- 2 days ago
Category
📺
TVTranscript
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 kittens
10:19Give me all the kittens
10:21Give me all the kittens
10:23Why are they so pretty?
10:24I got off from me
10:26Why are they so pretty?
10:29Bertie, the seven-month-old fox-red Labrador puppy, has had CT scans to assess what can
10:41be done to alleviate his painful ankle.
10:44I love red Labradors. I'm going to say that I'm fox-red now. I'm not Ginger, I'm fox-red.
10:52This is beautiful. These are the CT scans right here. There's a massive hole on the left
11:05side. It's a critical size defect. The other side, unfortunately, is affected, but to a
11:13lesser extent. If we look at the lesion, it's the same but smaller.
11:21So you're here in time, but only just.
11:24To a level thing?
11:25Yeah. I absolutely do not think the fragment removal is going to be of any use whatsoever.
11:30So we either go 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 and put a resurfacing
11:43in there.
11:46At such an early age, the bouncy pup is facing not one, but two ankle operations.
11:51Well, I mean, think about it.
11:52Yeah, I don't think we need to think about it.
11:53Right. So I'll ask the engineers to look at the CTs tonight, and I'll come back to you
11:58with an answer tomorrow on time frame.
11:59Okay, brilliant.
12:00Yeah.
12:01Good boy.
12:02Both of his legs are affected. The left's a lot worse. So basically you're going to
12:09have a sort of partial joint replacement in each. Because without it, he'll not only be
12:14in pain, he'll get arthritis quite quickly anyway. It's just upsetting because you can't
12:20explain to him what's happening. Whereas with a patient, you can do that. And I find that
12:25quite difficult emotionally.
12:40It's early evening. Jade, the rescue cat is being prepared for her total knee replacement.
12:46Her implant has been 3D printed based on her CT scans, but operating on Jade won't be routine
12:54due to her deformed leg.
12:56So in real life, the kneecap should be somewhere up here on the front of the knee, but instead
13:03it's over here on the side of the knee.
13:05Noel's first challenge is to cut out the deformed joint and prepare the fragile bone for the implants.
13:14So I've made sure that I can flex the ankle and line up the front of this implant so it's exactly
13:23perpendicular to the tibia and exactly parallel to the ankle.
13:28If the implant isn't straight, then Jade's kneecap could continue to dislocate.
13:33Okay, I think that looks pretty good. Now we'll prepare the femur.
13:38You can see here where we've shaped the stem in a curve to fit the very curved femur when we push it in.
13:49So this is very difficult to sculpt because the femur is bent both on the outside and the inside.
13:55So the marrow cavity is also bent.
14:00Finally, Noel needs to relocate the kneecap into the groove and connect the tiny femur and tibia implants
14:10with a specially hinged plastic bushing.
14:14You can see here that the knee can flex, extend and also rotate.
14:23So physiotherapy is going to be critical to success.
14:27We've no idea yet how Jade is going to use this knee.
14:30The function will be entirely dependent on whether the quadriceps muscle can loosen up enough to flex.
14:37We can only do our best.
14:39OK.
14:55This morning's patient is also looking to Noel to fix a painful knee.
15:00Joe's brought in her four-year-old springer spaniel, Sophie.
15:04Hello. Just take a seat. They're not going to be long. Thank you very much.
15:08We're here because when she was a pup, she had luxating patellas.
15:17So basically it's the kneecap slipping in and out of the joint. It's not staying in.
15:25Joe lives 400 miles away in Cheshire.
15:29I live on my own with my three dogs, Hope, Sophie and Indy.
15:34Indy is currently nicknamed Dobby because she keeps stealing socks.
15:38Indy.
15:39Hi.
15:40Indy.
15:43Oh, I love the springer spaniel breed.
15:46Good.
15:47Due to Sophie's condition, she's not been able to join in the games.
15:56They are a lovely family unit and they include me in that as well, which is nice.
16:01There's a good girl.
16:02There's a good girl.
16:03I know some people don't seem to understand that bond between people and dogs sometimes,
16:08but for me it's a very profound bond.
16:11Indy.
