TPLO vs. TTA for Cranial Cruciate Ligament Repair

Bull Terrier with Cranial Cruciate Injury

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.

So which is better, TPLO or TTA?

Well, if your veterinary surgeon has no experience performing TTA’s, as it was only introduced to US surgeons starting in 2004 so many vets do not, you will want to opt for the procedure with which your vet can demonstrate proficiency and results. Many veterinary surgeons perform both TPLO’s and extracapsular imbrication techniques, but there are not many who perform all three. If you have the option of choosing between a surgeon that does a TPLO and a TTA, and have an active, large breed dog that would not do well with a traditonal, or extracapsular imbrication, repair, you will want to weigh all the characteristics of both procedures.

Which is less invasive?

The TTA is surgically less invasive than the TPLO. The amount of stifle angle shifting that takes place during a TTA is minimal when compared to that of a TPLO, where the tibia (the weight bearing part of the knee joint) is surgically cut and altered. In the TTA the osteotomy is made into the tibial tuberosity (not a weight bearing part of the knee joint), not the tibial plateau itself, giving dogs a greater ease in healing, recovery and overall success of the procedure.

Which has a shorter recovery time?

The TTA, because it is a surgically less invasive process, has a shorter recovery time than the TPLO. While most TTA and TPLO dogs are able to begin weight bearing within the first 24 to 48 hours postop, TTA dogs continue to improve with time, whereas TPLO dogs often demonstrate a more gradual healing process taking place over months instead of weeks.
Which has less risks of complications?

The TTA carries less risk of surgical and post operative complications, including surgical failure, again due to the fact that the surgery itself is less invasive than the TPLO. The TTA uses titanium implants, which carry less risk of infection, rejection and hold up better than the stainless steel implants used in TPLO. Also, because the TTA is a simpler procedure to perform, there is less time spent in the operating room, which means less of a chance for infection or anesthesia related complications. Ultimately the risk of complications is related to the surgeon performing the procedure, with the rates of complications for TTA being low, due to the simplicity of the surgery, whereas rates of complications from TPLO are higher because of the amount of skill required to perform such an invasive procedure – catastrophic failure can occur when an unskilled veterinarian performs a TPLO.

What does each procedure cost?

Cost of TTA, TPLO and Traditional CCL Repairs

The least expensive method of cranial cruciate ligament (or CrCL) repair is always going to be the extra capsular imbrication method, as it does not require the use of any implants or an osteotomy procedure, and you can expect to pay between $700-$1100 to have a traditional repair done. This procedure can be a great option for many dogs, and I encourage all owners to read more about its risks and benefits when considering surgery for a CCL rupture.

When comparing the TTA and TPLO, the TTA is less expensive, and this is due to the simpler nature of the procedure as well as the fact that it does not require as much equipment, despite the fact that titanium costs more than stainless steel. A typical price for a TTA will run between $1500-$2000 vs. a TPLO ranging between $2200-$2700, which usually includes all of the pre-operative testing, postop medications and post-op visits for suture removal, bandage removal (if applicable) and radiography.

263 thoughts on “TPLO vs. TTA for Cranial Cruciate Ligament Repair

  1. Hello. I have a question about TTA and TPLO. Is there “an estimated” cost $ for each of these? I have seen and been quoted different costs. Thank you very much.

    1. I have a now-10 year old big shepherd mix who had both TPLO, at 3, and TTA at 6. His sister, 25 pounds smaller, had TTA also, not remembering what age, but somewhere between 4-7. Both have done very well. We opted for the TTA following the TPLO at age 6 because of financial reasons, and have not been able to detect a difference between either procedure to date. Also, we used three different doctors for three different procedures, I think they all did well. Another essential variable is after-care — you must keep them as still as possible, not easily done, but worth it, and I believe has contributed to a good and lasting effect. Depending on age I would not go for the TPLO again, as it is a far more invasive surgery, and also extremely costly. They both have done very well, thankfully, with the TTA, which seems to have been an easier operation for all. We were very mindful with after care (not easy with two dogs and two kids, but definitely doable). We have tried to keep their weight down, keep exercise to enough but not overly strenuous, and give them lots of love. We’ve been extremely lucky — hope you are too!

      1. I have a10 month old rottie that we just found out has both back legs acl tears, we are getting all the info we need to see which is best for our girl, tta has been suggested since she is still so young so should have great outcome with healing. so you have any other advice for us?

        1. I have two twelve-year old shepherd mixes, litter mates, with four knee surgeries between them (two each). We have had all three surgeries, all successful to date (starting at the age of three and as recent as two years ago). Being that they have all been successful, I think the variables are cost, invasiveness, and after-care, which I think is possibly the most important factor. Any trusted vet will help you based on factors of cost, age, invasiveness, and availability of options. Again, after-care is of supreme importance, as is the provider I’m sure. All work but have different risk factors, also to be weighed. Good luck!

        2. My Akita was 3 and about 85 lbs when she slipped in our concrete floor and blew her knee out. We took her to the vet and opted not to cut the bone and do a steel plate but to do the tight rope. Most Akita do not cage well so we put carpet in our living room, multiple baby gates and blocked the couch off. We leashed her every time she went out. We never confined her to a cage only a small area in the living room. Well after a few months she blew it out again. The 2nd surgery the Vet put a tight rope on both sides of her leg. We again confined her and leash walked her. We did this for several months and we even got a twin mattress and we took turns sleeping with Her in the living room. I spent hours on the Internet every night researching until I was exhausted. I came up with this 1. Depends on the dogs age and health 2. I find that most dogs going thru the surgery are mid size dogs, not big like mine 3. Depends on vet 4. Depends on how good the aftercare is 4. Also depends on how soon you take them home after surgery… Leave them at vet a few extra days so they are monitored and on pain meds 5. Depends if u keep them calm when u get home and no guests
          Our dog was not allowed off leash for 6 months. Now she can go out without it but we still freak out when she runs…. Always the possibility of her blowing it out. She is 6 yrs old now and back to 90 lbs. please do what’s right for the dog and don’t be selfish Because “you” want them here. Use your mind and don’t put the dog thru more than nessesary. Good luck. All in all we spent about $10k but it depends on the vet and we also put carpet in our house with lots of area rugs. Wood floors, tile and concrete is not good for recovery or aftercare, keep that in mind. We went above and beyond because we had the means.

      2. She’s young and yes she should do very well indeed. My own preference is the TTO (triple tibial osteotomy) followed by physical therapy (underwater treadmill cold laser tx). The TTO is nearly like the TTA but adds an “L” cut to the bone so it has the advantages of more complex TPLO. So it’s less invasive.

        With any surgery you can expect to come home, using a sling or towel at first. Ice will deminish swelling and pain. I found that ‘grip wrapping’ a gel pack to the area. My dogs liked it so much they’d even try to hold the leg up for me.

        You start out with short frequent walks, and gradually increase the length and duration of the walk. Always on lead. No running.

        Cold laser Tx can be done at either the vet or the PT. It takes a good six months to rehab. They’ll likely do one leg at a time surgically, but some of your rehab recovery may be concurrent. ( prefer it that way)

        She’s young and she should do very well. Good luck with her. She sounds lovely.

        1. My 64lb 2 yr. old pit had TTA surgery 2 days ago. Her name is Blue. I’ am concerned about her recovery. Any tips?

      3. My Rotty male had TTA at 18 months, he’s now 7 & had no problems at all. Totally agree with the TTA being the better op to have than the TPLO, plus TTA is done with Titanium which is so light in weight, the TPLO is done with stainless steel, much heavier metal & more chances of rejection from the body as a foreign object, causing problems that could be long term, TPLO is a much longer & much more invasive surgery, & not necessary for many normal ACL’s tears or rips. If you have the choice, opt for the TTA, your dog will recover much sooner, they can bear weight carefully on the leg within 24 to 48 hours after the op. Much less stressful for the dog too !!! Good luck

    2. About $5,000 for either depending on what is charged for included post surgical care or certain meds used

  2. Hi Matt,

    The estimated cost for a TTA is $1500-$2000, and $2200 and above for TPLO procedures (I have heard cases of TPLO’s being around $3000). Different estimates are common and are related to a number of different factors including:

    1) Size of the Dog – the smaller the dog, the lower the price. This has to do with the fact that smaller dogs require less anesthesia, medication, sutures and equipment.
    2) Where the Surgery is Being Performed – your local veterinarian is going to charge less than having the procedure done at an orthopedic surgery center with 24/7 staff.
    3) What is Included – usually estimates include other exams/tests in addition to the surgery itself; be sure to find out exactly what will be done for the estimate you are given.

    1. In Denver metro area TTA and TPLO are both $3400-$3700… or more for dogs in 40 lb range– I spent a week calling all recommended places.

  3. Hi; I have a 4.5 yr old female German Shepherd. She had the TPLO on the one side last August, and just last week the TTA on the other side. The TPLO side was a result of stress from the original tear on opposite side at 9 months. FOr over two years she used the [yet to be done] TPLO side too much… thereby instead of doing one surgery early on, we were forced to do two, with the worse side having surgery first.

    Had I done the original surgery when she was younger I might have avoided the second ACL tear. I felt she was too young as her bones/structure had not completely developed… this was seconded by the surgeon, however, I waited another year which by then she had torn the other side. I was hoping limited movement, stress ont he leg, providing Chondrotin supplements, etc., were ‘working’.

    I was very wrong.

    The second tear was far worse than the original, she had no muscle mass on that side and hence was done first. She had become some what of an artist hiding how she was hurting since the hurt must have beenn familiar to the one at 9 months.

    I followed her down the stairs one day and instead of seeing the ‘tribbling’ down the stairs with all 4 paws, I saw ‘ker-plop’, ‘ker-plop’, ‘ker-plop’ all the way down… she was carrying the worse leg.

    Cost: TPLO was $3200 [include radiography, physical therapy which is needed if you love your dog]; TTA was $3800.

    While this may seem excessive given varying clinics/vets around the country, go with some one who is experienced. If the Dr had said its going to cost $10K I am not Ms Moneybags, but I would have paid it == I wanted him to perform the surgery after knowing he had already performed some 2000…

    You do get what you pay for, whether your own Dr [who may have graduated bottom of the class at med school, worthwhile to investigate before you sign up to let him open you up] or pay more for someone who is highly skilled and graduated top of the class.

    Research is recommended; go with someone who only does orthopedic surgery. He/she is then a specialist and has performed many of these surgeries prior to having your pet go under the knife with this person…. going with someone who is a generalist, would be like asking your general physician to perform brain surgery rather than a brain surgeon or having your general physician perform open heart sugery rather than a thoracic surgeon who specializes in heart surgery, hmm?

    Just something to consider.

    First surgery: success at 4 months, knowing she is the alpha of three I restricted her for up to 5months. She was a real dog again, and I saw for the first time since she was a pup, the ‘sphinx’ sitting for a treat.. I know she had healed and healed well.

    Second surgery: waited only 2 more months to make sure the leg was strong enough to carry the other for recovery and of course, let the dog be a dern dog – romp play.

    The ‘ker-plop’ versus the tribbling returned 10 days prior, and off to the surgeon we were once again.

    1. So, the TPLO was first, and was successful? And the TTA was second, and wasn’t? Is that what you are implying with that last last sentence?

      1. It depends a bit on the size of the dog. Larger breeds generally seem to do better with the TPLO of the two you mentioned. Y-e-a-r-s and years ago… I had the TTA done on my then 11 year old Cocker Spaniel. He did very well. He was rambunctiously active and happy all of his 17 years.

