Biceps Tendinopathy
Problems with the biceps tendon are thought to be the result of chronic repetitive overuse and may result in chronic changes within the tendon or inflammation. The terms tendonitis/tenosynovitis may be used to describe these problems in the biceps tendon, but there is a lack of inflammation in most dogs. For this reason, the term tendinopathy is more appropriate. We try to avoid surgical intervention in most dogs, but this is dependent on how severe the problem is as determined by imaging studies such as ultrasound. Conservative options may include therapeutic exercise, extracorporeal shockwave, initial exercise restriction followed by a slow return to activity, and laser therapy. The judicious short-term use of anti-inflammatory drugs is also considered. In many cases, no anti-inflammatory drugs are used at all.
If the severity of the problem is significant enough or should the patient fail conservative management, surgical options for biceps tendinopathy exist. Most commonly, a small camera is placed into the joint to provide a “release.” This simply means the surgeon transects the tendon. This allows the tendon to slip into its sheath where it will adhere to surrounding tissues. This is usually considered in tendons sustaining substantial tearing or in a tendon poorly responsive to conservative management. This is known as arthroscopic tenotomy of the biceps tendon.
Medial Shoulder Instability
Shoulder instability is defined as laxity that is associated with clinical signs, such as pain and lameness. Medial shoulder instability is the most common form and refers to instability on the inside of the shoulder. The cause of such instability can be traumatic in nature or as a result of chronic repetitive overuse injury. As with other shoulder conditions, non-surgical management of these cases is attempted first. Should this conservative management fail, a variety of surgical methods are available. Conservative management can be attempted in more mild cases. This management involves the placement of hobbles or a commercial hobbling system to prevent unwanted abduction and thus further tearing of the ligament. Anti-inflammatory medications and a slow reintroduction to activity only after physical therapy are also instituted. The intent is to provide joint protection, range of motion, comfort, improved muscle mass and ultimately translate this into strength. A host of surgical procedures have been developed to treat medial shoulder instability if rehabilitation is unsuccessful. These procedures aim to stabilize the inside portion of the shoulder. Your Spry Companions surgeon would discuss options as well as the desired postoperative care and rehabilitation.