Veterinary Orthopedic Surgery in St. Louis

In-house veterinary orthopedic surgery — cruciate repair, TPLO, luxating patella, and fractures — with multimodal pain control and full rehabilitation support.

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Veterinary surgeon performing orthopedic surgery on a dog's knee at Clix Family Hospitals in St. Louis, MO

Medically reviewed by Dr. Marcus Williams, DVM Associate Veterinarian · Last reviewed April 17, 2026

Clix Family Hospitals performs in-house veterinary orthopedic surgery in St. Louis, MO — including TPLO (tibial plateau leveling osteotomy), cruciate ligament (CCL/ACL) repair, luxating patella correction, fracture fixation, and femoral head ostectomy (FHO). Procedures are led by Dr. Marcus Williams, DVM, with advanced orthopedic training and regional nerve-block anesthesia, multimodal pain control, and a structured 12–16 week rehabilitation plan. Consults start at $250; most surgical cases run $2,200–$5,500 per leg.

TPLO performed in-house using ACVS-aligned surgical protocols
Advanced pain management: epidural, nerve blocks, NSAIDs, gabapentin, take-home meds
Digital radiographs on day one; 6-week bone-healing X-ray included
Structured 12–16 week recovery plan with written home exercises
Underwater treadmill & rehab partner in-network for fastest return to function
Same-day consult scheduling for acute non-weight-bearing lameness

By the Numbers

Veterinary Orthopedic Surgery by the Numbers

2–5%: lifetime prevalence of cranial cruciate ligament (CCL) disease in dogs — the most common canine orthopedic injury
~90%: excellent-to-good lameness outcome rate following TPLO in peer-reviewed systematic review
40–50%: of dogs with one CCL tear will rupture the opposite side — often within the first year

4–5×: higher patellar-luxation risk in Pomeranians, Yorkshire Terriers, and Chihuahuas vs. the general dog population (diagnosed prevalence 5–7%) O'Neill et al., Canine Genetics & Epidemiology 2016
12–70%: hip dysplasia prevalence varies widely by breed — Labs & Goldens ~12–20%, Rottweilers ~20%, Saint Bernards ~47%, Bulldogs & Pugs over 70% Orthopedic Foundation for Animals (OFA)
Measurable: gains in stifle range of motion, thigh muscle circumference, and earlier full weight-bearing with structured post-op rehabilitation vs. exercise restriction alone (RCT) Monk et al., AJVR 2006

Overview

About Orthopedics

Orthopedic conditions — cranial cruciate ligament (CCL/ACL) disease, hip and elbow dysplasia, luxating patella, and fractures — account for more mobility-related vet visits than any other category. Cruciate disease is the most common orthopedic injury in dogs, with lifetime prevalence reported at roughly 2–5% depending on breed (Witsberger et al., JAVMA 2008), and roughly 40–50% of dogs who tear one CCL will rupture the opposite side — often within the first year (Buote et al., Veterinary Surgery 2009). Early, accurate diagnosis changes outcomes.

Our St. Louis orthopedic team is led by Associate Veterinarian Dr. Marcus Williams, DVM, who completed advanced orthopedic training at Tuskegee University CVM. We perform TPLO, cruciate repair, luxating patella correction, FHO, and fracture stabilization in-house using ACVS-aligned surgical protocols, dedicated anesthesia monitoring, regional nerve-block pain management, and a structured rehabilitation plan with our in-network hydrotherapy partner. For cases requiring advanced CT imaging, MRI, or total hip replacement, we coordinate directly with a board-certified veterinary surgeon.

Why Clix

Why Choose Clix for Orthopedics

In-House TPLO & Cruciate Repair

Skip the specialty referral wait — most surgeries scheduled within 1–2 weeks of diagnosis.

Advanced Pain Management

Epidural anesthesia, regional nerve blocks, NSAIDs, gabapentin, and tapered take-home meds.

Digital Radiography On-Site

Same-day X-rays to stage the injury and map the surgical plan.

Rehabilitation Partnership

Underwater treadmill, laser therapy, and structured PT with our in-network rehab partner.

