Tightrope Knee Surgery for Dogs – Maxwell

tightrope knee surgery for dogsMaxwell is a 103 lb Rhodesian Ridgeback mix in excellent athletic shape and very active. At 4 years old (last year – summer 2013) he tore his CCL on his left stifle completely while running and turning quickly. My normal vet said I would have to seek out a surgeon, she was unable to offer any surgical options.

Finding a Tightrope Repair Surgeon

I contacted 5 different surgeons in the Tampa, Florida area – all were completely focused on the very invasive TPLO or TTA procedures. Extracapsular Imbrication (some people refer to this as the “fishing line fix”) was not indicated for a dog Maxwell’s size. Ironically – I’m an engineer who works in the Human Sports Medicine industry and I was completely against the very invasive and aggressive TPLO and TTA procedures… so I went out of my way to find a surgeon with a long line of success using the Arthrex Tightrope procedure. (…and no, I do not work for Arthrex!) This procedure is truly different than anything I mentioned above. I finally did find a surgeon to do the job.

Tightrope Knee Surgery + PRP

tightrope surgery post opThis surgeon combined the Tightrope procedure with PRP (put simply, PRP uses your dog’s own blood plasma then concentrates the platelets in the plasma. The surgeon then applies this, within the surgical site, to promote faster healing.)

Tightrope Surgery Recovery

The end result was that Maxwell was touching his toes within 2 weeks and taking short walks within 4 weeks post op. We strictly followed the passive exercise (also known as PROMs) instructions, using ice packs and 10 minute intervals of full movement. At 2 months he was walking normally, but tired easily. At 6 months, if you didn’t notice the 2-inch scar, you wouldn’t have known anything had happened.

tightrope surgery 4 weeks post opOne week after surgery Maxwell appeared to pick up a secondary infection, but our surgeon gave him a more aggressive antibiotic that cleared the problem within a few days.

I can say, honestly, I would recommend this procedure – but I would caution that you should GRILL the surgeon:

How many has he/she done?

What has his/her success rate been?

What, if any, complications have they recorded?

Do they use PRP along with the Tightrope?

Will they be doing this arthroscopically?

tightrope surgery recoveryIf you get answers that make you less than enthusiastic… you have the wrong surgeon. If you get picture-perfect answers… you may still have the wrong surgeon. I wanted experience; I asked for references to other clients he had done. Do your homework. This surgery is highly dependent on technique and experience. It was comparative in price to a TPLO or TTA. It cost me about $3500, not including post-operative medicine (antibiotics, anti-inflamatories, and pain killers).

Maxwell was predicated to have a 60% chance of the right stifle needing the same surgery. We’ll wait and see I suppose.

17 thoughts on “Tightrope Knee Surgery for Dogs – Maxwell

  1. I enjoyed reading of the success Maxwell has enjoyed. Obviously due in great part to you due diligence sir. I am today just learning about CCL damage as our 95LB female Mastiff mix appears to have a CCL injury. Our Vet in Citrus County, recommended a surgeon off of Hillsboro in Tampa. He has been in biz 14 yrs. I’ll be sure to ask about the TTA.. I would appreciate it if you could pass along the surgeon you used? Either way thanks for sharing.

    1. We have been trying for over 4 weeks with rest, short walks etc., however, out Golden Retriever, Tessa, is getting worse. Like Maxwell’s owner, I only want to do the tightrope knee surgery and have been reading for weeks any info and do not like to have her go through TPLO etc.
      I live in Northern California and if anyone has any recommendations as far as surgeons, I would be thrilled. I will try UC Davis and phone some other vets.
      Thanks for the article since it confirms the options for surgery for our pup. Edie

  2. To All,

    Please keep in mind one or two things. First, there was over one billion dollars spent on ACL repair in dogs in 2004! Who knows what it is now though I am sure someone has the statistics. To my knowledge, fewer than one in ten is performed by a boarded surgeon (ACVS).
    I have personally done over 400 tightrope procedures in dogs. There is no functional weight limit on the implant itself. It is a Kevlar-like material, in other words, the stuff is used to stop bullets.
    We routinely release our patients approximately 4 or 5 days postop. They rarely leave our hospital with more than a slight limp on the operated limb. Aftercare begins immediately with 5 minute leash walks twice a day to be increased by 5 minutes per week.
    I agree that one must know their surgeon. I believed in tightrope since I attended my first lecture in 2009. It was so new that there wasn’t a very large group of veterinarians that had experience. That being said, I am slavish about record keeping and making sure that every client knows that they are spending money on a result, not a surgery. Therefore, if ANYTHING turns out in a way that I do not expect the only thing the owner pays is medication or cost of “parts”. We rarely have to intervene with anything other than hospital supervised cage rest.
    Dr. James L. Cook, head of comparative orthopaedics at the University of Missouri has the most current information on WHERE to find experienced tightrope surgeons. HIs team is a fantastic resource for those interested in the procedure. While Dr. Cook does most of his anterior cruciate surgeries mediated by arthroscopy he continues to be a fantastic resource for general practitioners like myself. I do not have enough kind words to say about him.
    All that being said, it is not unusual for a veterinary college or a boarded veterinary surgical practice to offer the TPLO as the only recommended surgery. There is another way, tightrope!!!!