16:12Indy.
16:13Where's it gone?
16:15And I do have to remind myself that they are dogs, not children.
16:21The others are still doing that, sort of running around and just clearly loving life.
16:25That's why it's so sad with Sophie a little bit is because she's so tied down.
16:31Sophie's had three surgeries already so far and time away from me has made her even more clingy.
16:40But certainly if we ever go back to the vets, she'll sit on my knee and cuddle in just wanting reassurance.
16:46Sophie's operations were for a slipping kneecap and a cruciate ligament rupture on the same knee, but both failed to hold the kneecap in place.
16:57And she's also had surgery on her right elbow.
17:01I can't see what else they can do.
17:04Sorry.
17:09I see it as her last chance to get it right.
17:13I feel like I've tried to do my utmost with the physio and the hydro and doing it at home.
17:20And it just hasn't worked.
17:23So I think it's just wanting a final surgical solution.
17:26So it's 13 months and I just want her to be okay.
17:34Jo's local vet has sent Noel Sophie's medical history with x-ray pictures of her disease joints.
17:40Nice to see you. Nice to see you.
17:41Nice to see you.
17:42You okay? Please take a seat. You on your own?
17:43Yes, I am.
17:45You're a doctor?
17:46Not medical.
17:48What kind of psychology? I definitely need you.
17:51Yeah, right, you're hired.
17:54That's good.
17:58So which leg has she got a luxating patel on?
18:01Both, but it's the right one that's had the operations on it.
18:05When I extend it, the easy comes out and then it's completely out.
18:10Okay.
18:11And when I put it back in, it's in.
18:13Yes.
18:15Yeah, it's a tough situation, isn't it?
18:17Mm-hmm.
18:19Despite her multiple surgeries, Sophie's kneecap is still dislocating.
18:24The elbows concern me as well because they're pretty significantly affected by osteoarthritis.
18:31Can you tell that from the x-ray?
18:33Yeah, on the right side especially.
18:35That's not right.
18:36But also on the left side.
18:40In terms of the left knee, we wouldn't do anything at the moment.
18:42It's static.
18:44With regard to the right knee, this kneecap was slipping that way and that way.
18:48What you want to do is you want to try and stop the kneecap coming out sideways.
18:53You've exhausted all reasonable possibilities of deepening the groove.
18:57And you've exhausted all reasonable possibilities of moving the front of the kneecap attachment over.
19:03If the alignment was okay, then there will be ways to address it.
19:08One would be to put on artificial ridges to stop it slipping out.
19:13Yeah.
19:14And the other question is whether we perform arthroscopy on the elbows at the same time or not.
19:19Okay.
19:20For me, you are her last hope in relation to her back leg at least.
19:25I wasn't expecting the front legs today but, you know, I'd be grateful for them to be done.
19:31I certainly think we should check in.
19:34I hate the thought that she is in pain.
19:36Leaving her behind was hard but she needs surgery and that's that.
19:49Okay.
19:51There you go.
19:53I just want her to be better, I suppose, at the end of the day.
19:55After taking radiographs and CT scans, Noel uses an arthroscopic camera to look inside Sophie's joints.
20:06He will try and save Sophie's right hind knee joint.
20:09It's just the ridges on either side are not high enough to keep the kneecap in.
20:18And that's the problem.
20:21Instead of removing the whole joint, Noel will design an implant that will aim to keep the kneecap in place.
20:30Next, he moves on to Sophie's front legs.
20:32You can see that there's raw bone here with no cartilage on it.
20:38That's not good.
20:41So that's rubbing.
20:43Noel will have to operate.
20:45So what I'm going to do is I'm going to cut the ulna.
20:48The top part kicks down and back and then it heals itself without any stabilisation.
20:53So no pin, no plate required.
20:55Luckily, Noel won't have to operate on Sophie's other front leg for now.
21:02There we go.
21:04The ulna is free to move.
21:08It's obviously not going to cure the arthritis, but it should certainly help to decrease pain in the elbow as a result of rubbing.
21:16It will take about 8 to 12 weeks for this to heal properly.