Symptoms

Signs Your Dog May Need an Orthopedic Evaluation

Dogs are stoic about joint pain — they often keep moving until the damage is significant. If you notice any of the signs below, especially two or more, schedule an orthopedic consult.

Sudden limping or non-weight-bearing on a hind leg
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Classic CCL tear presentation — often after a jump, slip, or hard play.
Sitting with one hind leg extended to the side
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The "sit test" is a strong indicator of a torn cruciate ligament.
Bunny-hopping gait (both hind legs moving together)
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Common with hip dysplasia or bilateral cruciate disease.
Reluctance to jump on furniture or climb stairs
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Usually the earliest sign of hip, knee, or lumbosacral pain.
Skipping steps or "hopping" one leg while running
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Classic intermittent luxating patella presentation in small breeds.
Muscle atrophy (thinning) in one hind leg
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Means the dog has been offloading that leg for weeks — ligament or joint issue likely.
Popping, clicking, or grinding in a joint
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Meniscal injury, dysplasia, or advanced arthritis.
Stiffness after rest that improves with movement
Routine

Osteoarthritis signal — time to stage severity and start a management plan.
Yelping or flinching when a joint is touched
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Acute non-weight-bearing with visible swelling or angulation
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Possible fracture — call our emergency line before coming in.

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The Process

What to Expect

Lameness Exam & Imaging

Gait analysis, joint palpation, drawer/cranial-tibial-thrust testing, and same-day digital radiographs under sedation if needed.

Diagnosis & Surgical Plan

We walk through the exact findings, the procedure options (TPLO vs. lateral suture vs. conservative), expected outcomes, and an itemized estimate — all before you commit.

Surgery Day

Drop-off 7:00–8:00 AM, pre-anesthetic bloodwork, epidural or regional nerve block, surgery, and monitored recovery. Most pets discharge the same afternoon or the following morning for complex cases.

Structured Recovery

12–16 week rehabilitation plan with written home exercises, scheduled rechecks, pain-med tapering, and a 6-week X-ray to confirm bone healing.

Recovery

TPLO & Orthopedic Recovery Timeline

Orthopedic recovery is a marathon, not a sprint. Here is what to expect week-by-week after TPLO or other major orthopedic surgery — strict rest first, controlled rehab next, gradual return to activity last.

Day 0 (surgery day)

Wake-up & discharge

Dedicated technician monitors recovery from anesthesia. Most TPLO patients discharge the same afternoon with an e-collar, take-home NSAIDs, gabapentin, and sometimes a mild sedative. Complex cases (bilateral TPLO, fractures) stay overnight. Offer a small soft meal 2 hours after arriving home.
Weeks 1–2

Strict rest phase

Confined space (pen, crate, or gated room). Short 5-minute leashed bathroom breaks only — no stairs, no jumping, no off-leash activity. Use a sling or towel under the belly for support. Incision check at 10–14 days and suture or staple removal if non-absorbable.
Weeks 3–8

Controlled activity + home rehab

Gradual increase in leash walks (5 → 20 minutes by week 8). Start basic home exercises: 3-leg standing, sit-to-stand reps, cavaletti walks. Optional underwater treadmill sessions with our rehab partner. Still no stairs, jumping, or slippery floors.
Weeks 8–12

Rehabilitation ramp-up

Leash duration increases to 30+ minutes. Light hill work and controlled jogging introduced. Continue PT and/or hydrotherapy. A 6-week bone-healing X-ray confirms the osteotomy is fusing — plate and screws stay in permanently.
Weeks 12–16+

Return to activity

Progressive return to off-leash play, running, and sport. Most dogs reach near-normal function by week 16. Long-term: daily joint supplements, weight control, non-slip surfaces, and an annual orthopedic recheck.

Transparent Pricing

Orthopedic Surgery Pricing by Procedure

Orthopedic pricing depends primarily on the procedure and whether one or both legs are treated. Every surgical patient gets a detailed itemized estimate after the consult and imaging — before you commit to surgery.

