Veazie Veterinary Clinic
1522 State Street, Veazie, ME
(207) 941-8840

Cruciate Ligament Surgical Options

Dave__Keeley post CCLThere are many different surgical repair techniques used in veterinary medicine today. The two most common are a Lateral Suture Ligament Replacement (extracapsular repair) and the Tibial Plateau Leveling Osteotomy or TPLO. The extracapsular repair is the most common repair performed in veterinary practice.

Extracapsular Repair

During this procedure:

  • The joint is opened and inspected for damage
  • The torn ligament is removed
  • Arthritic changes may be removed
  • The meniscus is inspected and removed if necessary
  • The joint is stabilized by replacing the failed ligament with one or more nylon bands
  • These bands will provide stability but can give and flex as needed to allow for mobility. The bands normally remain in place for life.

This surgery is done routinely at the Veazie Veterinary Clinic. We perform a thorough evaluation prior to surgery to be certain this procedure is necessary and appropriate for your dog.

  • A pre-surgical evaluation including blood work and radiographs will be done
  • An IV catheter, fluids, pain medication, antibiotics will be administered
  • Our rehabilitation technicians will perform post-operative care and rehab
  • We will provide you with all medications, icepacks, and instructions to ensure your dog have the best outcome possible.

Tibial Plateau Leveling Osteotomy (TPLO)

The TPLO is a new procedure that must be performed by a veterinarian licensed to perform this surgery. This surgery is complex and involves special training in this specific technique. We recommend that this procedure be performed by surgeon experienced in the technique.

  • Several radiographs are necessary to calculate the angle of the cut in the tibia
  • The joint is opened and inspected for damage
  • The torn ligament is removed, arthritic changes may be removed
  • The meniscus is inspected and removed if necessary
  • The tibia is cut and rotated until the sloped tibial plateau is perpendicular to the line between the stifle and the hock joint centers.
  • Once in a neutral position, the need for a cruciate ligament is eliminated.

Tibial Tuberosity Advancement Surgery (TTA)

The forces within the knee are very complicated and change as the knee is rotated through its range of motion. In a normal standing position there is a tendency for the lower end of the femur to slide backwards on the tilted tibial plateau, this is called tibial thrust. This force can be corrected by counteracting this force by changing the angle of pull of the very strong patellar tendon by advancing the tibial tuberosity (TTA).

  • In this technique, the front edge of the tibia is cut
  • A titanium wedge is placed between the body of the bone and the tuberosity
  • This movement changes the angle of the patella ligament to the stifle
  • In turn, this neutralizes the shear forces and eliminates the problem in the joint.

What if the Rupture Isn’t Discovered for Years and Joint Disease is Already Advanced?

A dog with arthritis pain from an old cruciate rupture may still benefit from surgery. Some of the arthritic changes can be removed. If the meniscus is damaged it should be removed and the joint stabilized.

What if the Cruciate Rupture is Not Surgically Repaired?

Without an intact cruciate ligament, the knee is unstable causing premature wear of the cartilage. Degenerative joint disease occurs causing chronic pain and loss of motion. This process can be slowed or arrested by surgery but cannot be reversed.

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