21:19During that time, we'll be making the new ridges for the knee.
21:25So the timing is just about right.
21:29Sophie can go home in a couple of days to recover.
21:33But she'll have to wait for a custom implant to be made to repair her slipping kneecap.
21:38Sue has brought in seven-month-old Labrador puppy, Bertie.
21:57Her son Johnny has come to help, although he too has struggled with her sleeping kneecap.
22:02I think the frustration got hold of Bertie this morning and I picked him up to stroke him and he's gouged my nose out here.
22:17And the last four months or so, we've had him on the lead a lot and he's just had a lot of pent-up energy.
22:23Bertie's going to have his first of two operations.
22:26He's having a resurfacing of his ankle joint on his left leg.
22:31Very nervous.
22:33Bertie Taylor, please.
22:36Hi, guys.
22:41How are you today? Hello, mate. How are you?
22:44I heard the dog scratch you. I'm sorry about that.
22:47Oh, dear. Yeah, he's very boisterous, isn't he?
22:50He's very boisterous.
22:52Here's some tissue.
22:53There you go.
22:55Right, OK, so you know what I'm doing today.
22:57I'm going to put a custom ridge onto his ankle joint or we'll give him some sedatives to help him to cope.
23:04Yeah, I think that's our main worry. We're not quite sure how he's...
23:08Yeah, it's everybody's main worry because he's so boisterous, as you can see. I'm sorry about that.
23:13OK, guys. God bless. See you later. Bye-bye.
23:16Bye-bye.
23:17Hopefully, when he's had the surgery, then he'll get back to being a lovely puppy that can actually get rid of his energy and then he won't be quite so mad.
23:31First, Noel will access the joint by temporarily removing a piece of tibia bone.
23:45Next, he opens the ankle and prepares the diseased surface to place in the new custom implant.
23:50Finally, he'll fix the ligament attached to the piece of tibia back into position, securing it with special eyelet pins and wire.
24:03As we open up the ankle, so we can see here where the big hole is, and unfortunately that big hole of raw bone has already rubbed away a bit on the other side here.
24:20We're just going to sculpt the correct shape in order to put our implant in.
24:25So we want this to fit just right.
24:32OK, so that's the metal ridge in place now. We've filled the hole.
24:38What 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.
24:48Then we'll do the other side in six weeks.
24:50Jade, the rescue cat, has been recovering at the practice for nine days after her total knee replacement.
25:12But she's still got a long way to go.
25:14She'll need intensive physiotherapy and laser treatment daily to stretch her contracted muscles.
25:21Hello. How are you?
25:24Good.
25:26Jo has returned with her daughter Jenny for a visit.
25:31Jade adores my daughter and she's missed her like crazy.
25:36She loves her cuddles with you as well, doesn't she?
25:39Yeah, 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, OK?
25:51So what we're encouraging every day is this, like so.
25:55So she's got to put that down.
25:56Yeah, so she's got to put that down. You see that?
25:58Pick her up there.
26:02She's wanting to pull it forward, but she can't flex it.
26:05Come on, beautiful.
26:06I'm still concerned whether we're going to get function or not into that quadriceps,
26:12because it's been deformed for so long.
26:16She'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 or two weeks?
26:23No, of course we're not.
26:25No, I appreciate that.
26:26And as I said to you from day one, it will take as long as it takes.
26:29OK, Bub, in you go. Well done. Good.
26:32It's definitely hard leaving her behind, but we know we're on the road to getting her better and fixed,
26:41and hopefully using that leg again properly.
26:44So we're going to be waiting now with bated breath for updates.
26:51See you later, ladies. We'll see you again.
26:53Lively Labrador pup Bertie has been at the practice for a week after having his first partial ankle replacement.
27:14Bertie, take your seat or let him know you're here.
27:17Sue has returned to pick him up with her other son, James, to give her a hand.
27:23Very excited here. I'm a bit worried he's going to go mad.
27:28Hopefully he won't scratch us like he scratched Johnny.
27:34This is your new ankle ridge replacement.
27:37As you can see, the objective of the operation is to replace the entire defect with this cap.
