Orthopaedics and Spinal Surgery
Orthopaedics and Spinal Surgery overview
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- Willows has one of the most experienced
Small Animal Orthopaedic and Spinal Surgery teams in the UK - Eight highly trained Specialists…
- with over 70 first author papers in peer reviewed journals
- who are regularly invited to speak at conferences/CPD meetings in the UK and overseas
- Unsurpassed, comprehensive service, 24 hours a day, 365 days of the year
- Hospitalised patients benefit from 24-hour veterinary and nursing care
- Rapid Radiographic Reporting service with advice on case management
- Free telephone advice given with the minimum of delay
Personnel
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RCVS/European Specialists |
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BVMS MVS DSAO MACVSc MRCVS |
BVSc MVM DSAS(Orth) DipECVS MRCVS |
BSc BVetMed CertSAS DipECVS MRCVS |
BVM&S DSAS(Orth) DipECVS MRCVS |
MA VetMB CertVR CertSAS DSAS(Orth) PGCertMedEd FHEA MRCVS |
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RCVS/European Specialists
Malcolm McKee
BVMS MVS DSAO MACVSc MRCVS
Toby Gemmill
BVSc MVM DSAS(Orth) DipECVS MRCVS
Jonathan Pink
BSc BVetMed CertSAS DipECVS MRCVS
Stephen Clarke
BVM&S DSAS(Orth) DipECVS MRCVS
Gareth Arthurs
MA VetMB CertVR CertSAS DSAS(Orth) PGCertMedEd FHEA MRCVS
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RCVS/European Neurology Specialists |
Neurology/Neurosurgeon Clinician |
Neurology/Neurosurgeon Resident |
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DVM DipECVN MRCVS |
DVM DipECVN MRCVS |
DVM MRCVS |
BVetMed MRCVS |
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RCVS/European Neurology Specialists
Sebastien Behr
DVM DipECVN MRCVS
Raquel Trevail
DVM DipECVN MRCVS
Neurology/Neurosurgeon Clinician
Roberto José-López
DVM MRCVS
Neurology/Neurosurgeon Resident
James Elford
BVetMed MRCVS
Areas of special interest
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Lameness investigation |
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Some lameness cases can be extremely complex and require specialist training and advanced imaging in order to make a diagnosis and formulate a treatment plan. Our orthopaedic surgeons benefit from on-site:
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Computed tomography (CT scan) at Willows |
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Humeral condylar fissure visible on CT but not shown on X-ray |
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Lameness investigation
Some lameness cases can be extremely complex and require specialist training and advanced imaging in order to make a diagnosis and formulate a treatment plan. Our orthopaedic surgeons benefit from on-site:
- Digital radiography
- Arthroscopy
- Computed tomography (16 slice)
- Magnetic resonance imaging (1.5 tesla)
- Ultrasonography
- Interpretation by three Imaging Specialists
Computed tomography (CT scan) at Willows
Humeral condylar fissure visible on CT but not shown on X-ray
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Arthroscopy |
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A range of chemotherapy protocols is available. Particular areas of interest include:
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Arthroscopy at Willows |
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Bicipital tenosynovitis ina Labrador Retriever |
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Arthroscopy
A range of chemotherapy protocols is available. Particular areas of interest include:
- 1.9 mm, 2.4 mm and 2.7 mm arthroscopes
- Enabling detailed examination of many joints, including the shoulder,
elbow and stifle1 - Arthroscopic surgery in selected cases, for example:
- biceps tendon release for bicipital tenosynovitis
- subtotal coronoidectomy for elbow dysplasia
Arthroscopy at Willows
Bicipital tenosynovitis ina Labrador Retriever
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Cruciate ligament surgery |
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Rupture of the cranial cruciate ligament is the most common cause of lameness in dogs. We carefully assess each patient to decide whether surgery would be beneficial. Some dogs require only a menisectomy, whilst others benefit from a tibial osteotomy to dynamically stabilise the stifle. In selected cases we perform:
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TPLO in a Rottweiler |
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TWO in a Golden Retriever |
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Cruciate ligament surgery
Rupture of the cranial cruciate ligament is the most common cause of lameness in dogs. We carefully assess each patient to decide whether surgery would be beneficial. Some dogs require only a menisectomy, whilst others benefit from a tibial osteotomy to dynamically stabilise the stifle. In selected cases we perform:
- Tibial plateau levelling osteotomy (TPLO)
- Tibial wedge osteotomy (TWO)
- Tibial tuberosity advancement (TTA)
- Triple tibial osteotomy (TTO)
TPLO in a Rottweiler
TWO in a Golden Retriever
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Joint replacements |
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Willows is a leading Specialist centre for joint replacement surgery:
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Bilateral hybrid hip replacement in a German Shepherd Dog
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Joint replacements
Willows is a leading Specialist centre for joint replacement surgery:
- Over 500 hip, knee and elbow replacements have been performed in dogs
and cats referred from all over the country, including Northern Ireland, Eire and the Channel Islands - We recently published the results of 78 consecutive hip replacements and
reported good clinical results in over 95% of cases2 - Specialists Toby Gemmill and Malcolm McKee performed the first total knee replacement in a dog in the UK
Bilateral hybrid hip replacement in a German Shepherd Dog
- Total knee replacement in a Bearded Collie
- Cementless TATE elbow replacement in a Labrador Retriever
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Fractures and joint luxations |
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We manage fractures that are both relatively straightforward and those that are very complex3. ‘Y’ fractures involving the humeral condyle are one of the most challenging fractures that orthopaedic surgeons face. We repair these articular fractures via combined medial and lateral approaches with bilateral fixation and we have reported good success with this technique4,5. We manage joint luxations with a variety of techniques, including hinged external skeletal fixators, to optimise limb function. |
Humeral ‘Y’ fracture repair in a Clumber Spaniel with a transcondylar screw and medial and lateral plates
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Fractures and joint luxations
We manage fractures that are both relatively straightforward and those that are very complex3. ‘Y’ fractures involving the humeral condyle are one of the most challenging fractures that orthopaedic surgeons face. We repair these articular fractures via combined medial and lateral approaches with bilateral fixation and we have reported good success with this technique4,5.