        My Rottie’s both had the newer TTO which is not universally available. It combines the best aspects of both the TPLO and the TTA, and is less invasive. Had I not had the TTO available I’d have gone with the TPLO just based on the size of my dogs.

        Just so there is no confusion, none of my dogs had the TPLO. My friend, however, did have the TPLO on her Rottie boy. It took some time but he was able to earn a few agility titles after.

  4. I have read your web page and would like to share some info on the subject of cost comparing tta and tplo. I have spent the last year learning about this problem and the procedures to correct it. My very large breed dog has partially ruptured her cruciate ligament in both legs. I have been all over the north east visiting vets and Tplo is like $3000-$4000 and the tta is the same. For one leg …both is going to be like $8000. The reason I am leery on going ahead with TPLO vs TTA surgery is because a family member had the same issues with their dog and she recovered good from the first surgery but the second one the poor baby just isn’t the same. She had the TPLO done on both legs a few years ago 2002 and 2004.

  5. We have a 4 year old female Irish Wolfhound x Great Dane who we opted to have the TTA done (after putting it off for nearly two years) after MUCH research. At first, we figured that her stiffness was due to her arthritis and over use after we adopted another dog two years ago but quickly realised in April that it was not the case anymore.

    We live in Australia and knew that she could not make it through another Winter and upon seeing the specialist (which by the way was the most recommended surgeon in the area for this procedure) we opted to do the surgery at a cost of $3,222 PER knee.

    She is five weeks post surgery with her left knee scheduled for next week. Immediately after her first surgery, she was trying to run – proving that the level of pain prior to the surgery was immense! It only reassured us that we made the right decision and it is wonderful to see her full of life again – although it is a challenge to keep her on all four feet…even when she is on a lead!!

    I do recommend that if you have this done you DO have a clinic with 24/7 care AND, if only a surgery centre, it is affiliated with a vet for emergencies. We have had several visits to the vet over the past five weeks due to our dog “killing” the tip of her tail from hitting it on the crate & needing it cut off. I think we now own stock in both the Surgical Center & Vet!!

    Oh yeah…and be sure you are ready for the emotional roller coaster you will go on with seeing your dog in a crate for SIX long weeks!! Something we had no idea would have such a huge impact on us. Tip for you all – line the crate with non slip padding so your dog doesn’t end up in the vet with an unexpected $500 surgery to fix her tail when she beats it to death with the excitement of seeing you!!

    Do your homework, check out websites and ask other people for tips PRIOR to making this huge decision. You get what you pay for and NOT all surgeons are capable of doing this procedure. If you are serious about having it done, investing the money and time then I recommend you see a surgeon who specialises in TTA procedures.

    1. Hi Alicia

      The vet told me this afternoon that Jack, my shihtzu needs the surgery done. She is ringing me back tomorrow to tell me the price and talk about it. I didn’t know what she was talking about but after being on the internet for the last hr I have more of an idea.

      The vet kept him all day and Ive been worried sick because I didn’t know what was wrong with him. Now reading about the problem and surgeries I’m even more worried

      I live in Victoria, Australia and I was wondering how do I find out what vet is experienced in the TTA method of surgery or any of the other surgeries.

      My dog is 10yrs old and not overweight. He was very good for his age. Most people thought he was a puppy because he was so playful and active….not since this morning though and I dont even know how it happened.

      1. Hi Dale,

        My dog Lola tore her ACL at age 7 (still acting like a puppy now at age 9) and not overweight. I just posted on the website all my details – but we went with pain medication the first few weeks, plus Rimadyl and Glucosamine and within 4 months Lola was her old self. When she was 8 1/2 she either hurt it again jumping and spinning or it just started feeling “tricky”, making her favor that leg. We took her to a holistic medicine vet who did chiropractic adjustment and she is again just like new.

        My neighbor across the street had a 9 yr. old lab who tore her ACL about the same time. She opted for non agressive care and “Bailey” recovered to normal in about 3-4 months, too. I know vets believe they are offering the best option, but there is a lot of research saying the surgeries are not the be all and end all. A friend whose dog had TPLO at age 2 had arthritis set in very quickly – he has never really been completely well since. Best wishes what ever you decide.

        1. Hi Lisa

          Thank you very much for your quick reply. Im taking Jack to the city for a 2nd opinion as soon as I can get an appt. His leg seemed good after no walking on Thurs, Fri and most of Sat then on Sat he hurt it again so Ive been carrying him everywhere since and it seems to be better again.

          My 24yr old is profoundly disabled and I care for him 24/7 with no husband or other support so I dont know how Im going to do this physically or emotionally on my own The surgery and associated pain and the separation anxiety Jack experiences anyway without being away from me for a whole day or 2 (not sure) worry me terribly. at least the vet knows he suffers from separation anxiety and the reasons why.

          The vet has given me no pain medication or anything nor told me to do anything at all about confining Jack or stopping him from walking (found out about that on the internet). She gave me antibiotic cream for his paw because it has a mild infection in it and he keeps licking it but thats it. She only said about the crate and restrictive movement if he has surgery

          Thank you again for your help and I hope Lola stays healthy and well for you


        2. Are you implying that a chiropractor healed the torn ligament? Is your dog getting less exercise? perhaps scar tissue has begun to form and stabilize the tear?

          1. The Chiropractor did not heal the torn ligament. The ligament healed on its own or scar tissue built up around it and stabilized it – we really don’t know. What we do know is after a couple years with no issues Lola started limping and we thought she might have torn it again. When we went to the vet (who practices traditional and alternative medicine) he said that it did not appear to be torn nor was it arthritis. He told us to stop the Rimadyl which is for arthritis and which she doesn’t have. He said continue the Glucosamine. He said that her knee might be a “trick knee” that occasionally gives out on her and she might be favoring it, which put her spine out of alignment. He did an adjustment on her spine and she walked out of his office without a limp. We took her back for two more spine adjustments over the next 5 weeks at the vet’s suggestion and she has been fine ever since (another year plus has gone by). She is 10 years old now and still jumps and spins like a puppy, bounces around like a bucking bronco when she is excited, easily walks 2 miles a day around our neighborhood besides chasing birds in her yard. I think it does help that she has never been overweight…the vet said that has worked in her favor. I have heard people swear by the surgery and people who would not do it again given the choice. I still believe in taking a wait and see approach…we have no regrets and 5 great years since her injury!

      2. If you have not had this done yet, you may want to reconsider. My vet just told me about a study of a group of dogs weighing less than 20 lbs with torn cruciate ligaments. Half had the surgery, half did not. After 6 months, no difference was observed in the 2 groups. My dog had the surgery today, because he weights 130 lbs.!

  6. My dog a 55lb Chow mix started favoring his left rear leg about 3 weeks ago. Our Vet examined him and recommended surgery which he said he can perform. He is recomending TTA.
    I am feeling like I should have this done immediately so that he doesn’t injure his knee more. It seems like other people have waited months or years
    How do I know my Vet will do a good job? He told me he has done TTA 10 times. His price quote was $2,600
    My dog is very active and I don’t know how we will keep his inactive for several weeks at the very least
    I’m trying to talk to other vets to get opinions

    1. Linda,
      My own feeling is decide quickly between surgery and conservative management. Once decided, if surgery is chosen, move as quickly as your circumstances allow. The muscles atrophy significantly from the actual surgery. That part can’t be helped. I’d want to minimize as much muscle waste as I can.
      Sometimes, there may be reasons for waiting, as folks have mentioned. Full recovery may take a bit more work and time but can certainly be achieved.
      To give you an idea: I see a significant difference between Stetson and Raven. Their individual injury and subsequent surgery are 9 weeks apart, one knee each. While Rae was recovering, Stetson was busy with agility… 9 weeks worth of building muscles. He was in better shape, physically, before his injury. What a difference! He lost so much less muscle volume in those first 4 weeks when they are so limited. Her recovery is moving along nicely. No complaints. But, I am certain his will be the easier of the two.

  7. Linda-
    Do NOT let a surgeon who has only performed a surgery 10 times operate on your dog. Go to the closest University Vet School and have the procedure done. I had top notch care last week on my 65 lb. Black Lab and she’s doing great so far. In all, we spent around $2000 total on her surgery and pre-op radiographs. My surgeon has done the procedure close to 100 times in the past year. This is not simple surgery. Make sure you have someone who knows what they are doing. Don’t let someone practice on your dog. Good luck.

  8. Hello,

    Thank you very much for this great website resource. It is greatly appreciated.

    I have been reading about a new procedure called Tightrope CCL. Does anyone have any opinions on this or know of any surgeons who are performing it yet? Any information/experiences would be helpful.


  9. Hi, I’m from Brazil and my sister’s labrador retriever, a male aproximately 14 months old, just under went TTA procedure a couple weeks ago and the vet who performed the procedure told us the dog would have to rest and “lay low” for a week before getting back to it’s normal life. After following all the steps indicated by the vet, the dog is limping (I’m not sure about this word in english so I better describe what I mean by it… When the dog steps on the ground it fails to step regularly just as it does with the other 3 legs). She is really worried about it and asked me for help, so I’ve decided to look for some help out of the country, after all, before this procedure got to Brazil, it was already being performed there on the US.
    I’m preety much looking for help of anyone who had or knows about a similar situation and could give me some tips on what to do now.

    I can also email the pictures of the X-rays taken from Bob’s leg to someone who understands enough to emmit some opinion.

    My email is If you can help me, please email me.

    Thank you all so much.

  10. Hello, My nine year old mut had a TPLO several years when six, and she has been active with zero setbacks. Feb ’08, she received a TTA on her other leg. Our understanding was the vet was very experienced w/ TTA, and it seem a better choice especially since she had severe arthritis. Two weeks ago she began limping on her TTA leg. Now we are being told it is either arthritis or a meniscus tear. It is advised she have exploritory surgery.

    Does a TTA lead to a higher change of meniscus tearing than a TPLO? What are your thoughts?

    Thank you for your concideration, Lorna
    (FYI: my dog is large and we keep her a thin 55 lbs. In addition, she is very stoic and doesn’t show pain unless it’s really bad)

  11. My Dog is a 2.5 year old yellow lab, she gets her tta surgery done Tuesday at U of Penn. Then she gets the other knee done 8 weeks later. I think that I have coverded every aspect as far as researching the surgerys TTA, Tightrope, and TPLO. But did anyone have any problems with there dogs depression after sitting in a crate for 4 months or did there dogs temperment change.

    Thanks in advance. Oh the cost was $4000.00 Per knee

    1. Was wondering how your dog was doing. My girl has injured her back leg and we will be seeing the vet tomorrow. If needed we will be going to U of P also. Would be interested in your experience there

      1. Same story here. about to begin my search for a dr to perform this surgery on my 8 month old golden retriever Lucy. Her litter mate sister Sammy Jo will not understand why she cannot play. i do not know what i am going to do.

        1. Oh Holly,

          You love your dog. It hurts and I remember that bewildered, what am I going to do feeling. Did your vet have any suggestions for where to go for the surgery? Mine does the TTO and the TTA. But he did mention nearby Cornell University and Colonial that do the TPLO. Talk to your vet. In the end I decided on my own vet at Chenango Animal Hospital and the TTO, which he has had great success over the past 3-4 years. Results are comparable to the TPLO.