27:43The cap is a super smooth surface that will rub forever on the opposing surface of the tibia.
27:50Super clear?
27:52Yeah. Good.
27:54Post-operative confinement is the main thing.
27:56So no running, no jumping, no slipping, no sliding.
27:59If the family manage to keep Bertie calm,
28:03Hi Bertie.
28:04And everything goes to plan, he will have his right ankle surgery in six weeks' time.
28:11Come on, mate. Now, here we are.
28:14It's up to us now, really. We've just got to make sure that he doesn't leap around or jump or what have you,
28:19so that he's got the best chance of it working, really.
28:23So, just got to do our best.
28:25It's lovely out there.
28:36It's alright. I'll stay in here. Keep warm, keep dry.
28:42The day has come for Jo to leave Springer Spaniel's Sophie at Fitzpatrick's once again,
28:48this time for surgery on her knee.
28:49You are pups. You're going to have to stay here.
28:54I know.
28:56I know.
29:02Okay, it's okay.
29:04Hopefully this operation will be Sophie's last.
29:09When I left her with, she was just looking. It was just...
29:13Don't believe me, Mum.
29:15She's my child, and I love her.
29:20That's partly what's crucifying, is...
29:23Yeah, just...
29:27She can't play or anything like that.
29:31She is the dog that's with me all the time.
29:35So, it's like I've lost my shadow.
29:38First, Noel starts by preparing the joint for the new custom implant.
29:46We've drilled away the cartilage from the old worn groove,
29:51and now we're going to put a new smooth groove on.
29:53Noel uses bone graft collected from Sophie's bone
29:57to create a bed for the new groove to sit on.
30:00This implant is made out of cobalt chromium,
30:03which is three-dimensionally printed from the CT scan.
30:05The undersurface is made out of a mesh.
30:09We've coated it in a mineral called hydroxyapatite,
30:13which attracts bone cells onto it.
30:15Okay, so we're just going to put the kneecap back into the groove now.
30:19There we go, stitch up, we're done.
30:22So, the kneecap is gliding nicely at the moment.
30:24Let's hope it stays that way.
30:26Let's hope it stays that way.
30:28The practice has a specialised rehabilitation technique.
30:31The practice has a specialised rehabilitation centre, including hydrotherapy pool.
30:32For many, it's the gateway to a full recovery.
30:33For many, it's the gateway to a full recovery.
30:36The practice has a specialised rehabilitation centre, including hydrotherapy pool.
30:39For many, it's the gateway to a full recovery.
30:40Good boy.
30:41Usually, it's the dogs getting the benefit.
30:42But, surprisingly, cats can enjoy it, too.
30:43It's the gateway to a full recovery.
30:44The practice has a specialised rehabilitation centre, including hydrotherapy pool.
30:58For many, it's the gateway to a full recovery.
31:01Good boy.
31:02Usually, it's the dogs getting the benefit.
31:07But, surprisingly, cats can enjoy it, too.
31:15Some of the time.
31:17Jade is having hydrotherapy, a beneficial treatment to help stretch her quadriceps muscle after her knee replacement.
31:25You avoided that one well.
31:33After two weeks of daily rehabilitation, she's progressing enough to go home.
31:44In just a week, the improvement there is massive.
31:48A little bit apprehensive about the rehab, but we'll just keep going and play it day by day at the moment.
31:56My daughter's really, really happy to have her home.
31:58She's her little baby.
31:59So, yeah, she's over the moon.
32:07Down in Hampshire...
32:12Bertie, the Labrador pup, is at home recovering after having his second ankle surgery.
32:19Bertie.
32:20He's on strict cage rest.
32:22I hadn't realised how hard it was going to be to have him in the crate.
32:27You can't leave the room.
32:29He starts to cry or get upset.
32:33It's just the sad look that is the worst thing.
32:39Every time you do take him out, you're terrified that he's going to damage it.
32:43It's very intense, to be honest.
32:44It's not what a puppy should be doing with it.
32:51It's, you know, he should be having fun and being able to play.
32:55Bertie!
32:58Bertie!
32:59Shh!
