Orthopaedic Surgeries
​During James’ studies, he has been very fortunate in having Professor Dr. Dick White FRCVS, founder of Dick White Referrals, and Dr. Martin Owen MRCVS founder of East of England Veterinary Specialists, as mentors.
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James enjoys all types of surgery but has a particular interest in soft tissue and orthopaedic surgery, especially stifle (knee) surgery.
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Meet Dr. James!
Dr. James R. Sutton BVM&S Post Graduate Certificate Small Animal Surgery MRCVS, to give him his full title!
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James has been a small animal vet for over 20 years after graduating from Edinburgh Vet School in 2003. With a keen interest in surgery throughout his career, he completed his Post Graduate Certificate in 2024.
At House & Jackson Veterinary Hospital, we are able to offer Tibial Plateau Levelling Osteotomy (TPLO) for cruciate disease, De Angelis repair (lateral suture) and Medial Patella Correction (luxating patella) surgeries.
TPLO Surgery
This is an arthrotomy and surgical stabilisation of the ruptured cranial cruciate ligament (CCL) using a Tibial Plateau Levelling Osteotomy (TPLO), to stabilise the knee joint. A TPLO requires the cutting of the tibia (shin bone) and rotating the tibial plateau, altering the articular surface of the tibia, allowing function and weight bearing through the knee joint, without having to rely on the redundant CCL for stability.
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TPLO involves opening the knee joint, examining and removing the damaged portions of the cruciate ligament, and examining the meniscus. Damaged portions of the medial meniscus, if present, were excised, leaving the remaining intact meniscus. This acts as an important joint stabiliser, and impact cushion inside the knee joint.
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The cut shinbone is fixed in the correct position during the TPLO with metal plates and screws. The plates and screws hold the bone in its new position until the bone is healed (approx. 8-10 weeks). The implants will remain in place for life unless they are causing concerns.
De Angelis (Lateral Suture) Repair
to stabilise ruptured cruciate ligament
This is an arthrotomy and surgical stabilisation of the ruptured cranial cruciate ligament (CCL) using the De Angelis Technique.
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Surgery involves opening the knee joint, examining and removing the damaged portions of the cruciate ligament, and examining the meniscus. Damaged portions of the medial meniscus, if present, are excised, leaving the remaining intact meniscus. This acts as an important joint stabiliser, and impact cushion inside the knee joint.
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After the joint is examined, a strong suture (50-100lb strength) is placed around the fabella (a small bone at the back of the knee), and thread through a hole drilled in the tibia (shin bone). This is tightened to create a stabilizing force within the knee joint to compensate for the torn CCL.
Luxating Patella surgery
This surgery addresses a luxating patella or dislocating/slipping knee cap. The patella should normally slide up and down in a groove at the bottom of the thigh bone (femur) as the knee joint is working as a hinge. Medial luxation is where the patella slips out of the femoral groove inwards. Surgery involves a combination of three procedures to return stability to the patella.
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Wedge Recession Trochleoplasty: Deepening of the femoral groove by removing a wedge of bone. Enables the patella to sit deeper in the trochlear groove.
Tibial Tuberosity Transposition: Used to re-align the patella ligament which joins the patella to the tibia (shin bone). Helps pull the patella back into the groove to allow it to track properly. Requires the cut bone to be held in its new position with 1-2 metal pins and a tension band wire.
Soft Tissue Reconstruction: Tightening or loosening the soft tissues on either side of the patella to allow it to track smoothly.
RECOVERY
Post surgery
You will be advised about the specific recovery path for your animal, but usually the initial reassessment of limb function and wound healing will be performed seven days after the surgery, and a final wound check will be two weeks after surgery. A check will generally follow at 4 weeks post-surgery, with a final check three months after the surgery.
Rehabilitation
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Physiotherapy and laser therapy can commence two weeks after surgery if the wound has healed, both of which we can offer at H&J. You can find out a little more about these on our Rehabilitation page
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We recommend including hydrotherapy as part of your animal’s rehabilitation, which can commence four weeks post-surgery. We include 10 hydrotherapy sessions with our trained hydro team at Blackmore, are included in the price of the surgery, if you do not use these sessions they will be refunded to you.
Prognosis
The prognosis is good to excellent in over 90% of patients, with the majority of dogs returning to normal athletic activity, depending on their condition and degree of osteoarthritis (OA) already present at the time of injury. OA is expected in all patients that have joint injury; however, this may be managed with maintaining a lean body condition, physiotherapy, hydrotherapy, appropriate use of joint supplements (fish oils, MSM), use of anti-inflammatories, and moderation of exercise - mind is willing, body may not be able.
As our animals get older, their mobility can begin to decline, but there are often things we can do to help. It may not always be surgery. We will work with you to find the best path for your pet to give them a better quality of life.
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To find our more or to make an appointment, please call us - 01277 823858.