    1. Can you recommend any good tightrope surgeon in the Montreal area (Canada)? So far I couldn’t find any, unfortunately. I don’t mind any reasonable driving, so if you know someone in the area – please let me know!

      Thank you,

  3. The place to start looking is Dr. James Cook, University of Missouri. He has an excellent database and is chairman of the Department of Comparative Orthopedics.
    That is where I would start. BTW, I just took the bandages off my latest TR surgery and he is already walking with a mild limp

    1. Thanks, I contacted Dr. Cook already. He sent me the list of clinics, but I also wanted to know if someone has first-hand experience with particular surgeon.
      Hopefully we’ll be able to avoid surgery altogether (so far CM seems to work well for our berner), but I want to be prepared in case we have to do a surgery.

      1. Wayne
        What type of treatments did you research and why did you choose the tightrope procedure? Our yellow lab just blew out his CCL and the costs associated with the TPLO are more than I can afford. (and I’m told the other leg will likely do the same within a year.

        Would you mind sending me the contact info for Dr. Cook? Thanks

  4. Wayne, so far we managed without surgery. CM works fine, our Bernese Mountain Dog stopped limping completely. We still don’t let her run off-leash, and we keep doing some exercises to strengthen her muscles. Plus supplements, plus laser treatments – all that seems to work fine.

    The surgeon told us that we “must do TPLO, other options are not suitable”. After reading about TPLO success rate, side effects and complications I strongly disagree, especially in our case of partial tear and pretty lazy and slow dog.

    The surgeon also told us that most likely Maya will have a tear on the other leg, but “most likely” is about 50%. But he also said that CM won’t work, so we decided to ignore his warnings for now 🙂

    Tightrope is much less invasive than TPLO, and the recovery is easier and faster. It might not work for all dogs, but that’s the risk you need to consider. TPLO doesn’t guarantee anything either.

    Dr. Cook’s email: cookjl@health.missouri.edu

    Good luck!

  5. I am glad for the success stories of Tightrope, but I will never ever do one on one of my dogs. The infection rate and the bone-tunneling rate can be significant and the damage can be significant.

    My dog had TPLOs done about 2 years apart and he was walking by the third day and never looked back. TPLO used to scare me, but I’ve seen what it can do and I’m convinced it’s the only surgery for my dogs.

  6. Update for Maya (5 yrs old berner): after 6 months of CM we ended up doing TPLO. Maya had her good days and bad days during CM, but by the end of fall everything went downhill. She refused to walk, even for few min; she didn’t want to move at all. It was obvious she’s in pain…

    So we scheduled TPLO. The surgeon is amazing, and now 6 months post-op Maya is 100% back to herself. All restrictions lifted, she runs off leash and enjoys life again.
    My only regret is that we waited that long…

    So far her second knee is stable but we won’t hesitate to do another TPLO if/when needed.

    Good luck to all dogs and their owners here!

  7. It was very informative to read about you experience with the tightrope procedure. Recently our 2 year old Akita(107lbs) has a torn CCL. We were wondering how Maxwell is currently doing.

  8. I also have a Rhodesian Ridgeback mix I got as a puppy, (84lb’s 5 years old now), Jake’s the best friend and smartest dog. I own my own business so i was able to bring Jake to work with me almost every day, it was great we were together 24/7 until he slipped while running at my shop and damage his ccl in his left leg, so now he stays home in the house with potty breaks and small walks, he’s so smart he just let’s me think I’m in-charge. I have a appointment for TPLO next month, but i would like to go with the TightRope, driving my self crazy, got to decide, I did take Jake to another Vet here in Fresno, he offers the TightRope, but after talking with him he suggested I keep my appointment, guess i asked two many questions or something, he did say it was 2 months sense his last surgery.
    Thanks for all the story’s and info, I’m going to e-mail Dr. Cook to see if he can recommend some one in my area.

  9. It’s odd you said, ” I wanted experience; “…..and all of the vets all around you performed the TTA and TPLO procedures. Yet you, with no experienced, decided their technique was inappropriate and found the rare surgeon who would perform the technique you preferred. Seems if you wanted experience you would have gone with one of the techniques that 95% of all surgeons and 100% of boarded surgeons agree is the appropriate technique for a very large and young dog. Seems you didn’t want “experience,” you wanted to have your way.

  10. Can you please share your doctor in Tampa? I am also in Central Florida going through the same thing with my dog. Please please send me an email at alexandermendozav@gmail with the info PRP AND ARTHREX DOCTOR

  11. Good morning- If anyone has the name of the vet that was used in the Tampa FL area for Maxwell please email me.

    We are in the Central FL area and are seeking a highly experienced orthopedic vet surgeon to do our Jake’s Tightrope surgery. He is a 12 years old Aussie at 75 pounds and we would prefer to do the least invasive surgery as possible due to his age.

    Any contact information is greatly appreciated.

    Thank you

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