Consult

Orthopedic Evaluation + Imaging

$250–$500

Comprehensive lameness exam
Joint palpation & manipulation tests
Digital radiographs (sedation if needed)
Written diagnosis & treatment plan
Credit toward surgery if scheduled within 30 days

Tier 1

Luxating Patella Correction

$2,200–$3,800

Pre-anesthetic bloodwork & IV fluids
Regional nerve block & epidural
Surgical correction (trochleoplasty + tibial tuberosity transposition as needed)
Overnight pain meds & e-collar
Complimentary recheck at 10–14 days

Tier 2

TPLO / Cruciate (CCL) Repair — Per Leg

$3,800–$5,500

Everything in Tier 1
TPLO bone-plate osteotomy (gold-standard for dogs >30 lbs)
Intra-op fluoroscopy
Take-home NSAIDs, gabapentin, sedatives
Written 12–16 week rehab plan
6-week bone-healing X-ray

Tier 3

Complex: FHO, Fracture, Bilateral, Multi-Ligament

$5,500–$9,500+

Everything in Tier 2
Femoral head ostectomy (FHO) or fracture fixation
Bilateral TPLO (single anesthesia event)
Extended anesthesia monitoring
Priority rehab slot with in-network partner

What Affects Your Estimate

Type of procedure (patella, TPLO, FHO, fracture)
Unilateral vs. bilateral repair
Pre-surgical imaging and bloodwork
Regional nerve blocks and epidural anesthesia
Post-op rehabilitation package
Clix Wellness Membership discount (10% to 15% off, by plan)

Our Transparency Promise

We call you with an itemized estimate after X-rays and probing — before any treatment begins. No surprises, ever.

Get a Personalized Estimate Call (314) 555-CLIX

Clix Wellness Members save 10% to 15% on procedures, depending on their plan. Learn about membership →

Serving St. Louis Metro

Orthopedics for Pets Across the St. Louis Area

Clix Family Hospitals is located at 601 E. Lockwood Ave., Webster Groves, MO 63119, just south of Forest Park and minutes from I-64/Highway 40. Pet parents regularly travel to us for orthopedics from across the metro area, including:

Central West End
The Hill
Forest Park Southeast
Clayton
Maplewood
Webster Groves
Kirkwood
Brentwood
Richmond Heights
University City
Dogtown
Tower Grove
Ballwin
Chesterfield
Creve Coeur

Address: 601 E. Lockwood Ave., Webster Groves, MO 63119
Phone: (314) 555-CLIX
Hours: Mon–Fri 7am–7pm
Sat 8am–4pm
Sun 10am–2pm
Accreditation: AAHA Accredited · Fear Free Certified

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Tailored Care

Orthopedic Risk by Species & Breed

Dogs

Dogs account for >95% of veterinary orthopedic surgery. CCL tears are by far the most common surgical case; luxating patella, hip and elbow dysplasia, and fractures round out the core caseload. Large, over-conditioned, and spay/neutered dogs carry elevated CCL risk; small breeds dominate luxating patella prevalence.

Cats

Cats develop orthopedic disease less often than dogs but are experts at hiding pain — arthritis affects roughly 60% of cats over 10. Patellar luxation, hip dysplasia, and fractures from falls are the most common surgical presentations. Cats usually do very well with FHO (femoral head ostectomy) when the hip is unsalvageable.

Breed-Specific Guidance

Large breeds (Labrador, Golden, Rottweiler, Newfoundland, Boxer, Saint Bernard): Highest CCL tear rates and at elevated risk for hip & elbow dysplasia. Early-adult X-ray screening (especially for planned working or sport dogs) catches dysplasia before arthritis sets in.
Small breeds (Yorkie, Pomeranian, Chihuahua, Toy Poodle, Maltese): Diagnosed patellar-luxation prevalence in these breeds runs roughly 5–7% — four to five times the general dog population (O'Neill et al., Canine Genetics & Epidemiology 2016). Grades 1–2 are often managed conservatively; grades 3–4 typically need surgical correction to prevent arthritis and cruciate strain.
Giant breeds (Great Dane, Bernese Mountain Dog, Mastiff, Irish Wolfhound): Elbow dysplasia (fragmented coronoid process, UAP, OCD) is common. Controlled growth rates, large-breed puppy diets, and minimized concussive exercise during the first 18 months lower lifetime surgical risk.
Sport & working dogs (GSD, Malinois, Border Collie, Vizsla, Australian Shepherd): High per-capita orthopedic injury rate from repetitive high-impact activity. We coordinate conditioning plans, CCL-prevention nutrition, and early intervention with our rehab partner.
Senior dogs (7+): Pre-anesthetic bloodwork, cardiac auscultation, and body-condition assessment determine candidacy — not age. A healthy 10-year-old Lab tolerates TPLO about as well as a 4-year-old. Dr. Chen coordinates kidney, cardiac, and endocrine management with the surgical plan.

