surgery in six weeks time come on mate now here
28:13we are it's up to us now really we've just got to make sure that he doesn't leap around or jump
28:18what have you so that he's got the best chance of it if it working really so just got to do our best
28:32the day has come for joe to leave springer spaniel sophie at fitzpatrick's once again
28:48this time for surgery on her knee you're gonna have to stay here i know i know
29:02okay it's okay hopefully this operation will be sophie's last
29:09when i left her with she was just looking it was just don't believe me mom
29:16she's my child and i love her that's partly what's crucifying is um
29:23yeah just just she can't play or anything like that
29:32she is the dog that's with me all the time so it's like i've lost my shadow
29:42first noel starts by preparing the joint for the new custom implant
29:46we've drilled away the cartilage from the old worn groove and now we're going to put a new smooth
29:52groove on noel uses bone graft collected from sophie's bone to create a bed for the new groove to
29:59sit on this implant is made out of cobalt chromium which is three-dimensionally printed from the ct scan
30:06the undersurface is made out of a mesh we've coated it in a mineral called hydroxyapatite which attracts
30:17bone cells onto it
30:20okay so we're just going to put the kneecap back into the groove now there we go stitch up we're done
30:38so the kneecap is gliding nicely at the moment let's hope it stays that way
30:50the practice has a specialized rehabilitation center including hydrotherapy pool for many
30:59it's the gateway to a full recovery good boy usually it's the dogs getting the benefit
31:10but surprisingly cats can enjoy it too
31:12some of the time jade is having hydrotherapy a beneficial treatment to help stretch her quadriceps
31:23muscle after her knee replacement
31:30you avoided that one well
31:34after two weeks of daily rehabilitation she's progressing enough to go home
31:42in just a week the improvement there is massive a little bit apprehensive about the rehab but
31:52we'll just keep going and play it day by day at the moment
31:56my daughter's really really happy to have her home she's her little baby so yeah she's she's over the moon
32:08down in hampshire
32:13bertie the labrador pup is at home recovering after having his second ankle surgery
32:20he's on strict cage rest i hadn't realized how hard it was going to be to have him in the crate
32:28you can't leave the room he starts to cry or get upset it's just a sad look that is the worst thing
32:37every time you do take him out you're terrified that he's going to damage it it's very intense to be honest
32:48it's not what the puppy should be doing
32:53you know he should be having fun and being able to play and
32:55batty shh he's um you know he's missed out on being a puppy
33:12it's three days after sophie the springer spaniel had what joe hopes is her final knee surgery
33:30she's arrived eager to collect her companion i'll probably describe myself as nervously excited for
33:37some reason i don't know why i just haven't been able to get her off my mind
33:42this is what your implant looks like right so you can see that the surface architecture of this
33:49implant has been designed to perfectly contour the original femur but i'm very pleased with
33:55that and so is your dog so if you push your chair back i will show you come on there there we go good
34:03now hello hello mommy hello mom doing fine oh baby doing fine she's actually walking on it without too
34:13much trouble the kneecaps in a very nice position it's central everything's good she's wagging her tail
34:17she's happy okay thank you all right my entire pleasure it's great you mean you love her very much
34:23and she's very lucky you're very lucky to have each other like with the harness don't let her jump
34:28no and then we'll just support her like that in my back end okay oh i've missed you this time
34:36no no messing with sophie in the car okay be good with her she's still a bit of fragile
34:40well safe journey thank you so much no worries take care bye bye you're back home now darling yes it's
34:48going to be fine orthopedic ankle surgeon graham and his wife sue are back with labrador bertie six
35:08weeks after his second partial ankle replacement well he's still holding that leg up a bit oh i don't
35:15if it's hurting him or not not as good as the other one graham was concerned there could be a
35:20problem with this second surgery when he's out walking it's good yeah but when he pauses he will
35:28sometimes lift it not always yeah so i'm sort of worried to death yeah yeah all right let's just take
35:34him through that's fine okay let's just go through that okay let's go straight yeah all right thanks
35:41thanks bertie is immediately sedated and taken for a ct scan
35:49while graham and sue wait
35:54when noel operated on bertie's second ankle he added a metal plate on the side to stabilize the repair
36:02the results are in
36:03sadly your hunch was right there is something wrong it's very unusual i've not seen it before
36:12what he's done is he's actually cracked the implant
36:16what the metal the metal
36:21the other side when we rotate it you can see that there's a nice smooth
36:26ridge and it's actually integrating well there's no issue
36:30but on the other side which is the side that's affected by the swelling but he has cracked the
36:39metal here around the peg before the one has grown in so i think what's happened is for whatever
36:50reason in the cage or otherwise he's pivoted on it because direct compression shouldn't crack it
36:56because it's got a bomb bed to sit on yeah and it's a tight joint we have some of these out three
37:01years now and they're still fine but i've not seen one crack yet because clearly he's putting more
37:09load on this than any dog we've had before well you've seen what he's like yeah
37:13i can't leave that the way it is so i've got to replace that and i'll probably have to take off a
37:24couple more millibon and make a thicker shell and i obviously feel awful about it but no no it's not
37:31don't do it yeah as well you'll understand as a surgeon you're going to get complications but i
37:38definitely did not see that one coming okay give me a couple of secs i'm sorry okay
37:49you're right to be doom and gloom isn't it it's better than the infection soon