33:00He's, you know, he's missed out on being a puppy.
33:03Bertie!
33:04It's three days after Sophie the Springer Spaniel had what Joe hopes is her final knee surgery.
33:18She's arrived eager to collect her companion.
33:19I'll probably describe myself as nervously excited for some reason. I don't know why.
33:21I just haven't been able to get her off my mind.
33:24This is what your implant looks like.
33:25Right.
33:26So you can see that the surface architecture of this implant has been designed to perfectly contour the original femur.
33:31Oh.
33:32Bertie!
33:33It's the last part of the fifth neck.
33:34It's three days after Sophie the Springer Spaniel had what Joe hopes is her final knee surgery.
33:38She's arrived eager to collect her companion.
33:42I'll probably describe myself as nervously excited for some reason, I don't know why.
33:47I just haven't been able to get her off my mind.
33:50This is what your implant looks like.
33:51the original femur but I'm very pleased with that and so is your dog so if you
33:57push your chair back I will show you come on there there we go good now
34:04hello mommy hello mom doing fine oh baby she's actually walking on it without too
34:13much trouble the kneecaps in a very nice position it's central everything's good
34:17she's wagging her tail she's happy okay thank you all right my entire pleasure
34:21it's great you mean you love her very much and she's very lucky you're very
34:24lucky to have each other like with the harness don't let her jump no and then
34:29we'll just support it like that oh I've missed you this time no no messing with
34:37Sophie in the car okay be good with her she's still a bit of fragile well safe
34:41journey thank you so much no worries take my bye-bye you're back home now darling
34:46yes it's gonna be fine
35:02orthopedic 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
35:13leg up a bit so I don't know if it's hurting him or not not as good as the
35:18other one Graham was concerned there could be a problem with this second surgery when
35:24he's out walking he's good yeah but when he pauses he will sometimes lift it not
35:29always yeah so I'm sort of worried to death yeah yeah Betty all right let's just take
35:34him through that's fine okay let's just go through that okay let's go straight
35:38through yeah all right thanks 30 is immediately sedated and taken for a CT scan
35:47while Graham and Sue wait when noel operated on Bertie's second ankle he added a metal plate
35:58on the side to stabilize the repair the results are in sadly your hunch was right there is something
36:08wrong it's very unusual I've not seen it before what he's done is he's actually cracked the implant
36:15the metal the metal the metal the other side when we rotate it you can see that there's a nice smooth
36:25ridge and it's actually integrating well there's no issue but on the other side which is the side that's
36:37affected by the swelling but he has cracked the metal here around the peg before the bone
36:45has grown in so I think what's happened is for whatever reason in the cage or otherwise he's
36:52pivoted on it because direct compression shouldn't crack it because it's got a bone bed to sit on yeah
36:58and it's a tight joint we have some of these out three years now and they're still fine but I've
37:04not seen one crack yet because clearly he's putting more load on this than any dog we've had before
37:11well you've seen what he's like yeah I can't leave that the way it is so I've got to replace that and I'll
37:23probably have to take off a couple more millibon and make it thicker shell and I obviously feel awful
37:29about it but yeah as well you'll understand as a surgeon you're gonna get complications but I
37:38definitely did not see that one coming okay give me a couple of sex I'm sorry okay you're right to be
37:50doom and gloom I mean it's better than the infection soon yeah I know I mean he's potentially solvable
37:59what a little thing I just feel sorry about it oh well that's why we feel awful not only out of the
38:05breeze is it I mean you just feel dreadfully sorry for him
38:07now you crazy boy I'm sorry mate stay brave okay thanks now bye it's a major setback for Graham and
38:28Sue Bertie will need yet another surgery to replace the broken implant but must wait for a stronger
38:34thicker implant to be made look at his little face something had to be wrong it's just going through
38:41all again for him he can't play he can't do anything you couldn't listen to that for long could you
39:04boisterous Labrador pup Bertie is back at the practice for his third surgery a week after breaking his ankle
39:15implant it's a big day in more ways than one is it his birthday today what a shitty way to spend your
39:26birthday what a great way to spend your birthday oh my god Bertie is one year old today okay so this