          Dogs are quick studies. Generally, the second dog will gather her friend is in pain and unable to play. (If not, crate or baracade the injured dog) Mine seemed very concerned and compassionate toward Raven. They tread sofly when nearby. They “ask” their friend if they are alright. It’s quite touching. Sammy Jo will figure it out, and become a good nurse

          Now, the injured dog in pain knows it’s injured… most prevalently in the beginning when the pain is worst. Grip wrap gel ice packs to the leg 2-3 times a day the first few days to keep the swelling down. You will know what to do when the time comes, Holly. The heart in your throat feeling goes away once your dog is home.

          Do you know which surgery you prefer? Sometimes it depends on availability. Cost is a consideration. And I like to think post operative PT is important. TPLO’s, the most invasive, ha excellent results, are very painful, and you’ll be using a sling quite a bit in the beginning, I expect.

          The TTA’s and TTO’s the dog may be walking the first post surgical day on it’s own. Total recovery time is close to the same, tho the TPLO may be a slightly longer. Don’t let the vet skimp on pain meds. This is equivalent of a surgically broken leg. 2 months of pain meds is recommended.

          You will need a sling for getting in and out of the car. Google “4 flags over Aspen”. They unlined large is $19.00. Or, your vet may have one you can borrow.

          With or without PT, recovery is slow and methodical. I am advised to keep the dog on lead even for bathroom breaks. Who knows but a squirrel may entice my dog to run before she is ready. At 12 weeks she has just been approved for on lead trotting.

          My boy, at 4 weeks, would like nothing better than to wrestle with the girls. He doesn’t understand. It will be a much more difficult task to keep him from risking injury than her. But I have to do it.

          You will be fine… just use your love for your dog to guide you. Soon it won’t seem so insurmountable. It will become a managable routine. You will know what to do, and you’ll do the right things. Honest. 😉

  12. My 4 year old German Shepherd had TTA surgery 5 months ago. He was crated for about 6 weeks the he was allowed to roam a small room during the day while I was at work. Yes, there was a temperment change in him during the time that we crated him. I spoke to the surgeon and asked if he could spend some quiet time with me in the living room on the floor. He was given the ok for small amounts of time as long as I didn’t allow him to make sudden movements like running, jumping or lurching up on the couch. He had to be tethered to my side. His leg healed perfectly! It’s a very long healing process but I feel it’s worth it. Unfortunately, he just tore the other knee and we are headed down the road for surgery #2 in a month. It costs me a little over $3000 for each knee.

  13. Our English Mastiff was 8 in June when we has the TTA done. The cost in NJ was $4700, really over 5k when you include the final xrays and test to insure the TTA was needed. We were warned that 40% of dogs do the same ot the other leg.

    Just this week it happened and another surgery is needed. We were debating on the TPLO because we were told it was cheaper? After reading up on both I think we need to stick to the TTA.

    It was amazing how this 160 lb dog walked the day after surgery. Dont get me wrong, its a tough stressfull time for all, especially the first few weeks.

  14. Hello from Estonia!
    I have a Lab-girl, 1,5 years old and she tore her right CCL in October 2008. I don`t know about others (countries, clinics :)) but in our case it took over two months to make it to the surgery. For the first 3 weeks she was held on a traditional repair with confinement and anti-inflammatory medication. that didn`t work, so we scheduled the TTA operation, which took about a month of waiting. Now almost 6 weeks has passed from the surgery. It seems, that she is feeling very good, the limp is practically gone and sometimes we have a really hard time to keep her from “dancing” and speeding up in our small apartment. We are still keeping her in a crate during night and while we are at work. When we are at home we let her out to our living room and we covered practically every room with the carpet so she wouldn`t fall because of the slippery floors.
    During first 4 weeks we had quite many “oops” situations: climbing over barriers, jumping to the door etc. So after one bigger “accident” we thought it would be best to go and check her leg in x-ray (the 6 weeks check-up was too far away). It was almost 4 weeks after surgery and the doctor said looking at the x-ray picture that the bone was healed. it was actually surprising since I´ve read all over the internet that it takes much longer (or have I misunderstood something :S). The doctor said there is no harm in her (the dog) taking the stairs on her own (we live on a second floor) and she has been doing that ever since (after 4 weeks post-op). Also we are taking 10-15 min walks twice a day. It will soon be 6 weeks post-op and I totally agree with the previous (Bryan): it is really a very stressful time for ALL.

  15. I would like to add a little common sense and experience to this topic. There is no surgical procedure or medical procedure that is always successful. Conservative treatment should always be the first option for the majority of medical issues, not surgery. If a conservative treatment fails, you still have a surgical option. If surgery fails you may have a lame dog for life. Wouldn’t you be hesitant if the only treatment that was offered to you was surgery. I have used the A-TraC Brace on my dog and it was very successful and I didn’t have to do surgery. The brace requires some getting used to but if you persist it is gives good results for a lot less than $3000. Yes it might not always work or your dog may not get used to it, etc.. However, its a far better option than surgery that also predisposis to a 50% inury rate on the opposite leg.
    Use your common sense, get the brace first.


    1. The problem with waiting to see if non-surgical treatments fail is the knee continues to drawer, and arthritis builds quickly. Also, scar tissue develops and complicates surgery. Common sense tells me to listen to an experienced Vet, and do what he tells you. The vast majority of surgeries that fail are related to recovery.

  16. My 65lb very active boxer mix has torn her Cranial Cruciate Ligament. Surgery is recommended, however very expensive. Has anyone opted to have their dog put to sleep because of this injury?

    1. Sandra, if you can’t afford surgery at the moment, you can try a a-trac brace or something similar (its about 500) or you can do the traditional surgery for less than half the price of TTA or TPLO. Ur dog can still be happy with a bad leg until you save up for proper management. My husband is in the military and we dont make very much money but we are saving up for surgery and my dog is still a happy pup.

  17. Sandra: why would you have your dog put to sleep because of a knee injury? look around or find a way to raise funds, jeez.

  18. Marlene’s common sense advice to invest time and care with a conservative treatment approach first certainly rings true for me. My 7 yr old mixed breed female (sml, fine boned G. Shepherd X) was recently diagnosed with a cruciate tear. I’m keeping her confined and on Metacam while I figure out a plan of action. I’ve read very conflicting reports on the success of a brace (esp. the A-TraC). Some report good wearing tolerance and great success over the long term – others report that the brace was intolerable, and excessively complicated to use.

  19. Hi,

    My dog Lothar is a 175 lb. caucasian ovcharka who tore both knees up when he was 3. We had TPLO on both knees, the TTA wasn’t available back then. FWIW, he just turned 9, and while he walks kind of like an old man now (so do I) and takes healthy doses of tramadol and rimadyl, he still takes a 1/4 mile walk every morning, climbs in the snow, and can run and wrestle when he feels like it. Given his size, age, and condition, his vet is amazed to see what he does. The surgery really did save his life. It’s not like you can lift dogs this big into the car and bath, they need mobility or life is over. We spent $2000 per knee in 2003 after considerable shopping. High estimate was $3500 per.

    He wasn’t crated – he wouldn’t have tolerated it. He was tethered to a stake for 3 months after the first knee, then 3 months after the second. He tore his stake out of the ground numerous times. It was 7 months of as much inactivity as he would put up with.

    There’s nothing wrong with TPLO if that’s what your doc is comfortable with, and you’ve got a giant breed. It worked for us!

    Good luck!

  20. After reading the above posts and doing some online research, i have opted for the TTA surgery to fix my dogs ruptured cruciate ligament. Following surgery I need to drive with my dog four hours to the country cause i can’t have her in my apartment due to stairs, is this ok? How much pain are they in following the surgery? I also do not want to crate her. she is 10 and will go nutso in a crate. no climbing on the bed and couch? for how long?

  21. Lisa,

    I have just returned from the vet after having TTA surgery on my boy’s right knee. I do not know if you choosing which procedure (TTA vs TPLO) is such a good idea. Factors as age, weight, and the shape and size of the tibia are all important factors in maing a decision. The surgeon I selected is a specialist who does both procedures, and I left the decision up to him (same cost). TTA is relatively new, so make sure your surgeon is experienced in TTA.
    This is day one of his recovery. When I picked him up, he was already putting some weight on that leg (very little). He did not seem to be in pain, due to the fact the vet had placed a fentanyl patch on his back. This is an opiate, good for about 3 days (so they say). Please ask your vet about the 4 hour ride. Maybe some kind of tranquilizer can keep him quiet for that time. Also, he will have an elizabethian collar to wear (like a lampshade) to prevent chewing on the cast. If you can keep a close watch on him, it can be removed, but dont leave him alone or in another room than you are in. Same goes for the cage. If you cannot watch him, as in leaving the house, he must be in the crate. They get used to it fairly quickly. And yes, no stairs or climbing allowed. I did not get a definitive answer from the vet for how long. It depends on many factors. I am going to lift him onto my bed myself. He is there now, sound asleep. Again, you have to watch him closely. It could result in serious injury if he were to jump off the bed in the middle of the night.
    Good luck. I will return to this websites with updates for anyone who might be interested.

  22. Can someone advise on the comparison between traditional extracapsular and TTA? We have a 6-yr. old, 90 – lb. mixed breed (herding type) who had a TPLO on one knee three years ago. The cost is prohibitive for us at this stage, so we are considering the extracapsular repair. But we’re wondering if we are just throwing our money away and will need to do the TTA later. Thank you.

  23. Hi all, after much deliberation, research and angst I decided to go ahead with TTA for my 10 year old, 75 lb, rotweiler/golden retriever mix. It was the best decision I have ever made. It has only been 2 weeks and my dog is already taking 3 20 minute walks every day. The first two days she was in much pain, the first night especially, but just as with in humans, pain medication, rest and food, and love had her on the mend fairly quickly. After the first four days, she was taking 2 10 minute walks and 1 quick walk. As Ted mentions above the dog was given a pain patch and oral pain meds. I gradually took her off the oral pain medication and by day four was not giving her any pain medication at all. If the knee is throbbing – they will let you know by crying, pacing or panting. In short – if you can afford do it. If you live in NYC – the Animal Medical Center on 61st has doctor’s that are skilled performing the less invasive TTA surgery. Feeding them is key as well. they won’t eat the kibble. Soft food or warm rice with chicken works well and help them recover quicker and gain strength.

  24. Hi All,
    We are in the process of researching TPLO and TTA for our 4 year old Boxer/Pitt mix. I was wondering if anyone had any recommendations of good, experienced vet surgeons in Northern California or Southern Oregon that do these procedures? We live in Eureka, Ca and are willing to drive a few hours- as really that is our only option.

    Thanks in advance for any help!

    1. Dr. Steve @ Southern Oregon Veterinary Specialty Center is a highly recommended Orthopedic Surgeon in Medford, Oregon.

  25. Today I found out our Black Lab has to have a TPLO on his right leg. He had his left leg done in 2007 and we were told at that time that it is quite common that his other leg will also need to be done. We also have a female Black Lab (his litter mate) and she had a TPLO on her left leg in 2008. We are not made of money and each of these surgeries cost $3000. Our surgeries have been done at the University of MN Vet Clinic and our results have been awesome. You would never know that either of them had a TPLO and they are able to run again. The University was doing a study on why this is happening so often in dogs. In the lab breed they thought was it because they were trying to breed labs with good hips that they in turn created bad knees. Another thought was all of the dog parks. In our case I think it is the breed. If you can afford it I would recommend finding a good surgeon and doing the TPLO. I would check out your local University and hopefully the have a vet school.

    Good Luck and I hope we get the same result with our third surgery as we have with the other two surgeries.

