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.

We would expect TR costs to be substantially lower than TPLO or TTA, but slightly higher than a conventional Lateral Suture Surgery (extracapsular imbrication, traditional repair).  Reported Tight Rope costs have ranged from $700 to $2500, and seem to depend mostly on geographic location and type of facility where the surgery was performed.  At a private practice in North Dakota an owner paid $1108 for everything, which included exam, diagnostics, anesthesia, scope, surgery, FiberTape implant, post operative monitoring, bandages, and medications (TPLO was $1900 at the same practice). At one major US state university vet facility, the total bill for TR done by top ortho surgeons including was in the $2200-2500 range.

The materials used in TR are a lot less expensive than those used in TPLO/TTA, and the surgery itself is a lot less complex. A typical TPLO procedure takes about one hour, whereas TR is completed in about 20 minutes. Less time under anesthesia, less surgical time, a simpler procedure, and fewer materials should translate into a lower cost for dog owners. I expect in the future we will see the prices for Tightrope repair somewhere in the $1000 range as more veterinarians become trained and proficient in this technique.

Remember, when looking for a veterinary surgeon, a higher price does not necessarily mean a better surgeon or superior procedure.

Below is the invoice for an estimate I received when contemplating Tightrope repair for my dog.  The low end of the estimate was $3,551.16 and the high end of the estimate was $3,635.94 for Tight rope surgery.

A few things to note before going into the details of the invoice:

1)  My dog in an American Bulldog weighing roughly 90 pounds (normal weight), and is 5 years old.

2)  He is in good health with no pre-existing conditions that would complicate anesthesia or surgery.

3)  This estimate, although some of the information has been blacked out to protect privacy, is from a speciality veterinary clinic with veterinary surgeons who specialize in cranial cruciate ligament repair surgeries in dogs.

4)  I live in Southern California, and this estimate is from a veterinary office in that area.

I will go line by line to go over the charges included in the cost of Tightrope surgery.  For smaller animals some of the values will be less, and accordingly for larger dogs.  Hopefully this invoice will give you a basic picture of what you can expect to pay for a Tight rope repair, and where all of the money goes.

EST Tightrope Procedure – $0 – Placeholder to tell us what type of estimate we are looking at.

CBC and Chemistry Profile – $163.80 – Blood panel including complete blood count and general chemistry to make sure your dog is healthy enough to tolerate anesthesia and the TR procedure.

Radiograph, 2 Views – $224.70 – X-rays needed prior to surgery to both confirm diagnosis of torn CCL (rule out other possible causes of lameness), and to act as a guide for the veterinary surgeon during the procedure.

Radiology Interpretation – $45.68 – Cost to have a veterinary professional examine and read the x-rays.

Catheterization, Intravenous – $94.00 – An IV will be placed in your dog’s vein through which your pet will receive medication and fluids during and immediately following surgery.

Surgery Room Use – $113.82 – Fee associated with use of the operating room for the duration of time required to perform the Tightrope surgery (this value is significantly more for a TPLO).

Isoflurane Gas Anesthesia, Initial 15 Min – $117.88 – Cost for the anesthetic gas used to put your dog under anesthesia during the procedure.

Isoflurane Gas, Additional – $168.60 for 60 minutes and $252.90 for 90 minutes – Cost for additional quantities of anesthetic gas depending on how long the ccl repair takes.

Tightrope Standard – $470. 00 – Cost of Tightrope surgery related supplies, this is mostly the cost of the Fiber Tape.

Surgical Anesthesia, Level I – $294.00 – Cost associated with keeping your dog under anesthesia during surgery and providing medications/monitoring.

Surgical Supplies, Orthopedic – $268.54 – Fee for use of general surgical supplies used during Tightrope repair (scalpel, drapes, cautery tools, etc.), this does not include the cost of the actual Tightrope Fibertape material.

Surgeons Fee 2 – $960.75 – Price the surgeon charges to perform Tightrope repair surgery.