At-Home Prevention

At-Home Orthopedic & Rehabilitation Care

Surgical outcomes are made or broken at home. Structured rest, daily rehab exercises, weight control, and joint support are what separate a 95% outcome from a frustrating one.

Confined recovery space

A pen, crate, or gated room with a non-slip orthopedic bed is the single most important recovery tool. Free roaming in the first 6 weeks is the #1 cause of implant failure and re-injury.

Home rehab exercises

Daily 3-leg standing (5–10 seconds per set), sit-to-stand reps (10 per session), slow figure-eight walks, and cavaletti (low-bar) walks build strength without stressing the osteotomy. We provide a printed plan with video links.

Joint supplements

Dasuquin Advanced (glucosamine + chondroitin + ASU) and an omega-3 EPA/DHA supplement (at least 90 mg/kg EPA daily) have the strongest evidence for reducing arthritis progression. Start the day after surgery and continue for life.

Weight management

Even a 10% body-weight reduction dramatically reduces joint load and pain. Ask us for a precise feeding plan and body-condition score target before surgery — many owners underestimate how much a lean dog improves outcomes.

Librela / Adequan injections

For dogs with bilateral disease or significant arthritis, we often add monthly Librela (bedinvetmab — a canine NGF monoclonal antibody) or Adequan (polysulfated glycosaminoglycan) injection series for chronic pain and cartilage support.

Home-safety modifications

Runners or rugs over hardwood/tile floors, baby gates blocking stairs, elevated food and water bowls, a ramp or steps to get onto furniture, and a car ramp for SUVs prevent reinjury during and after recovery.

Product and medication references are illustrative — always confirm dosing with your veterinarian. For long-term joint support, look for products evaluated by the National Animal Supplement Council (NASC) .

Meet Your Care Team

Veterinarians Leading Orthopedics at Clix

You'll never wonder who is handling your pet's care. Every orthopedics procedure at Clix Family Hospitals is performed by a named, credentialed veterinarian with specific training in this area.

Dr. Marcus Williams, DVM

Associate Veterinarian

8+ yrs experience · Tuskegee University College of Veterinary Medicine

Dr. Williams is the lead orthopedic surgeon at Clix Family Hospitals. He performs TPLO (tibial plateau leveling osteotomy), cruciate ligament repair, luxating patella correction, FHO, and fracture fixation in-house using ACVS-aligned surgical protocols, regional nerve blocks, and intra-op fluoroscopy. Every surgical patient leaves with a written 12–16 week rehabilitation plan.

"A TPLO is half surgery and half rehab. If we nail the osteotomy but the owner cannot keep the dog rested and doing daily home exercises, we lose half the benefit. My job is to set the surgical foundation and the recovery roadmap equally."

350+ orthopedic surgeries performed at Clix — TPLO, luxating patella, FHO, and fracture cases

Specialty training & credentials

• Advanced orthopedic surgical training — Tuskegee University CVM
• TPLO certification & ACVS-aligned surgical protocols
• Regional anesthesia certified (epidural, femoral, sciatic nerve blocks)
• Fear Free Certified
• Member, Veterinary Orthopedic Society

Dr. Sarah Chen, DVM

Medical Director

12+ yrs experience · University of Missouri College of Veterinary Medicine

Dr. Chen runs the medical workup for every orthopedic surgical case — pre-anesthetic bloodwork, cardiac auscultation, body-condition scoring, and coordination of any kidney, cardiac, or endocrine conditions with the surgical plan. She also manages long-term multimodal pain and arthritis care for post-op patients and dogs in conservative management.

"A great surgical outcome starts with the medical workup. My job is to make sure we are going in with the clearest possible picture of the whole dog — not just the knee."