37:54no i know
37:57i mean he's potentially solvable
38:01poor little thing i just feel sorry for him
38:03oh well that's why we feel awful not only out of the breeze is it i mean you just feel dreadfully
38:07sorry for him
38:13now you crazy boy
38:18i'm sorry mate stay brave okay thanks ma'am bye
38:25it's a major setback for graham and sue bertie will need yet another surgery to replace the broken
38:32implant but must wait for a stronger thicker implant to be made look at his little face
38:39something had to be wrong it's just going through all again for him he can't play he can't do anything
38:44you couldn't listen to that for long could you
38:55it's a big day in more ways than one
39:07is it his birthday today
39:10is it his birthday today
39:25what a shitty way to spend your birthday what a great way to spend your birthday
39:29okay yeah oh my god yes oh i love it bertie is one year old today
39:37okay so this implant is thicker it's got a thicker surface in here in the middle around the peg so it's less likely to crack
39:51so that's our new implant in place now looks like a nice fit
39:59i'm happy with that it's seating down nicely okay so now we put the plate back in
40:04soo will collect bertie in a couple of days in the hope this second implant will withstand bertie's bouncy behavior
40:25so
40:28joe is back with springer spaniel sophie
40:31good girl
40:32good girl
40:33yeah let's see
40:33she's hoping that sophie's latest surgery has finally stopped her kneecap slipping
40:39all right sophie good girl let's have a little bit you
40:42good girl well done so you've been following the rules i can see
40:46i've been doing my best right has she escaped at any time
40:52um she's got on and off the sofa
40:54well at least you're being honest
40:58so i'm gonna take an x-ray picture to make sure that the illness healing as well as
41:03an x-ray picture of the right knee
41:05today is an important day because today is all about
41:09is the kneecap tracking appropriately and is the implant intact
41:13yeah one of the things i've forgotten actually she's actually in season all right um and my
41:21other dog is quite gay with her oh i see and i turned around when she came in disease and then
41:26she was twice she'd got onto a bat i was like no humping and jumping
41:32i couldn't believe it was something okay that wasn't on the post-operative uh confinement sheet
41:39it should say no humping and no jumping
41:43the x-ray pictures have been sent through the good news is that the line of the kneecap's very
41:51nice now and it's in its groove and it's seated very nicely and the elbow um now you can see bonnie
41:58healing there so that's all hunky-dory no need to cry at least at least there are tears of joy
42:05i know it just feels like it's been a long long journey now you still have a little bit of the
42:10journey to go because you've lost a shed load of muscle you know yes yeah that seemed to go overnight
42:15yes yeah that needs to be really worked on
42:17yeah there we go thank you very welcome well done thank you now no off lead and no humping and no
42:29jumping no no no no no humping no jumping okay thank you all right take care thank you
42:35thank you no hunting no jumping
42:47at home in cheshire joe and sophie are taking their homework very seriously
42:54i get up at half past four i do the muscle stimulation with her before we go out for a walk
43:01probably takes about an hour by the time you've got the pads on and everything else
43:06and at some stage during the morning i'll do her physiotherapy exercises
43:11walking over the poles sit to stands good girl i've had to cut my work hours down to half
43:21it doesn't sound very much actually but it feels as though it's quite constant during the day
43:25is that all we do so
43:32and the hard work has paid off so i started letting her off the lead just a little bit in this garden
43:37but it's not very much at all i do get a little bit worried if she picks up speed and she starts
43:42running around in circles and things and hopping as she goes so i'm trying mostly just to keep her
43:47exercise nice and steady i have managed to avoid sophie being humped especially because my other two dogs
43:54are in season my oldest one tried and then i managed to stop her in time so that's okay
44:01i'm very very grateful to noel for what he's done she's got a lot of years ahead of her still
44:12at home in surrey after a grueling four months of physiotherapy to stretch her leg muscle jade is
44:19finally making steps in the right direction the op obviously was the major part getting
44:25the knee fixed but without the physio we wouldn't have the cat we've got today jade does live in a
44:32house with eight other cats some she doesn't get on with quite so much but you know being able to move
44:39around more freely now and be able to run she can choose who she interacts with and who she doesn't
44:45she tends to stick with upstairs and she has her own little space hey good girl yeah come on get it
44:58yay she's playing really well she loves to jump around run around now
45:04she never used to do any of this so it's just amazing to watch her
45:07hey good boy look at you in hampshire after three surgeries and nine months of treatment
45:21bertie the energetic labrador is finally catching up on his missed puppyhood
45:27he's doing really really well we're really pleased and he's really able to play with ollie and just have
45:33a great time it's left its mark we both put on half a stone comfort eating you know you get quite
45:39depressed looking at the dog behind bars but it's all been worth it i think he's comfortable he's
45:45cheerful he's jumping on the furniture again if you don't really keep an eye on it
45:51i'm pleased that we went for the partial resurfacing rather than having a fusion we felt it was unfair
45:58in a young dog to to do that really i'd like it very much if we had an implant that we could use in
46:04humans which is similar to the one that bertie's had technology's there it could be done clearly it's
46:08been done in bertie so there are a few patients who'd benefit from that it's just lovely seeing him you
46:16know just bounding around the garden and exploring it's just lovely to see
46:27so
46:40so
46:41you
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