39:45implant is thicker it's got a thicker surface in here in the middle around the peg so it's less likely to
39:51crack so that's our new implant in place now looks like a nice fit I'm happy with that it's seating
40:00down nicely okay so now we put the plate back in Sue will collect Bertie in a couple of days in the hope
40:14this second implant will withstand Bertie's bouncy behavior Joe is back with springer spaniel Sophie she's
40:33hoping that Sophie's latest surgery has finally stopped her kneecap slipping all right Sophie good girl
40:41let's have a little bit girl well done so you've been following the rules I can see I've been doing
40:47my best right has she escaped at any time and she's got on and off the safer at least you're being honest
40:55so I'm gonna take an x-ray picture to make sure that the illness healing as well as an x-ray picture of
41:04the right knee today is an important day because today is all about is the kneecap tracking
41:10appropriately and is the implant intact one of the things I've forgotten to mention actually she's actually
41:18in season all right um and my other dog is quite gay with her oh I see and I turned around when she came in
41:25disease and she was twice she'd gone to about like no pumping and jumping okay that wasn't on the
41:36post-operative confinement sheet it should say no humping and not jumping the x-ray pictures have
41:46been sent through the good news is that the line of the kneecaps very nice now and it's in its groove
41:52and it's seated very nicely and the elbow now you can see Bonnie healing there so that's all hunky-dory
42:00no need to cry at least at least their tears of joy I know it feels like it's been a long long journey
42:09now you still have a little bit of the journey to go because you've lost a shed load of muscle yes
42:13yeah that seemed to go overnight yes yeah that needs to be really worked on
42:17now there we go thank you very welcome well done thank you now no off lead and no humping and
42:29no jumping no jumping no jumping okay thank you all right take care thank you no hunting no jumping
42:38at home in Cheshire Joe and Sophie are taking their homework very seriously
42:52if I 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
43:04and at some stage during the morning I'll do her physiotherapy exercises
43:10walking over the poles sit to stands good girl I've had to cut my work hours down to half it doesn't
43:22sound very much actually but it feels as though it's quite constant during the day is that all we do so
43:27and the hard work has paid off so I started letting her off the lead just a little bit in
43:37this garden but it's not very much at all I do get a little bit worried if she picks up speed and
43:42she starts running around in circles and things and hopping as she goes so I'm trying mostly just
43:47to keep her exercise nice and steady I have managed to avoid Sophie being humped especially
43:53because my other two dogs are in season my oldest one tried and then I managed to stop her in time
43:58so that's okay I'm very very grateful to know for what he's done she's got a lot of years ahead of
44:06her still at home in Surrey after a grueling four months of physiotherapy to stretch her leg muscle
44:18Jade is finally making steps in the right direction the op obviously was the major part getting the knee
44:25fixed but without the physio we wouldn't have the cat we've got today Jade does live in a house with
44:33eight other cats some she doesn't get on with quite so much but you know being able to move around more
44:40freely now and be able to run she can choose who she's interacts with and who she doesn't she tends
44:48to stick with upstairs and she has her own little space yeah yeah she's playing really well she loves
45:02to jump around run around now she never used to do any of this so it's just amazing to watch her
45:10in Hampshire after three surgeries and nine months of treatment Bertie the energetic Labrador is finally
45:24catching up on his missed puppyhood he's doing really really well we're really pleased and he's
45:31really able to play with Ollie and just have a great time it's left its mark we both put on half
45:36a stone comfort eating you know you get quite depressed looking at the dog behind bars it's all
45:43been worth it I think he's comfortable he's cheerful he's jumping on the furniture again if you don't
45:48really keep an eye on it I'm pleased that we went for the partial resurfacing rather than having a fusion
45:56we felt it was unfair in a young dog to do that really I'd like it very much if we had an implant
46:03that we could use in humans which is similar to the one that Bertie's had technologies there it could
46:08be done clearly it's been done in Bertie so there are a few patients who benefit from that it's just
46:14lovely seeing him you know just bounding around the garden and exploring it's just lovely to see
46:44you
Be the first to comment