Co-manages every Clix orthopedic surgical patient and 200+ chronic-pain patients annually

Specialty training & credentials

• Pre-anesthetic medical screening lead
• Advanced training in chronic pain and arthritis management (NSAIDs, gabapentin, Librela/Adequan protocols)
• Ultrasonography (abdominal + musculoskeletal soft tissue)
• Fear Free Certified

Real Patients

What St. Louis Pet Parents Say

Zeus tore his ACL at the dog park and I was devastated. Dr. Williams performed the TPLO surgery and the entire team was amazing through recovery. Zeus is back to full speed — you'd never know he had surgery. Worth every penny.

Scout tore her cruciate chasing a frisbee at 6 years old — completely non-weight-bearing the next morning. Dr. Williams had us in for a consult the same day, did the TPLO a week later, and walked us through every week of the 16-week recovery plan. Six months out, she is back to frisbee with the other leg already screened. Same-day booking and an in-house surgeon saved us weeks of referral wait.

Penelope has been skipping on her back leg since she was a puppy — turned out to be grade 3 luxating patella on both sides. Dr. Williams corrected both knees in a single anesthesia event. The rehab plan was detailed down to daily sit-to-stand reps. At her 12-week recheck she was literally running figure-eights in the hallway. She is a different dog.

Frequently Asked

Orthopedics FAQs

At Clix Family Hospitals, TPLO (tibial plateau leveling osteotomy) for cruciate repair runs $3,800–$5,500 per leg and includes pre-anesthetic bloodwork, regional nerve block and epidural, the TPLO osteotomy, intra-op fluoroscopy, take-home pain medication, a written 12–16 week rehab plan, and a 6-week bone-healing X-ray. Bilateral TPLOs or complex fracture cases run $5,500–$9,500+. Clix Wellness Members save 15%.

A fully torn cranial cruciate ligament does not heal without surgery. Small dogs under 30 lbs with partial tears sometimes respond to strict rest, weight management, and rehab, but the gold standard for dogs over 30 lbs is TPLO. Waiting tends to accelerate arthritis in the knee and increases the chance of the opposite side tearing — published data show roughly 40–50% of dogs rupture the second CCL, often within the first year (Buote et al., Veterinary Surgery 2009).

The cranial cruciate ligament (CCL) is the canine equivalent of the human ACL — it stabilizes the knee. Most canine CCL tears are not acute sports injuries but the end-stage of slow degenerative disease in the ligament. Signs include sudden hind-leg limping, non-weight-bearing on one leg, sitting with the leg off to the side, and muscle loss in the affected thigh.

For dogs over 30 lbs, TPLO has the highest published success rate — roughly 90% excellent-to-good outcomes in systematic review (Bergh et al., JAAHA 2014) — and the fastest return to athletic function. Lateral suture and TightRope techniques are less invasive and less expensive but have higher failure rates in large, active dogs (Gordon-Evans et al., JAVMA 2013). We match the technique to the dog — size, activity level, body condition — and walk you through the trade-offs before you commit.

Plan on a structured 12–16 week recovery. Weeks 0–2 are strict rest with only short leashed bathroom breaks. Weeks 2–6 introduce controlled leash walks and basic home rehab exercises. Weeks 6–10 ramp up leash duration and optional underwater treadmill sessions. A 6-week bone-healing X-ray confirms the osteotomy is fusing. Most dogs return to near-normal activity around week 12–16.

Published data show roughly 40–50% of dogs with one CCL tear rupture the opposite side, often within the first year (Buote et al., Veterinary Surgery 2009). If imaging at your initial consult shows early degenerative changes in the other knee, we discuss bilateral TPLO (both legs in a single anesthesia event) as an option — higher upfront cost but one recovery period instead of two and a single anesthesia risk.

Systematic review of TPLO outcomes reports ~90% excellent-to-good function (Bergh et al., JAAHA 2014). Lateral suture techniques have lower published success rates, particularly in larger, more active dogs (Gordon-Evans et al., JAVMA 2013). Structured rehabilitation (underwater treadmill, targeted PT, weight management) measurably improves outcomes across every technique (Monk et al., AJVR 2006).