Elective Ortho Hospitalization, General – $138.92 – Fee to have your dog kept in the veterinary hospital overnight following the CCL surgery with monitoring.

Misc. Medications, Surgical – $400.00 – This includes prescription medications given to your pet post operatively and those sent home with you during the post operative period.  They would include a sedative (Acepromazine), pain relief (Tramadol), anti inflammatory (Rimadyl), and an antibiotic(Cephalexin), and possibly other medications at your veterinarian’s discretion.

Fentanyl 75 mcg patch – $65.00 – Pain relief patch that will be placed in your pet to control post operative discomfort.

Buster Collar 25 cm, Clear – $23.86 – Collar to be placed on your dog during the post operative period to prevent them from ripping out their stitches or injuring the surgical site.

Also included are all of the post operative recheck visits, but be aware that if you pet develops any complications related to the surgery you will be required to pay for any additional expenses incurred.

What Does TightRope Surgery Cost? is a post from: Dog Knee Injury

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. 

Unfortunately, not every dog is a good candidate for the tightrope procedure.  Below you will find some general criteria that excludes certain dogs from tightrope surgery.  Remember – This list is in no way conclusive or exhaustive, your veterinarian will take into consideration many factors including your dog’s age, weight, health history, onset of injury, and physical conformation when making a treatment recommendation for your pet.

Who is not a Candidate for Tightrope CCL Repair?

1)  Dogs weighing less than 30-40 pounds.

2)  Dogs (and people) that cannot follow a physical rehabilitation protocol after surgery.

3)  Canines with limb deformities of any kind.

4)  Dogs with a steep tibial plateau, usually an angle of more than 30 degrees.

Is My Dog a Candidate for Tightrope Surgery? is a post from: Dog Knee Injury

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.

In tightrope repair, a stronger material called Fiber Tape is used to connect bone to bone.  The FiberTape is held in place on the bone via metal anchors and small holes drilled through the bone.  The surgeon makes a few small incisions to access the points of attachment to the bone.  While the Fiber Tape will eventually degrade and possibly break over time, it is thought of as a superior material for larger dogs due to its greater durability and strength – buying your dog more recovery time.  While in place the Fiber Tape will act to control tibial thrust and prevents the cranial drawer sign, while allowing your dog to maintain full range of motion.

Both traditional repair and tightrope are considered to be minimally invasive procedures when compared to other surgical options like TTA and TPLO, which both involve cutting and changing of bone angles.

Tightrope Surgery vs. Extracapsular or Traditional Repair is a post from: Dog Knee Injury

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.

Tightrope CCL is an extracapsular technique using the lateral suture stabilization (LSS) procedure in conjunction with a material called FiberTape to provide bone to bone stabilization.  The Fiber Tape is placed in the dog’s knee through a few small incisions which create tunnels through the bone.  Once the implant is anchored to the bone it is able to control cranial tibial thrust, and provide correction for the canine drawer sign, all while allowing internal rotation of the knee joint and normal range of motion.  Similar to traditional extracapsular repairs using monofilament sutures (similar to a leader line or fishing line), the Fiber Tape used in TR repair will degrade over time and is not meant to provide permanent stablization to the knee joint.  Bascially, the Fiber Tape is there to hold the joint in place while the knee forms scar tissue around the knee to permanently stablize the joint.

The cases of failure in the study were related to incidences of not properly following guidelines related to physical therapy in the post operative period.  A recovery period of 10-12 weeks is recommended for all dogs recovering from CCL repair surgery, and this is the same guideline used for the Tightrope surgery.

Right now this surgery is still in the clinical phases, but with such encouraging preliminary results, I expect to see much more on this procedure in the very near future.

Tightrope CCL Procedure is a post from: Dog Knee Injury

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 4 surgical procedures before talking to your veterinarian about which one he/she recommends.

Surgical Repair Techniques for CCL Repairs:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
   

Surgical Repair Options for Cranial Cruciate Ligament Repair is a post from: Dog Knee Injury