  26. My dog Duke recently suffered a cruciate ligament injury to his leg while running out in the field. My vet. said he should have surgery but also told me about the A-TraC Brace. I looked up the web site and did some research on the brace. I found many positive stories from people who used the brace so I elected to try it. I felt that it made more sense to try this before surgery. I received the brace promptly within 3 days and fit my dog with it. Within the same day a dog who had not put weight on his limb was putting full weight on it. At first he figited and looked funny walking but after a while he seemed to like it. We went through the entire treatment program recommended by woundwear and returned to my vet. who said he couldn’t believe it but the leg was healed and there was no arthritis on x-ray. I continued to use the brace for another 2 months just when Duke was playing outside. It has been 8 months since his injury and he is a happy dog full of life. The brace took a little time to get used to applying properly but it was worth it. Dr. Spatt was very helpful in providing helping me get the best fit for my dog. I can honestly say this brace from WoundWear saved me from thousands in surgery bills and saved Duke from pain and potential problems from surgery. Thank you WoundWear for giving Duke another chance at a good quality life.


  27. My granddog Moto is a 14 month old pitbull. When he was almost one year old he had a Triple Pelvic Osteotomy (TPO) for hip dysplasia. Now just a few months later he suffered a CCL Rupture in this leg. Does anyone know if this is associated with the TPO procedure? A $3000 or more procedure on this leg will only be the beginning as his TPO was unsuccessful. His other hip is severely dysplastic, plus the increased likelihood of the other CCL rupturing. It is so sad to see this incredibly sweet dog try to walk and to think of another painful surgery followed by at least 2 others. Anyone have any suggestions?


  28. Nell–

    Have you found a surgeon and had the procedure done yet? My dog just had TPLO a few weeks ago. So far, so good – the problem is to keep him from being as active as he now wants to be! The surgeon was Dr. Carl Kohler (I think that’s the spelling) and I believe he now is based in the Davis, California area but travels to different vet hospitals. I don’t know if he travels that far north. But maybe your regular vet could get in contact with him. If he’s not in the phone book, I think you’ll find contact information for him available from the Veterinary Medical Board’s website.

  29. I just had TPLO surgery on my 3 year old Greater Swiss Mountain Dog’s left leg on May 20th. The bruising and swelling the first three days was unbelievable but remarkably after the 5th day there was barely any. She really enjoyed a warm compress 3 times a day on the leg. She is confined to a small room with a rug to make sure that she does not slip. She had the traditional surgery on November 18th and after 6 long hard months of taking it easy the line snapped and here we are. If anyone has a large breed dog I would suggest going right to a TPLO or a TTA and not waisting time. The vet said that the right knee will only make it another 6 months tops becuase of all the stress on the leg. The cost was $3900 in New Jersey for me.

  30. Our 30 lbs beagle had TTA surgery 8 weeks ago and now needs to go in for the second leg. We have been very happy with the results from the TTA. We just moved to Dallas and it looks like they push the TPLO here, even though our last vet thought the TTA was superior to the TPLO due to being less invasive and a quicker recovery time (it also cost us less money than the TPLO). She was bearing weight on the leg with the TTA within a few days of the surgery. Our vet had her on pain meds, anti-inflammatories, etc for one or two weeks post-op. The main concern with the TTA is that we had to keep her crated for 8 weeks. Our vet let us have her on a leash sitting still in the living room with us in the evenings when we were home. We bought a small metal cage (didn’t have a ceiling or floor) for the back yard when we were outside with our other dogs so she could still be outside and sit in the grass and not feel excluded and depressed.

  31. I have a very active 6 year old, 75 lb boxer/rhodesian ridgeback that was just diagnosed with a CCL tear … he had injured it a few months ago and our regular vet said it was just arthritis (wrong!), so I gave it two months with medication but I knew something wasn’t right, so I went elsewhere and that is where we were given the diagnosis. And now I have been given the choice of TPLO vs. TTA … I have been reading all the posts and still can’t decided … Anyone have strong feelings either way? I was told that the TPLO surgery would be about $2,500 and the TTA about $4,500. Thank you so much for any feedback or advice you have!

    1. Hi Annamarie,

      TTA surgery is supposed to be the same price or less expensive than TPLO. maybe ur vet isnt experienced with TTA surgery and thats why he is offering TPLO at such a lower cost? If you want TTA, i would look at other vets.

  32. We have a 8 year old female pitbull mix. She recently had a limp and we found she had a CCL tear and damage to the meniscus. She had TTA (the specialist said her bone structure would determine whether they did a TTA or TPLO and the TTA was suitable) and has done well. This is the fifth day. I keep her laying down and with me and she seems to be doing great. Love her dearly and hope this give her more good years with us.

  33. HI Lisa,
    My 2 year old boxer had the tta surgery done on june 16th. he seems to be doingok. He started to limp a bit, but the doc said this is happening because I recently increased his walking to 20 minutes. I also hear some popping around the joint. let me know what you are experiencing at this point. thanks, Corie

  34. My 3 1/2 yr old German Shepherd male weighing 106lbs just has a TTA on July 22, 2009. Whe I picked up up I was shocked at how good he was doing. Then suddenly over the weekend he bagn to swell up really bad and his incision started to drain. This morning it was all over my sheets that I put in his bed. I paniced and and took him to the Vet immediately. No infection but I was told he should not have swelled up this much. He is also limping now that his foot is swollen 2x’s it’s normal size which I hope is the only reason.

    So far we are $3400 into this and I have to go each night this week for bandage changing and check-up. Has anyone experienced this? Otherwise, he is doing great as far as being a good patient and staying quiet which is normally very hard for him to do. I think all the drigs he is on is also helping with that.

    Although I will admit that I am somewhat nervous on the end result.

    This has been his third leg operated on. I pray we don’t have to do the other knee. We had to do his elbows at 9 months for Fragmented Corinoid Process which made him arthritic before the age of one. Poor guy has been through hell.

  35. My 3 1/2 yr old German Shepherd male weighing 106lbs was just has a TTA on July 22, 2009 due to a complete rupture of the ACL in his right knee. When I picked up up I was shocked at how good he was doing. Then suddenly over the weekend he bagn to swell up really bad and his incision started to drain. This morning it was all over my sheets that I put in his bed. I paniced and and took him to the Vet immediately. No infection but I was told he should not have swelled up this much. He is also limping now that his foot is swollen 2x’s it’s normal size which I hope is the only reason.

    So far we are $3400 into this and I have to go each night this week for bandage changing and check-up. Has anyone experienced this? Otherwise, he is doing great as far as being a good patient and staying quiet which is normally very hard for him to do. I think all the drigs he is on is also helping with that.

    Although I will admit that I am somewhat nervous on the end result.

    This has been his third leg operated on. I pray we don’t have to do the other knee. We had to do his elbows at 9 months for Fragmented Corinoid Process which made him arthritic before the age of one. Poor guy has been through hell.

  36. We have a Border Collie that is 8 years old and has torn the CCL’s in both knees. She has always been a VERY active dog and even with the pain she is in is still smiling and sweet as can be.

    We have no income at this point, my husbands retirement went away with the market crash as did many peoples. Our Vet and a surgeon who specializes in the TPLO recommend the TPLO and the Surgeon says her Meniscus are also torn.

    The prices we are getting everywhere seem to be $3500. each or $5700. – $6000. if we do both at the same time. We love her dearly and hate to see her suffer. She is on pain medications and anti-niflamitories to try and keep her as comfortable as possible but I don’t know how long they can do that without surgery.

    Does anyone know that answer?

  37. Hi all,
    I must do this. bear with me. Earlier, Andy advised Linda not to go for surgery with her own vet that have done only 10 TTAs, and rather go for the closest university vet school. some of the responds from you, great dog owners, were in the same line, talking about specialists and so on.

    Well I must say, although I agree in general that specialists suppose to have more experience, they also gain so much popularity. and who do you think operate on your dogs when the big shot specialist is to busy. Well my friends, it is the resident surgeon that is getting the experience and possibly have done less tan 10 TTAs (this is the very nature of specialist center) and do not let anyone tell you otherwise. Your very own vet that have done only 10 TTas is normally and hopefully the one vet that you know and trust. He or she usually know your pet better than any one else. Please do not let the perception of excellence full you. In many cases a specialist center is a very busy place and will never be able to give that same care, attention and love as your vet can. With my experience, if you ask your vet the right questions you cat get a very good idea if he or she is the one for the “job”. I you tell your vet for example that the number of surgeries is important to you as an indicator for success, than that vet will refer you to someone who have done may more. Beside, the fact that one have done more, dose not always mean it is better.
    I your vet has all the facilities, the ability, and the will, and you TRUST him or her, I feel that he/she definitely be a good choice. The fact remain (you can do the research) that complication rates are similar with specialist and non-specialist veterinary surgeons. The perception is that if it happen to a specialist, than it could not be avoided. well, do you think?

    My deer friends, I feel that this is mostly about professional integrity. If your vet has one, and you ask all the questions he or she will send you to the right way, that would be best to your pet. This way one may avoid situation like putting off surgeries for two years and letting the arthritis develop and worsening the prognosis. We tend to do so much research on issues that we have no idea about, thinking that we are getting more educated, instead we are just directed to a path, which is driven by perception only. nothing else. One of the most important service that a vet should give a client is advice. Why not using that service.

  38. Hi Carnetta,

    I agree with your vet that an osteotomy technique (TPLO, TTA, TTO) for her cruciate disease is probably the best way to go about. The reason for this is due to the fact that both her knees are affected and swift recovery is desired. It is not to say that other, less expensive surgery could not be performed with similar long term prognosis.

    Due to the fact that she has meniscal injury as well, she will benefit from surgery and conservative management with medication is not likely to give good results. the meniscus must be dealt with regardless of the type of surgery. I feel that given her breed and expected weight (if she is overweight this must be corrected with no delay)she will benefit from lateral suture surgery. This will be way cheaper, and will give similar long term results. The osteotomy surgeries tend to give better results short term, but recent data show that long term, the results are not differ much.

  39. Hi,
    I have a 3 yrs old border collie mix who has been diagnosed with TCL right back knee 6 months ago. I couldn’t do the surgery that time ,for healthy reasons I couldn’t take care of her if she had a surgery, now I want to do the surgery but the only place I found near us that does the TTA is the Animal Center in NYC where I know is going to cost about $ 5.000 and I have heard the most surgeries are done by students, so I am looking for a Vet in the area who performs this type of surgery if someone knows I really appreciate your recommendation.
    She only limps after being on a lay down position for a long time, but still puts weight on her leg and does do seems to be in pain, I just think I can’t wait any longer. Thank you for you advice.

  40. Hi,
    Does anyone know of an orthopedic surgeon in the Schaumburg, Illinois area who does TPLO or TTA? My 6 yr old 90lb Lab hurt his right knee and the vet said he tore his ACL. I’ve treated with anti-inflammatories but he continues to limp occasionally. Also, I’ve been reading about post-op care – but how do you keep a dog this size from going up and down stairs when the only way outside is down a flight of stairs? Is there really any one great surgery? I have priced the cost of the surgeries, but it isn’t the cost that worries me – it is the outcome.

    1. I recommend Dr. Averill @ Blue Pearl (847) 564-5775 in Northbrook who performed a successful surgery on my 6 year old chocolate Lab in August 2010.