Most accident-and-illness pet insurance plans cover CCL surgery, luxating patella, fractures, and hip dysplasia treatment — but only if you enrolled before the condition was diagnosed. Many plans also require a waiting period for orthopedic claims (often 6–12 months). We provide itemized invoices and pre-approval letters to help with reimbursement.

Sudden non-weight-bearing lameness needs same-day evaluation — especially after a jump, fall, or rough play. Intermittent limping lasting more than 48 hours, stiffness after rest, muscle atrophy in one leg, or popping/clicking in a joint also warrant a prompt orthopedic consult. Early intervention prevents permanent arthritic change.

Grade 1 luxating patella (kneecap slips in and out but returns on its own) is often managed with weight control, joint supplements, and muscle-strengthening exercises. Grades 2–4 — where the kneecap stays out of place or causes chronic lameness — typically need surgical correction to prevent progressive arthritis and cruciate strain. We grade the patella at the initial exam and walk you through the decision.

Hip dysplasia is a developmental malformation where the ball of the femur does not fit cleanly into the hip socket, leading to joint instability, cartilage damage, and secondary arthritis. Prevalence varies widely by breed per OFA data — roughly 12–20% in Labs, Goldens, German Shepherds, and Rottweilers, about 47% in Saint Bernards, and over 70% in Bulldogs and Pugs. Typical signs include a bunny-hopping gait, reluctance to rise, and difficulty with stairs.

Mild cases are managed conservatively with weight control, NSAIDs, joint supplements (Dasuquin, Omega-3), Adequan/Librela injections, and rehabilitation. Moderate-to-severe cases may benefit from femoral head ostectomy (FHO) or total hip replacement (THR — referred to a board-certified surgical center). We stage severity on X-rays and build a plan that fits the dog and the family's goals.

Age is not a disease — a healthy 10-year-old often tolerates TPLO as well as a healthy 4-year-old. Pre-anesthetic bloodwork, cardiac screening, and body-condition assessment determine candidacy, not age alone. Dr. Chen coordinates any kidney, cardiac, or endocrine management with the surgical plan for senior patients.

Strict rest is the single most important step — no stairs, no jumping, no off-leash activity. We prescribe NSAIDs (carprofen, grapiprant, or meloxicam) and often gabapentin or amantadine for multimodal control. Cold compresses on the joint for 10–15 minutes a few times daily and a padded orthopedic bed help. Avoid human pain medications — most are toxic to dogs.

Labrador Retrievers, Rottweilers, Newfoundlands, Staffordshire Terriers, Boxers, Mastiffs, and Saint Bernards have the highest published incidence (Witsberger et al., JAVMA 2008). Over-conditioned pets, spayed/neutered dogs, and active sporting dogs are also at elevated risk. Lifetime CCL-disease prevalence is roughly 2–5% of dogs — it is by far the most common canine orthopedic surgery in the US.

Before surgery day: set up a confined recovery zone (pen, crate, or gated room) with a non-slip orthopedic bed. Add runners or rugs over hardwood/tile. Block stairs with baby gates. Raise food and water bowls. Buy an e-collar or recovery suit. Plan for assisted bathroom breaks using a sling or towel under the belly for the first 2 weeks.

Every surgical patient gets a written 12–16 week home-exercise plan (sit-to-stand reps, 3-leg standing, cavaletti walks, controlled leash duration). We partner with a local underwater-treadmill and canine rehab facility for patients who want accelerated recovery — typically 1–2 sessions per week for 8–12 weeks. A randomized controlled trial (Monk et al., AJVR 2006) showed dogs receiving structured post-op rehabilitation achieved measurably greater stifle range of motion, thigh muscle circumference, and earlier full weight-bearing compared with exercise restriction alone.

Modern veterinary orthopedic surgery is very safe when performed with proper pre-anesthetic screening and monitoring. Major complication rates for TPLO run roughly 2–5% (infection, implant issue, or meniscal re-tear). Every Clix surgical patient gets bloodwork, IV fluids, continuous ECG/BP/SpO2/CO2/temp monitoring, regional nerve blocks, and a dedicated anesthesia technician throughout the procedure.

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