Dog Knee Injury

Prices for veterinary surgery vary greatly depending on where you are located no matter whether you choose TTA, TPLO, TR, or a lateral suture method.  The prices can also fluctuate due to the availability of a certain procedure, number of surgeons performing the surgery, and the size of your dog. A number of veterinary practices will include a number of weeks of post-op physical therapy, including hydrotherapy, as part of a package price for the surgery. It is important when comparing prices to understand what is included in the quoted price, so you are able to compare apples to apples.  Taking these factors into consideration can help to explain the wide variance in prices presently for the Tightrope (TR) CCL repair surgery. Read the rest of this entry »

The newest surgical technique to repair torn cranial cruciate ligaments in dogs is the tightrope procedure.  Tightrope CCL is an extracapsular technique which uses lateral suture stabilization in conjunction with a virtually indestructible material called FiberTape for knee joint stabilization.  The Fiber Tape is placed in the dog’s knee through a few small incisions, mostly done arthroscopically, which create tunnels through the bone, and is considered to be one of the least invasive surgical approaches to canine cruciate injury repair.  Read the rest of this entry »

How is Tightrope CCL Different from Extracapsular Imbrication or Traditional Repair?

The major difference between extracapsular imbrication/traditional repair methods and tightrope ccl is the way in which the knee joint is stabilized.  In a traditional CCL repair, a leader line (suture, or you can also think of this as a fishing line) is woven across the knee in a figure-eight pattern, connecting a bony protrusion on the femur to a small hole drilled in the top of the tibia.  The veterinary surgeon is able to access the knee through an incision on the knee a few inches long.   During the healing process, the leader line serves as a temporary way to stabilize the knee while scar tissue forms.  Eventually the leader line will break, and the scar tissue is solely responsible for providing knee joint stability. Read the rest of this entry »

The standard rehabilitation procedure for Tightrope repair is a bit different than TTA and TPLO, due to the less invasive nature of the procedure.  When dogs return home from Tightrope repair, owners are instructed to allow their dog to utilize the leg as they wish.  For some dogs this means they will start putting weight on it the next day, and for other dogs it could be 2-4 weeks before they feel comfortable bearing weight on the surgical leg.  Keeping your dog still while in the house, and keeping leashed walking to a minimum (bathroom breaks only) is critical during the first few weeks home no matter what procedure you choose, and exercise/movement restriction is advised for the first 8 post operative weeks.

At 4 weeks post op, most veterinarians will instruct owners to begin introducing their dog back to walks, particularly walking uphill in an attempt to rebuild loss muscle mass.  It is a good idea to start out by taking a few short walks every day, gradually working up to longer and less frequent walks.  This will prevent strain on the knee joint, which can hinder the healing process.  Post operative exercises need to be controlled, leashed walks, as any running, jumping, or roughhousing during the first 8 weeks can be detrimental to the stability of the knee and recovery process.

Upon his arrival home, your dog will need to take a number of medications for pain, inflammation, infection prevention, and possibly sedation.  If your buddy is not a willing pill taker, it is a good idea to try to get them into the habit of taking a small snack such as a piece of cheese, peanut butter, or a hot dog slice after their meals.  Each dog is different with regard to how long they need to be on a particular pain, inflammation, antibiotic, and sedation regimen, but usually the antibiotics are taken over 10 days, with the pain/inflammation/sedation used on an as needed basis.

As a general rule, just pay close attention to your dog and be sure to tailor their recovery to their particular needs.  There is no such thing as having a post operative dog rest too long, but there is always the risk of damage to the repair if your dog tries to do too much, too soon.  Tightrope CCL, like other traditional repair methods (lateral suture, extracapsular imbrication), is simply a way to stabilize the joint while scar tissue is being formed, it is not a replacement ligament.

The Tightrope CCL repair surgery is the newest surgical option available for dogs with cranial cruciate ligament injury.  Unlike in humans, canine CCL tears and damage generally takes place over a period of months or years, rather than being associated with a single traumatic event.  Because of the nature of these injuries, and their degenerative process over time, this new procedure focuses on a technique used in human ankle joints using bone to bone fixation in a minimally invasive way. Read the rest of this entry »

It is not unusual for dogs who have a cranial cruciate ligament rupture in one leg to develop one in the other leg. It is a little unusual to have two severe ruptures at the same time, but it does occur, especially in large breed dogs or overweight canines. Generally the signs of this type of injury will manifest itself in the dog with an impaired gait, shaking while walking, and/or dragging the back legs. It is not unusual for veterinarians and pet owners to think that partial paralysis is present or that the severe lameness is due to spinal disc disease because of the severity of the presentation. Read the rest of this entry »

When there is a joint injury like a cranial cruciate ligament (CCL) rupture, it is important for the vet to try to preserve the menisci to the greatest extent possible. Loss of all or part of a stifle’s meniscus has the potential to accelerate the breakdown of articular cartilage with resultant DJD (Degenerative Joint Disease). The more of the meniscus that is lost through injury or through surgical removal, the less stable the joint will be in future, and the greater the potential for DJD, i.e. arthritis. The risk of further damage to the menisci is minimized by greatly reducing activity after ligament injury while the dog’s body re-establishes stability in the joint. Read the rest of this entry »

If you and your veterinarian have decided to take surgical approach (TTA, TPLO, traditional/extracapsular/lateral suture repair, Tightrope) to correcting your dog’s cranial cruciate ligament rupture, you will want to be prepared for what to do prior to your dog’s knee surgery. The following checklist will provide a general idea of talking points to discuss with your canine’s vet prior to the ccl repair procedure. If you are aware of many of these policies and procedures before the surgery day, it will help to ease your worries about the surgery and ultimately make your dog’s recovery more relaxed. Read the rest of this entry »

TPLO, or tibial plateau leveling osteotomy, and TTA, or tibial tuberosity advancement, are two very new and biomechanically similar surgical techniques. Both the TPLO and TTA create stability within the dog stifle by altering the angle of the knee and using implants to hold the knee in place while the joint heals in its new position. The TTA procedure is actually a modified version of the TPLO procedure, using the removal of bone of the tibia to allow the restructuring of the stifle’s angle, which is subsequently held in place by metal implants. Read the rest of this entry »

TTA is the abbreviation for tibial tuberosity advancement.  The TTA is among the newer techniques for cranial cruciate ligament repair of the canine stifle, making its appearance roughly 10 years ago. The TTA technique was developed in 2002 at the University of Zurich, and, biomechanically speaking, the procedure is very similar to the TPLO, without carrying many of the risks. In fact, the TTA is a simpler procedure for veterinary surgeons to perform than the tibial plateau leveling osteotomy, or TPLO, and works to correct the injured stifle without over correcting the angle - as TPLO often does. Read the rest of this entry »