  41. My 10 year old GSP just had TPLO surgery last week. Once he started to feel better around day 4 post op it was very difficult to keep him quiet. He hears a sound outside and jumps up on the windowsill, I leave the bedroom for a minute he jumps on the bed, he pulls when on a “potty break” to see his favorite spots in the yard. In other words, it is so difficult to keep him quiet. I think, if this were to happen to another of my dogs I would not do the repair. Instead I would use anti-inflammatories and keep him as pain free and comfortable as possible.

  42. Hi Selma, Karen and Joan,

    I am not sure about surgeons in your area as I am a veterinary surgeon, practicing in the United Kingdom. It is quite interesting to note that there are some differences in the way we look at things here in the UK. I have noted ( I may be wrong but this was my impression) that most of you are kind of left alone, to decide what is the best thing to do and feel at times, overwhelmed with all the different opinions, options and suggestions. I am not sure what is the role the regular vet plays, and how much advice they give and how they are involved in the decision process.

    From my experience, there is not one right answer to all the cases and it is important to understand that each case has its own issues and may be a candidate to different procedure or to conservative management. It is also important to realize that two different vets may have different idea as what would be the best to the same dog. this is OK too. but how do one make sense of all of this?

    I have been practicing for more than 10 years now, performing almost all the cruciate surgery techniques including most of the osteotomies; TTA, TPLO, TTO, TWO, lateral stabilization, carbon wire, and the recently described Tight Rope technique. This is not to try and say how great I am but rather to illustrate that should there was one surgical technique that was fantastic, than we would not have so many different ways to try and fix this complex problem. The reasons for this is complex and I will leave them for later.

    One can see that in order to make the right decision for the right dog and the right circumstances we need more than just information and research and specialists. I truly believe that trust and relationship with your regular vet is the safest and best way to go about, or at least to start with.

    This is the person that suppose to know you, know your loved dog, the circumstances at home related to your dog and even the financial situation when need be. In most cases and hopefully this person has the best interest for you and your dog as you are there to come back after the surgery (in case of referral) and to stay for preventative health care and care as needed.

    Here comes the possible difference here in the UK. If your regular vet dose not have this relationship with you, than tell them that this is what you wish for. This is what you demand as a client. If there is no room to cater for this, look for one that will. I see it again and again. This is the one aspect that pay off more often than not. We should be more than just Doctors that fix things. We should be Doctors that care about what we try to fix. If we can prevent problems all together than great but we only human after all. ha ..ha..

    Selma has a genuine concern about the students at the specialist. The simplest way to limit this concern is to book a consultation with the recommended surgeon (preferably by your regular vet or professional person that you trust)and raise these issues, and so demand that he or she is the person to conduct the surgery.

    Karen is concerned about the post operative convalescence, especially with the stairs at home. Well, one can use an abdominal support or belt, that will carry most of the weight and limit strain on the affected leg during recovery.

    Joan also has concerns about the post op period, particularly with these large and active GSPs, that are well known to be handful even when painful. Well these dogs do not tend to do very great without surgery, and they tend to develop muscle wastage and weak leg. Some also develop hip or back problems, and together it is not a great combination.

    There are many ways to deal with this problem (again, you have noted that I said many ways for the same problem); confining to a crate to prevent jumping and running, consider larger implants that will be less likely to break, consider different type of surgery, abdominal support when out and so on. logically, some of which should be thought of before any surgery to be elected. I suspect that in your case a crate would be the best idea and an abdominal support while your are out with him.

    I hoped this would be a little insight to this vast condition. I saw this site and felt obligated to respond to some of the queries.

    Kind regards,

  43. looking to hear from someone with a boxer who has had ccl surgery on their dog in the past and where they are with it now? The longer ago the better. Need to make a decision with in the next week. Want to do the right thing for my very active boxer boy! thanks so much Julie & Whitee

  44. I have an 18 lb Jack Russell who needs CCL surgery. I am concerned about keeping him crated for the 2 month recovery period. Does anyone have suggestions about how to keep him from getting extremely depressed? He is very active and used to wandering around the two story house (so lots of stairs, beds and chairs to jump on, etc.). But in order to keep him from running, jumping, and climbing, we will have to keep him crated. Thank you!

  45. My 4 YO, 75 lb German Shorthair has ACl tears in both knees. Our ortho vet is proposing simultaneous TTA’s to avoid two surgeries. What do you think?

  46. Hi Jerry,
    Like your Ortho vet, I would consider simultaneous bilatral TTA. I would consider several issues.
    1- Is your dog very active? do you have a plan for proper exercise control and confinement?
    2- The complication rate after bilateral surgery is considered higher but not substantially, so at least by probability it would make sense.
    3- Bilateral surgery would be much cheaper.
    4- The convalescent period as you have stated is much shorter, even if minor complications should arise.
    5- Only one surgery so only one time post surgical pain (If epidural anesthesia is used the general anesthesia can be safer, the recovery is much better and less post operative pain is evident).

  47. My husband and I have an almost 3 year old mastive mix who is about 90 lbs and very high energy. Our Vet is almost sure he has a damaged anterior crucia ligament in left hind leg. Our vet told us that a possible ball park price for the surgery would be about $4,000.She gave us some names. But looking at the price I’m assuming they do the TPLO surgery. I’m finding out that there are differing surgeries to go with. Does anyone know of specialists who do the TR or fishingline surgeries in Chester County or Lanster County Pennsylvania?


  48. My 11.5 year old 60lb (27kg) lab tore her CCL about 3 weeks ago. Her x-rays show some arthritis, but less than anticipated for her age. Her leg also has a clicking sound when you try to move it (suspected miniscis damage). She was never as active as other labs I see. She is very sweet and has always preferred socializing with people at the picnic bench to the dogs in the park. Maybe occasional bursts of running in the yard when showing off to neighbor dogs or a visitor, but most of her days are spent begging, jumping up on the couch and ~1m (1.5km) with a daily walk on a leash (until recent). She is stockier lab build but trim and otherwise healthy for her age.

    My vet routinely brings in a contracted surgeon from the area for this who performs extracapsular repairs. He estimated that this surgeon had performed 30-40 in his office. He has watched her surgeries and described this vet as meticulous and had good things to say about the short/long term success of past patients. He said he would have her do the surgery on his own dog if needed. My vet is very trusted, established and experienced. This is a surgery that seems more complex than prior surgeries/treatments and available information seems conflicting.

    Calling other schools and specialty vets in the Chicago area, they say they mostly prefer the TPLO (maybe because they are teaching schools and specialty vets). Acknowledging all surgery has risks, is it reasonable to be optimistic on an extracapsular repair for this type of dog?

  49. Joan posted September 30th about her GSP. We have a 7 year old, very hyper GSP with a torn cruciate ligament and have been agonizing over what to do. Joan if you are still reading this website, I would like to know how things are going 4 months later. My email is Thanks, Lisa

  50. Help! I don’t understand the anagrams used on this site to describe the different types of surgery for cruciate ligament repair. My 8 year old, mixed breed, 45 lb. friend tore such in her left hind leg on 12/16/09 and had surgery with a tightrope implant that I believe was screwed in. No cast, but a 8 week recuperation period. What letters apply to this surgery? Then, on 1/09/10, the right hind leg became ‘loose’ and vet stated she needed same surgery. I can’t imagine her recuping safely from 2 such invasive surgeries. I will call University of Missouri Vet School on Monday, 1/18 to see if she is candidate for the less invasive tight rope CCL surgery currently in clinical trials. In the meantime, can anyone advise me as to which surgery anagrams she did have in december/09? Also, I currently have a broken left leg, casn barely walk her on a leash, can’t lift her so am looking for the fastest recovery time. Thanks, Marsha

    1. Missy, my 45 lb.mutt, blew out both of her knees on her back legs one year ago. The blow outs were one month apart. She had tightrope CCL surgeries. The winter weather made the recoveries tough-no hair on the back part of her body, lots of snow and cold weather. Plus I got sent out of town on business and she had to go to doggy day care during the day. Missy is never on a leash so she was heartbroken when she had to wear one every day through April.
      However, no complications with surgeries at all. By June, she was swimming in the Meramac River (it was hot and I figured that it was great therapy); By August, she was once again chasing squirrels and wrestling with her younger sister; and by October, had chased and caught a rabbit. Still active and thriving at 10 years old! Both tightrope implant surgeries were performed by Dr. Bouse of Sullivan Animal Hospital (Missouri)and cost $750.00 apiece, with followup xrays at about $150. Why would anybody want any other type?

  51. Janet posted 14th Jan 10, 11.5yr, 27kg lab.
    Given your dog has good weight for her breed and considering her age, I would say that Extra-capsular repair would be indicated and probably a good choice.

    There are several methods for Extra-capsular repair and I am not sure which one is intended for your dog. never the less, extra-capsular repair tend to be less invasive and no bone cutting is involved. One of the major issue I would look at when choosing type of surgery, is looking at the rate of healing and potential complications. Using this analysis I would be less inclined to to TPLO for an older dog.

    For the more “chubby” dog I would consider osteotomy repair (TPLO) as in these dogs the extra-capsular implant tend not to last due to the greater load.

    It is not to say that your dog can not have TPLO, but if your vet (the Doctor that examined your dog and knows her) feels she is a candidate for Extra-capsular repair than I would consider this as a god way to go about.

  52. Hi Everyone

    We just went thru a bilateral extracapsular stabilization on my 14 month old pit bull. She had a complete rupture of the right and 90% rupture on the left. She is doing great so far. We are 10 days post op and she is bearing weight, walking, full extension and partial flexion (this is what we are working on). My dogs surgery was approx 3000 with radiographs and all. If anyone has any questions I would be more than happy to help out. I am in NY and would highly recommend Dr Tim Robinson, he was excellent before and thus far after the surgery. She will be starting her rehab Thursday with the center also.

    1. Hey,

      My pit who is 15months old needs both legs repaired and I am looking at a 9,000 dollar price tag…why was yours so much cheaper (I am looking at doing a TPLO followed with physical therapy-is that what you did).

      1. Wow! That is really expensive. I live in northern Florida. Not sure if location makes that much of a difference but it may make some. And we went to the best specialist in the area. Needing both knees done, that must make it nearly impossible for him to walk. We didn’t need PT – we did out own at home with no problems. Of course, there was follow up. Have you looked around? Is this the expert that your regular vet recommended? $9,000 is very steep. If you have it, great! I got insurance (which is being cancelled without use, by the way) because I couldn’t afford that kind of bill.

      2. Janna remember there are conservative treatments like Woundwears A TRAC brace. See the comments under knee bracing and look at China for instance who I believe had both legs involved. It is always worth trying this kind of approach before putting your dog thru surgery and also the expense.Good Luck!!

        1. Your right! How dare Ace Ortho brace say that Woundwears brace doesn’t work. Go on Woundwears web site and see all the testimonials of happy dogs and their owners.Obviously, they are afraid of Woundwears success!

        2. yes I just came across this idea today and have an appointment to make cast molds of my dogs rear legs to get braces made by Ortho Pets. Have you ever hear of Ortho Pets? I also just canceled my $119 consultation with a specialty vet that does TPLO!

          1. Had wonderful success with Woundwears ATRAC ACL Brace. Only heard that Ortho pets brace is rigid and doesn’t allow for rehab of the leg. Woundwears has a rigid and semi rigid rod set which is used to both stabilize and later rehab the leg.

