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.
This procedure is substantially less invasive than other canine knee repair surgeries, especially TTA and TPLO, which involve the cutting and repositioning of bone. The Tightrope CCL is also easier to perform than these other procedures, making the risk for complications and infection substantially lower. The Tightrope CCL has been shown to be very cost effective when compared with TTA, TPLO, and even traditional repairs, and the estimated cost is $1000 less than a TTA or TPLO. Dogs that were involved in the clinical trial for Tightrope CC, “experienced fewer and less severe complications with outcomes that were equal to or better than those seen with the bone-cutting technique.”
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.