We manage joint luxations with a variety of techniques, including hinged external skeletal fixators, to optimise limb function.
Humeral ‘Y’ fracture repair in a Clumber Spaniel with a transcondylar screw and medial and lateral plates
Management of a shearing injury of the medial malleolus in a working Border Collie using a hinged transarticular fixator
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Arthrodesis |
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Pancarpal arthrodesis in an English Setter using orthogonal plates 
Pantarsal arthrodesis in a Border Collie using a customised plate |
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Arthrodesis
- All joints with the exception of the hip can be arthrodesed
- Function is especially good following fusion of the carpal and tarsal joints, and to a lesser degree the shoulder
- Wherever possible we prefer replacement of elbow and stifle joints, rather than arthrodesis, due to compromised function with the latter
- Our Specialists have published on the subject of arthrodesis6,7
Pancarpal arthrodesis in an English Setter using orthogonal plates
Pantarsal arthrodesis in a Border Collie using a customised plate
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Limb deformities |
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Limb deformities can be challenging and necessitate complex surgery, including correction of angular and rotational abnormalities and occasionally limb lengthening. The latter procedures require advanced training in order to minimise the potential for complications. We recently published a review on this topic8. |
Correction of severe pes varus in a Dachshund by opening wedge osteotomy and plate fixation |
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Limb deformities
Limb deformities can be challenging and necessitate complex surgery, including correction of angular and rotational abnormalities and occasionally limb lengthening. The latter procedures require advanced training in order to minimise the potential for complications. We recently published a review on this topic8.
Correction of severe pes varus in a Dachshund by opening wedge osteotomy and plate fixation
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Limb sparing surgery |
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Management of ectrodactyly ('lobster claw') in a West Highland White Terrier by transposition of the paw and pancarpal arthrodesis |
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Limb sparing surgery
- Some dogs and cats may be suitable for a limb sparing procedure, rather than amputation, to maintain limb function
- Limb sparing operations usually sacrifice the normal function of a joint in the limb
- Arthrodesis of a joint is generally necessary, although occasionally the joint can be replaced
- Limb sparing procedures can be life-saving in some patients where amputation is not an option
Management of ectrodactyly ('lobster claw') in a West Highland White Terrier by transposition of the paw and pancarpal arthrodesis
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Advanced spinal surgery |
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Our team of neurology and orthopaedic Specialists carry out advanced spinal surgery on a regular basis. Key areas of expertise include:
We have developed novel techniques for managing these conditions and have published widely on these challenging cases9,10. |
Management of atlanto-axial instability in a terrier by ventral fixation with screws and bone cement 
Tantalum spinal fusion block for the management of cervical spondylopathy-associated disc protrusion in a Dobermann
SOP plates in the management of thoracolumbar disc protrusions in a German Shepherd Dog
Cervical vertebral fracture-luxation in a Dobermann managed with pins |
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Advanced spinal surgery
Our team of neurology and orthopaedic Specialists carry out advanced spinal surgery on a regular basis. Key areas of expertise include:
- Atlantoaxial instability
- Cervical spondylopathy (Wobbler syndrome)
- Thoracolumbar disc protrusion
- Degenerative lumbosacral stenosis
- Vertebral fractures and luxations
We have developed novel techniques for managing these conditions and have published widely on these challenging cases9,10.
Management of atlanto-axial instability in a terrier by ventral fixation with screws and bonecement
Tantalum spinal fusion block for the management of cervical spondylopathy-associated disc protrusion in a Dobermann
SOP plates in the management of thoracolumbar disc protrusions in a German Shepherd Dog
Cervical vertebral fracture-luxation in a Dobermann managed with pins
and bone cement
- Gemmill, T. J. and Farrell, M. Evaluation of a joint distractor to facilitate arthroscopy of the canine stifle. Veterinary Surgery 38, 588-594, 2009
- Gemmill, T. J. and others. Hybrid cemented/cementless total hip replacement in dogs: seventy-eight consecutive joint replacements. Veterinary Surgery 40, 621-630, 2011
- Gemmill, T. J. Advances in the management of diaphyseal fractures. In Practice 29, 584-593, 2007
- McKee, W. M. and others. Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs. Journal of Small Animal Practice 46, 217-226, 2005
- Macias, C. and others. Y-T humeral fractures with supracondylar comminution in five cats. Journal of Small Animal Practice 47, 89-93, 2006
- McKee, W. M. and others. Pantarsal arthrodesis with a customised medial or lateral bone plate in 13 dogs. Veterinary Record 154, 165-170, 2004
- Clarke, S. P. and others. Clinical evaluation of pancarpal arthrodesis using a CastLess plate in 11 dogs. Veterinary Surgery 38, 852-860, 2009
- McKee, W. M. Growth deformities of the long bones in dogs. In Practice 32, 282-291, 2010
- McKee, W. M. and Sharp, N. J. H. Cervical spondylopathy. In: Textbook of Small Animal Surgery. 3rd edition. Ed Slatter, pp 1180-1193, 2003
- Downes, C. J. and others. Hemilaminectomy and vertebral stabilisation for the treatment of thoracolumbar disc protrusion in 28 dogs. Journal of Small Animal Practice 50, 525-535, 2009
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