        3. Two things and they don’t both necessarily belong here but success with this surgery is improved if we help take some weight off the dog. Since exercise is difficult, that probably means cutting back on treats and chow for some of our best friends. Please listen to your vet. If you respect them and love your dog, that’s your best source. Would you listen to strangers on a board if your Pediatrician said surgery and we said something different? Of course not. I respect everyone’s choice but this is a very painful problem. True, dogs deal differently with pain than we do but I couldn’t bear to see her in pain. And then I did research, read a lot of articles, talked to several specialist in and out of my area. For us not getting a permanent fix, i.e. surgery, was not an option. Down the road, arthritis is going to be issue, too. It’s going to be worse for a dog that doesn’t have this repaired in some way.

  53. Hi Karrie,

    Good to hear your dog is doing well after the surgery. My dog Pixie had the same problem, rupture of right knee ligament, I waited for 10 months doing the conservative managament , she was fine but now she started to limp more often and I am looking for a vet that performs the Tight rope surgery in NY. Could you give Dr Tim Robinson location info and if possible phone number.? I appreciate. Thank you! best for you and your dog.

  54. I have a 3 1/2 black lab who had a TPLO done on her left knee 2 yrs ago. She now needs one done on her R knee. Our Vet recommended this traveling surgeon who has done a few hundred to 1000 TTA. Which was not given as on opiton the first time around. Since the surgeon is a traveling surgeon there is no way to really “look him up” but our VEt and another custome but have recommneded him. He says either option is okay but due to dogs wt and age she is 85 lbs is opting more for the TPLO. I amm leaning more towards the TAA. How do i know which way to go? Also reading other people’s post, alot say their dog had to be in a kennel for months after surgery, our did not and recovered just fine why are so many going into kennels?

  55. I posted a comment a couple of days ago on my girl Kendra. She injured her front leg and the day before going to the specialists, tore both hind ligaments. She is a 3yr old, 170 lb., very active Mastiff. One Specialist recommended TPLO; one leg at a time. We went to Cornell University yesterday for a second opinion. I would do the same for myself, so I felt she deserved it also. We have had great success with highly specialized issues in the past. They perform all four procedures, hence, we felt they would be objective on the best solution for her. They have recommended, because she has bilateral tears…and a bad front leg, that we do bileateral TTA. They have recently done 5 or 6 bilateral TTA’s and the dogs were able to walk out the door in 4-5 days. She will then stay there for 4-5 days post op. The cost is around $5000 for both. This ends up cheaper than TPLO….we had quotes of $7000 to $8000 for both legs and we would only be able to do one leg at a time, doubling the recovery period. It takes two of us to hold her up and walk her and this is incredibly difficult at her weight. I worry that she will sustain further injury by waiting with conservative management in the dead of winter. Her surgery was supposed to be today, but she has been bumped to tomorrow morning. In the meantime, we called a 3rd Vet, Dr. Rene van Ee (Kenmore, NY…near Buffalo). He has been doing extracapsulation (fishing wire style) surgery for years. He comes highly recommended. He performed this surgery on our friends 195 lb. Mastiff about ten years ago. He had a second surgery done a few years later. This Mastiff lived to 13 1/2 yrs of age. Our friends took extra precautions with lead walking for 6 months. I would have strongly considered Dr van Ee, and this type of surgery, except he wasn’t available for two more weeks and Kendra really can’t wait. Their Mastiff, due to his weight, had to put some weight on the leg post op and he still fully recovered. This procedure may have been more difficult for Kendra as she is having trouble putting weight on 3 legs. We are also looking into the option of having her stay a few extra days for a longer period of rehab. I will update

  56. Kendra had bilateral TTA this past Friday. It turns out that both knees had near complete tears. There was no meniscus damage, thankfully. We visited Saturday evening and as we sat in the waiting room, we saw her being gurneyed outside. We watched through the windows as they unloaded her and two people sling walked her. I more appeared that she was walking them. I couldn’t believe my eyes. She could actually walk better than prior surgery, this, one day after surgery. Wow. Kendra’s biggest challenge is ahead of her, that and she isn’t eating much. I am cooking her food and trying different things she may like for now. On Monday, we went to drop off more cooked food and they said she was good enough to take home. 3 Days after both legs had TTA?! We were a bit shocked, but after the 3 hour one way trips…we were taking her with us. As she still has pain in the one front leg from arthritis, it takes two to walk her. I am applying heat to the edema 3x per day and meds 2x per day. I am massaging her muscles a couple of times per day also. I am going to look into something for the front leg…she needs to be able to help herself more with that leg for now, eventually, she will be able to rely more on her hind legs. She will be walked 5-10 min per day, for 2 or 3x per day for a few weeks, then we are strongly considering taking her for the 10 day physical therapy plan at Cornell. Our surgical cost for both legs, was the price of one TPLO. From what I have seen thus far, I have made the right choice. One wound is ready for the bandage to come off already. More to follow, the work begins.

    1. I just read your email and am so thankful you wrote it. I have a 2 year old male English Mastiff “Moby” who is diagnosed with partial cruciate ligament tear and degeneration – and will need both knees done. The vet here in Chicago recommended TPLO, but I will now check into the TTA. How is Kendra doing now? It’s been a year, right?

      1. Tiffany,
        Our dog Chip, a 5 year old, 80 lb German Shorthair Pointer, had bilateral TTA a little over a year ago at Cornell University Veternary Hospital. He was having trouble in both knees before the surgery. Now one year later he is like a new puppy. He has a little arthritis in one knee that the vet told us to expect but even that isn’t very bad. Usually after a good run we give him a buffered aspirin and that does the trick.
        The big thing is to follow your vet’s instructions precisely. We left Chip off the leash a little sooner that we should have and he slipped on ice and that was a setback for him. In fact the leg he hurt is also the one with arthritis now, though I can’t say the two are related.
        The vet told us that TTA was a better alternative to TPLO for Chip because TTA doesn’t actually affect the load bearing portion of the knee joint as much, so recovery is faster than TPLO, especially in dogs that need both knees done. I don’t think he would have done both knees at the same time if he had to do the TPLO surgery.
        Anyway we are very happy with the results and so is Chip! Good luck with Moby!

  57. Hi, I have a mix breed dog Blaze he is 2. I was just told he needs to have tplo surgery in both back legs. I know what everyone is going through and I hope for the best for all of you. I know the surgery is expensive but hes a part of my family and he has a long life left with us and I want him to be without pain. I hope i m doing the right thing by getting the surgery.

  58. I am too trying to decide what to do, but one of the vets I’ve visited has given me another option, it’s the old fashioned “suture technique” which he claims would be fine and less recovery time and costs on a dog that won’t be as active. My beagle is going to be 11 in July and is only 32 lbs and has a partial tear on his back left knee. He hobbles around fine but the back leg he won’t put pressure on it very much at all.

    I just don’t want him to be in any pain or discomfort, so I’m opting for surgery. The other reason is the pain pills (rimadyl) are supposedly not good for long term use (liver damage).

    The TTA sure seems like the way to go, the one vet didn’t even mention this one to me.

    I’d love to hear from any people out there on what their results have been of TTA or even this “suture” technique.


  59. I have a 19 mo. old pit/lab who is 60 lbs. His left front leg was amputated at 3 mo. Found him with the foot cut off above the first knuckle at 6 weeks.
    Now he has blown out his back acl , so is on two legs, but uses the left for some balance.
    He is very active and the vet said he could blow out the operation before it heals. I just don’t know what to do. He has been through so much in his short life.
    He is not leashed trained and the vet said I would have to take him out to go to the bathroom on a leash and at least a month to heal. He was jumping off the ground the other day and I just don’t know if he will heal.
    With only 3 legs I’m just considering leaving it alone.
    Anybody know what I should do???

  60. My just 3 yr. old Rhodesian Ridgeback had TTA surgery this afternoon. The surgeon would not advocate one operation over the other but said she was a perfect candidate for the TTA. I am retired, have little money but the success rate is higher then that of either the MRIT or the TPLO. I will keep you posted. You can email me with suggestions for recovery or questions.
    For older dogs the lateral or MRIT surgery is suggested, but if the boone angle is good the TTA surgery is suggested.

  61. My 4yr old American Stafford shire just tore her cranial cruciate ligament in her back knee. Her back barely comes up to my knees and the vet weighed about 75lbs yesterday and said shes made of pure solid muscle, well was until the other day. She loves to run through our horse pastures and wrestles rough with my dad and their Bull Mastiff Rotti. Not too sure what would be the best choice for her. I don’t want to ruin her friendly spirit and free will but I also can stand to see her suffer from this again. She loves going on multiple day long hikes and is VERY athletic. Does anyone have any advise for me? The DR were using we have been with for over 20yrs with all of my parents Champion German Shepherd show dogs so we find him to be extremely reliable and helpful. He recommended 3 surgeon specialists and said the surgery he recommends starts around $3,500 and “goes up from there”. Its either TPLO or TTA, he said those would be best for a dog with her muscle mass, size, and age. I don’t want to go the cheap route but I don’t want the most expensive one either, I need to do what would be the best for her life style to be least disturbed in the long run. I just worry after any operation, she may have to slow down a bit more then she or I will like and she will get really depressed.

    For anyone that has had the operation with an athletic, active dog, what differences and changes took place and how was your dog affected in the long run?

  62. Hey Devan I feel the stress and pain that you are going thru right now. I have a 7yr old Lab. Ret. named BUDDY and we were going hunting, feild trials,and training while we were at home on off seasons. so we was extreamly athletic until buddy hurt his rt rear leg just running around the pool and made a loud cry out, then he couldn’t put any pressure at all on that leg anymore. My Vet. said his rt knee needed surgery to fix the damage like you a TPLO was recommended because of BEEING VERY ATHLETIC,very lean stocky build, and his weight of 84lbs so a TPLO was done at 4yrs old. There are some things you NEED to think hard about. #1- follow post operating rehab. #2- I had to cut off all of Buddys hunting, field trialing, and most training exersizes because if he would do those things he would go all out until his legs would blow off. also it could cause the other leg to get hurt the same. #3- I had to prepare myself for all of that.
    Know Buddy is 7rs old with no more problems with the rt rear knee but his left knee seems to be hurt the same that is NOT what Buddy and I needed at all. I will be taking him in Monday and will be looking hard at not going with the TPLO proceedure this time instead the TTA is what i will go with. I think the recovery time with the TPLO is to long and it puts alot of stress on the other knee. After all of this is done I think buddys activites will be even more restricted. Only time and alot of work will tell.
    So I hope what i said does not worry you but instead help you with what to decide to do right the first time.

  63. I have a 4year old Schutzhund competition German Shepherd.
    What technique is suggested by anyone who has a high drive, active dog?????
    Looks like we have a partial tear.

  64. Great website!

    I’m here researching TPLO vs TTA for my 4-year-old lab mix. She has tears in both back legs and we went to Cornell yesterday. They gave us the two invasive options plus the one where they tie it. We’ve decided not to go with the “Tie” option because of her weight, 82 lbs, but are now not sure which is better TPLO or TTA.

    She used to be VERY active… walking, running, swimming every day, but now she is sadly almost lame. We would like to make a decision and have the surgery performed next week.

    Any info would be appreciated!!!

  65. I have been doing alot of reading and talking to vets and it has been stressfull. I came across a tightrope CCL operation that caught my eye. It seems like there have been some great results. I’m looking hard at this option. Has anybody had this type of surgery on there dog?

  66. I have a 7 year old pit bull. She blew out her right leg two years ago and we decided on Conservative Management. It is no less of a time and maybe longer for recovery. Well, as the Vets tell you, if they blow out one, they most likely will blow out the other one. From just the breed or due to the favoring of the good leg in the mean time.

