For dogs diagnosed with cranial cruciate ligament tears or ruptures there are a number of non-surgical and surgical options available. Each dog is different, and your veterinarian will take into consideration your canine’s weight, size, overall health, severity of injury and the duration since onset when determining what treatment is best for your pet. Non-surgical options are generally referred to as “conservative management” and this treatment involves the use of weight management, prescription non-steroidals and rest to strengthen the joint and begin the healing process.
There are a few different surgical options for dogs with canine cruciate injuries, and not all veterinarians are trained in each procedure. It is important to find out from your vet what procedures they perform, and ask for referrals to specialists if you would like more information on a different type of procedure. There are vets the specialize in orthopedics and, if possible, it is preferable to choose a physician with this type of experience. Be sure to read up on each of the following surgical procedures before talking to your veterinarian about which one he/she recommends.
Surgical Repair Techniques for CCL Repairs (Click on the titles below to read more about each procedure):
- Traditional Repair or Extracapsular Imbrication Technique – A leader line is woven in a figure-eight pattern through the joint beginning at the outer aspect of the femur to the tibial crest. The heavy suture will eventually be replaced by scar tissue providing support for the joint.
- Tibial Plateau Leveling Osteotomy or TPLO - The head of the tibia is surgically altered and plated to create a new joint angle and prevent the femur from sliding off of the tibia. This procedure is an invasive on and involves cutting and plating of bone; it is associated with a higher rate of complications than the other surgical options.
- Tibial Tuberosity Advancement or TTA - This is very similar to TPLO, yet considered to be less invasive, and involves stabilization of the stifle joint by cutting the bone and changing the angles of the knee.
- Fibular Head Transposition – The head of the fibula is rotated and the lateral collateral ligament is moved in such a way that it mimics the cruciate ligament. The new positioning of the fibula is held in place using pins and wires. This procedure is not done very often and you may have a hard time finding a veterinarian that will actually perform it.
- Tightrope Repair – An extracapsular technique using the lateral suture stabilization (LSS) procedure in conjunction with a material called FiberTape to provide bone to bone stabilization. Similar to traditional repair, the joint will form scar tissue, but the Fibertape will also provide support for a greater length of time.
- Triple Tibial Osteotomy or TTO – The idea behind the TTO is to combine aspects of the TPLO and TTA to create a new angle within the injured knee joint. During a TTO CCL surgery a veterinarian will make three cuts (where the “triple” comes from) into the dog’s tibia. These three cuts into the tibia bone will allow the surgeon to then rotate the tibial plateau slightly (as they do in a TPLO), while moving the tibial tuberosity forward slightly (as is done in a TTA).