    My dilemia is not the cost, we as dog owners will gladly spend the money on our dogs over our children, at least that is the way I feel. Do I get the TTA is my choice, but more are certified with the TPLO. I just do not like the whole TPLO procedure, changing a dogs gate and bone alignment. I would think evolution and nature got it right. So while TTA is a bit less expensive, that is not my concern. It has a little less recovery time, is not quite as invasive.

    So, those that have went the TTA route, I would love to hear from you. sgafta @


  67. Hey…..thought I’d jump into the mix and throw out a bit of information… if you all aren’t confused enough!!! I work as a veterinary technician for a board certified small animal surgeon, Dr. Terry Dew, at Azzore Veterinary Specialists in Russellville, Arkansas. Dr. Dew recommends either an External Fascial Strip or TTA procedure for CCL injuries. Some questions you may want to consider as you do your research should include not only what procedure do they recommend, but how many have they done and what have they seen in terms of long term results. Dr. Dew has done literally thousands of these procedures……..I love the results we see………the proof is in the happy clients!

  68. I have a 3 1/2 year old rottie/pit/lab mix who weighs 89 lbs. About 1 1/2 years ago we repaired her rear right cruciate ligament partial tear with the TTA surgery. While the recovery process took about 6 weeks, she healed very well, and was able to resume her crazy, hyper, wild routine. Just recently she has began to limp and show discomfort when she plays too hard, but that usually only lasts a day and then she is back to normal. X-rays showed that this is just normal arthritis, which is to be expected after a surgery. Of course her high level of activity and excitement has now lead to a partial tear in her left rear cruciate ligament. The surgeon who performed her first surgery, Dr. Fingeroth, has moved to Buffalo (we are located in Rochester), and the surgeon we met with today suggested no difference between the TPLO & TTA, and also told me that the TPLO would have a quicker recovery. After researching a bit myself today, it seems as though the TTA is the better surgery, and is actually the one with quicker recovery. I am now considering taking my dog to Buffalo to have the surgery performed, since Dr. Fingeroth did such a good job with the first one. Has anyone else heard or been told that TPLO results in a quicker recovery?

  69. I am researching knee surgery options for my dog, Roxy. She is a very active, 6 year old, athletic, 44lb medium sized mutt. She is not overweight at all.

    Everything I’ve found in the last few days seems to encourage the TPLO, but today I just started reading about the TTA and it sounds like the much better option. Kylie, everything I’ve found thus far seems to say that the TTA has the shorter recovery because the surgery is not as invasive. I found this site very helpful: be sure to click on the links on the bottom to read the FAQs and such. It explains and shows pics of both the different types of surgeries and why the TPLO is more invasive. More invasive = longer recovery. Though the article is written by a vet who does the TTA, it looks like reaally thorough and good info and that he is probably right about the “patented TPLO” method and why it is so frequently used. I’m going to see what my vet suggests tomorrow, but it sounds like either method “works” as long as you get a doc who is experienced in doing that method. I am definitely leaning towards the TTA because it is much less invasive.
    Best of luck to you and your pup too.

  70. Thanks to all who have published here. My labradoodle, Roxy, is 2 years and has spent the last year lame on and off with recommended “convervetive” treatment – she is coming home today after a TTA earlier today so I will let you know how it goes – I just know that she has been depressed and confused after being used to a least an hour a day walk to the last year of mostly nothing – unfortunatly she will run on her leg given any opportunity and we now know it developed into a full tear.

    The whole family are committed to keeping her quiet and making her rehab perfect so fingers crossed for my girl.

    1. Hi i was wondering how your dog was doing after her tta surgery. i have a lab with torn acl and have been doing conservative treatment for awhile but just met with a the vets today about doing the tta surgery. just wondering about your outcome. i know this was awhile ago. thanks for any info.
      kerry (yes my name is the same as yours!)

      1. Hi Kerry,
        I had my dog undergo TTA in both stifles about 15 months ago. He is a 80 lb, 4 YO German Shorthair Pointer. He is doing great. Ocasional arthritis in one knee as expected, but even that seems to be less and less as time goes by. Otherwise he is just like he was when he was a pup.
        Of course every dog is different, but for us, TTA was a miracle.

  71. My six year old 63 lb Golden Retriever blew out her knee chasing a ball. Affiliated Veterinary Specialists (AVS) of Jacksonville, Florida. $25 for a sling to lift her, $100 for the ramp for the SUV, $2,700 at the ortho specialist and $50 for flowers for the poor dog phobic neighbor who I solicited to get the drooling, frightened dog out of the SUV, post surgery. Watching her happy to snag balls again, priceless. She had the TPLO and it went smoothly. She’s down to 60lbs because I work to keep her light – diet food, ice cubes for more “treats” and a mid-day walker. They say it’s common to blow out the other one so I want to recommend insurance to everyone. I’d already lost her brother Golden to cancer the year before. That $3,000 didn’t have the happy ending we hoped for and I didn’t learn my lesson. Now we have insurance. They won’t pay for TPLO until 6 months after you have the insurance because of pre-existing condition issues that are easier to hide with pets than with humans. She was up on 3 legs the next day, in two weeks, she had all but forgotten about it and the hardest part was to keep her from doing too much for so long.

    If you have any questions, please let me know.

    1. if you get pet insurance really i mean REALLY check it out… they know that the ccl and other ligament problems are the most occuring… I got pet insurance and 1 month into it (fully coverd) a tplo or any other surgery was not covered.. you have to be insured 6 to 12 months before they will cover this injury. so PLEASE look closely and choose wisely.. sorry i think vets and insurance are rip offs…..NO COMPASSION 🙁

  72. Hi, anyone have experience with a dog with BOTH rear legs having a torn ACL? How did you get your dog in and out to the bathroom etc? My dog weighs about 80 lbs so carrying him is not really an option.

  73. HI all My lab Female 80# had her first tplo with epidural 2 years ago, was told by the surgeron that usually within two years the other knee goes.She blew the other knee about 2yr and 5months after the last surgery, by running a lot when it was already torn. I am know looking into the TTA instead. The vet surgeon told me that the TTA has as not as a good rap because when it first came out it was not as good,BUT it has advanced with changes and he recommends a TTA. still checking into this TTA . My most concern is she is an active lab, when it is time to play she plays until she falls asleep. BYT she did great after her tplo rehab was not fun for either of us but I work in the medical field and that helped quite a bit. c

  74. Amy,
    My 90lb lab just tore both his rear CCL’s within one week’s time and we are post-op day 9 from TPLO surgery on his right knee. Our Zeke had a difficult time walking to go pottie too but he is a trooper and managed to shuffle to and from outside. We had to lift him up and down our steps. I recommend getting your dog on an anti-inflammatory asap while you decide what route to take. The NSAID’s helped Zeke manage until his first surgery. I was very torn between Tightrope and TPLO. I knew that the TPLO would hold up with his weight and active lifestyle but it was so invasive that I originally went with the new Tightrope option until he tore his other leg a week later. The vet recommended that he definitely have the TPLO since both rear legs were lame. He was up walking on all 4 legs after surgery. It has been a chore to keep him calm and still! He just wants to run, run, run! Zeke seems to be doing well but only time will tell if we made the right decision. Now, we have to do this all over again for the left knee. I am considering Tightrope for the other leg since he has been on a strict diet and lost some weight. We will have to see how the remainder of his recovery goes for his first surgery. Good luck!

  75. I took my boxer to see the surgeon today and he told me about the TPLO and TTA. I had been reading about the TPLO and thought that was the way to go but now I’m unsure. My boxer is 4 yrs old and he’s 55 lbs. His surgery is scheduled for next Tuesday and the doctor told me to decide. Can someone please point me in the right direction? My baby is VERY active so I want him to have the best possible. Thank you

  76. This website has put me more at ease; however, my husband and I (like all of you) are struggling with what to do for our nearly 3 year old golden retriever who has an apparent ligament injury. He is EXTREMELY active. I have read a lot about the conservative approach and the success that it has had for many dogs. I am scared that WE would be making the wrong choice for our dog by doing this…not allowing him to have any activity for up to 8 weeks and then determine whether surgery is the option only to spend another 8 weeks post surgery. It seems like sooo much to put our dog through. I am terrified of the surgery option and the dangers it has for our dog.
    @Denise M: We have considered insurance for years and made a bad choice not getting it. Do you know if insurance can still be bought just in case the OTHER leg goes out in a few years? Will it still cover that even though it is a pre-existing injury (but the opposite leg)?

  77. Hey all, I have a 7 year old Pit Bull – he’s my son!! He tore his CCL this spring, and after conservative treatment and no improvements, I finally dove in and chose TPLO. He is a LEAN MACHINE – a killer Agility dog with Excellent level Titles, and Obedience Titled dog, with his Canine Good Citizen Cert., and now he is my #1 running partner. This has devastated me – broken my heart. His surgery was June 16, 2010. He came out like a champ, still so fit and ready to heal. His initial check-ups were poster child TPLO success. Then the implant/infections began. 6 weeks in the first infection, then 10 weeks, then more. I am now faced with yet ANOTHER surgery just to remove the plate and screws his body obviously cannot tolerate. They are causing him tremendous pain and he no longer uses his leg at all and the gorgeous muscle is gone in that leg. TPLO does not just cost $3000, it can cost yet another large sum just for removal. Worse yet, his hind leg structure is too straight, so we all know the other leg will come as well, hopefully later rather than sooner. Anyone out there have anything to share about the REMOVAL of the TPLO hardware and that recovery experience? I’m doing it asap, even though I fear his recovery failing, I have to try everything I can to give him all he deserves after all he has given to me.

  78. Hi All –
    very helpful discussion as we look to have bilateral CCL repair on our 2yo 110lb incredibly athletic, very lean Bernese/Lab mix Milo. complete CCL rupture on right, large tear on left. we hold great hope that his surgery will return him to his active life.

    As a human surgeon who frequently discusses different surgical options with my own (often times incredibly stressed) patients, here are some thoughts on TPLO vs TTA

    1. have your dog evaluated by a surgeon who utilizes both techniques. based upon joint angles and other specific features of your dog assessed on physical exam, one technique may clearly be superior than the other. find out how many surgeries for both TPLO and TTA your surgeon has performed. “a lot” is not an adequate answer to this question. if you cannot get a good answer to this, ask how many the surgeon has performed in the past month.

    2. ask your surgeon which technique would be recommended if this were his/her dog. you may or may not get an answer to this, but it is nonetheless worth asking.

    3. recent review of TPLO vs TTA demonstrated no significant difference in outcomes:
    that said, there can be factors which make an individual dog a better candidate for one procedure vs the other. Be careful about how much weight you might place in one person’s (e.g. – a friend’s dog) experience (either positive or negative) with a particular technique.

    4. complications of TPLO surgery:
    I cannot find data comparing complication rates of TPLO vs TTA. While TPLO recovery can be longer, this does not necessarily correlate with an increased complication rate.

    Both surgeries are relatively new and thus long-term data on outcomes is sparse, however the science behind both of these repairs is very good. There is some conflicting data on the complication rates in doing simultaneous bilateral TPLO vs doing staged TPLO (one side at a time), with the most recent data demonstrating no increase in complications with the simultaneous surgery.

    hope this helps for those faced with this decision. Milo will be evaluated next week with surgery planned for the following day. given the very similar outcomes for the two techniques in the vet literature, we plan to follow the recommendation of our surgeon as to which technique – TPLO vs TTA – will provide Milo with the best possible outcome.

  79. My 6 y/o 63 lb pit/lab mix, over 2 – 3 months, showed some very subtle symptoms at first. Instead of flying up the stairs like a bullet, there were a few times when he seemed hesitant to go up them at all. His leg not being tucked in under him when he sat. He lives to jump up into the back of the Grand Cherokee; he actually levitates. There were a few times when he wouldn’t jump and just stood there very excited and wagging his tail but had to be strongly encouraged to get in. Once or twice, I lifted him in. No limping or anything obviously injury related. They were so subtle, I thought some of them were behavioral – when hesitant on the stairs, he looked like he knew he did something wrong and was going to be reprimanded. When he would not jump into the car he was ready to go – tail wagging with that ‘oh boy, a ride’ look but like he was waiting for permission to jump in. And these signs would start and then stop long enough not to raise suspicion that it was something else. (I know what an ACL tear is – I had one but I never knew it was so common in dogs).

    Vet wasnt sure, suspected a tear, and put him on the DL for 10 days with metacam but it didnt improve. He referred me to the surgeon, a referral only specialist, who on exam estimated it was 80 – 100% torn.
    Nikki had TTA surgery 2 weeks later. This guy has done hundreds of TTAs and TPLOs. It was a 100% tear. The cost was $2900.
    He was putting some weight on it almost immediately. I was glad it was TTA not TPLO because as my vet said, TPLO is more like carpentry than sugery. More invasive and longer to heal. But, every expert has a different opinion. I was told the surgeon doesnt decide until he opens the knee. Nikki is almost 5 weeks post op now. At the 3rd week exam, the surgeon said all was well. I was relieved because even though the house had been prepared and locked down, he managed to get up the stairs X3 and down X2. I have been religious with his regimen of PT exercises and the ice. Lots of ice. One week post op, I was doing the bending the knee forward and back exercise and suddenly, I could feel his knee clicking. Rather willy-nilly I rushed him 60 miles back to the surgeon who didnt feel any clicking and was unimpressed. I felt silly but relieved.

    The exercises changed for weeks 4 & 5 and actually seem to be doing less than the first weeks. On walks he looks completely normal (except for the one shaved leg and a square on his side where the pain med patch went). Dogs dont complain so it is hard to judge how its doing. Still wont put his full weight on it when standing still. He cheats on the exercises intended to shift his weight onto the surgical leg. Intermittently he toe touches and lifts it off the floor. I learned not to freak thinking something happened – the surgeon said ‘you had an ACL tear – some days are better than others’.

    Its true the recovery is harder on you than the dog. Other than from the basement, there’s no way out of the house with using the stairs. I seriously considered living down there for 6 weeks or so, but that was too depressing so I carry him up and down. And up and down. And up again. Without seeing my feet. I’ve gotten so good at it that without a large dog on my chest I could go up and down the stairs with my eyes shut. All 28 of em.

    7 week exam it will be x-rayed. The real (and not cheap) PT starts next week. The question now is water treadmill or pool. Nikki doesnt do water. He certainly didnt like the introduction to the treadmill. If anybody has some experience with that choice, I’d love to know.

    So far, so good. I made a commitment that I would do whatever to takes to stack the deck in his favor. With any luck, he’ll be flying around like a bullet again in a few months.

  80. This is great information and commentary.
    I have a 9 1/2 year old Daneador (Dane/Lab mix) who is 100 lbs and she tore her cruciate in September. Because of her size and age, our vet was “borderline” on recommending TTA because they had never one one her size or age before and I think they had only done 10 ever. The vet suggested confining her and seeing if it improves on its own and it hasn’t. Has anyone had a senior dog do this and how quick is the recovery for an older large dog?

    I still feel like she has a couple good years in her and I want her to be able to be active and she can’t go on walks or to the dog park at all like this. 🙁

  81. My dog 4 year old Chesapeake Bay Retriever tore her ACL and partially tore her Meniscus in her right knee last January. We elected to do the TTA surgery and had wonderful success with it. It was a very stressful time, but she recovered quite well and the pain meds seemed to keep her quite comfortable. The cost of the surgery was right at $3000 and that included all pre-op, post-op, and laser therapy. If you live in or near Virginia, consider Dr. Godine at Ruckersville Animal Hospital.

    Unfortunately, she has begun limping on the other side now and our vet thinks she has started to tear the other ACL. I was hoping she wouldn’t be one of those 40% that tear both, but no such luck. We’ve kept her activity level low and had her on Deramax for 3 weeks, but her condition has not changed. We’re now considering going ahead and having it repaired before the major blowout (assuming that hasn’t already happened). I am pregnant with my first baby due in March and would really like to get the dog fully recovered before we take on our new challenge.

  82. Julianne – My vet has performed TTA’s on dogs over 100 lbs and said he has had great outcomes. However, due to her age I would just keep her medicated and quiet. She may stabilize after a few months and quit limping (that’s what Dakota did). My other dog (Casey) tore her cruciate and she is 10 too, so we decided against the TTA. Her injury has stabilized some and seems to get around okay with pain meds. However, Dakota (see below) is 5 years old and had the TTA.

    Compared to some of you guys’ costs – I had a major deal. Dakota’s TTA surgery was $1800. The vet quoted me at $2500 – $2800 but he said he quotes high incase it’s more difficult than expected. I live in Georgia and she had her surgery in the Dallas area. She is doing SO great. The surgeon is SO proud of her. She started using her leg within 48 hours and only rarely limps (usually maybe every couple of days I will see her limp and it’s only for a few steps). We are at Week 3 now and my only problem is keeping her quiet! Definitely recommend the TTA. (Oh she is a 70lb Rotti Mix).

  83. Beverly, would you mind giving me the name of the doctor in Dallas you used? I’m in Austin but have lots of family in Dallas, and it looks like my sweet lab will need the surgery. I’d love to take her to someone that has a rep good enough that someone would drive from GA to have it done! Thanks

    1. Meg,

      I am in Austin too and my 80lb, super active lab just tore his CCL. My vet referred me to a surgeon at Central Texas Veterinary Specialty Hospital who does like like 5 TPLO’s a day and is supposed to be really great. However, I have been reading so much and am now thinking that I might want to look into the TTA option. Have you talked to any other reputable TTA surgeons in the area? Would you also mind forwarding me the info for the vet in Dallas that Beverly recommended?

  84. I have two wonderful herding dogs, brother and sister, 8 yrs. old, who have 1 TPLO and 2 TTA’s between them. (Perhaps they share a genetic predisposition.) The male, 90-pounder had a TPLO five years ago and a TTA one and half years ago. He has had no trouble with either leg since the surgeries. The female (70 lbs.) had a TTA three years ago. She has not had complications, but she does limp a bit occasionally after vigorous exercise. When I took the male in ’09, our vet (relatively new to us) said many surgeons were no longer performing the TPLO as the results were not terribly distinguishable from the less expensive, less invasive TTA. We have found that to be the case. I would suggest, as someone did above, that you follow precisely the directions for post-operative care, and opt for the TTA. It is less invasive, painful, and expensive. We wound up having two operations on one dog, and were concerned going with the less expensive option, but were forced to by our budget at that time. We have not regretted that choice. In fact, when his sister developed the same condition, and then had bladder stones which required another operation (!) we were glad to be able to afford it. We are in NYC and northwestern Connecticut, so if you need advice on doctors, we may be able to help. Best of luck to you!

  85. I left a post on this site mid last year just before Roxy, my 2 year old Labradoodle had her TTA. Just to let you know, it went fantastically! She was touching down the same night, albeit tentatively. She had about 10 physio sessions afterwards with a qualified physiotherapist, as opposed to a trained vet nurse – and that really helped. The only ongoing effects are that she paces rather than walks like a dogs normally do, but that is probably just habit. She also sits with one leg out…again, possibly habit. It has gone so well and I remember how terrible I felt when the operation was due, and how much help this site gave, so I want to encourage those of you out there in the same postion.

    1. The question of conservative care versus surgical treatment is genereally viewed by human surgeons as a resolved isssue. When an effective conservative treatment is available the physician is obligated to try conservative treatment initially. The reason is that surgery is never 100% and can have significaant risks and complications. If conservative treatment does not resolve the problem,in this case CCL tear, then surgery remains a viable option. I would suggest a Canine Cruciate Brace, specifically the A-TraC Dynamic Brace. This brace prevents the abnormal movement at the Stifle joint while allowing for normal movement. This conservative treatment is about 90% effective and in our dogs case resolved the problem entirely. Physical therapy is great to promote muscle strength and enhANCE blood flow but does not prevent re-injury which is the key to potential healing. There are no risks with brace therapy and surgery can always be attempted if your dog does not benefit. Brace therapy also allows your dog to be more active than if surgery is chosen. Another great benefit is that this brace costs about $300 instead of $3000 to $5000 for the other procedures.
      This is really a no brainer and falls more in line with the treatment humans receive.


      1. I think everyone has to determine what is best for them and for their dog taking into consideration age, quality of living and available funds. For us, surgery made the only sense. And when I look at Savannah sometimes I feel like we could do a VISA commercial. Exam, $200, TPLO Surgery, $1,800, watch Savannah run full out again to shag a ball, priceless! She wanted to run again 3 days after the surgery – on 3 legs. I had to hold her back. Was very worried about her tearing her other knee. We took a straight line to 100% again.

  86. We have a Border Collie that has torn the CCL in both of her knees. They told us to crate her and not allow her to walk or run, that it was the only way to protect her. She is a very sweet and happy girl with lots of energy but trying to keep her down was more than she or we could take. She was soooooooooooo depressed, never smiled and barely even lifted her head off the floor. She wouldn’t even eat so that didn’t last very long.

    We went and had her fitted for and purchased the A-TraC Dynamic Brace for both legs at the cost of $450. We didn’t and don’t have the money for the surgery but had heard such amazing things about the brace and it’s success rate so we gave it a try.

    They told us not to take it off no matter what. She would learn to walk in it and go potty too. We followed their instructions and didn’t take it off for 7 days though she wouldn’t go pee or poo for the whole time. Finally she was crying and crying and we couldn’t take it any more, it was heart breaking, so we took it off.

    I had taken a 33 gallon garbage bag and spread it out on the floor of the hallway where we had her fenced into, had layered it with newspaper and puppy pads. When we got up the next morning, she had peed sooo much that it saturated everything so much that when we opened the bathroom door the pee had even gone into and covered the floor there too.

    We waited a few days and decided to try the brace again and again she wouldn’t go for 4 days so we took it off for good.

    We no longer try to keep her down or confined. She has learned how to walk and even run differently so that it doesn’t hurt her and she is happy as can be. We do have to give her pain pills on occasion though, sometimes when she try’s to get up after laying for a while, she struggles and is in pain.

    We hope someday to have the money to have the surgery but for now. She is happy and smiles all the time.

    1. Regarding the issue with the Border Collie. The A-TraC Brace is extremely successful from all the feed back I have read. No medical treatment or device is always effective and not every dog will benefit from it or even take to it. If you ask your surgeon about the success rate and complication rate of surgery you will find that they will not guarantee the results and will admit when pushed of the significant complication rate including risk of anesthetic death and amputation. Common sense is a commodity that is as important in treating a dog as it a human. Most people would call their doctor if they could not urinate or defecate for a week.. We used the technical support option offered with the brace and it was very helpful. Every dog is different and can react differently to treatment. I have a Border Collie that has used the A-TraC Brace for his ACL injury. In his case he feels so secure in the A-TraC Brace that he actually goes to get it when we take it off. Even though he has healed and can run normally without the brace we have him play Frisbee with the brace on just for extra protection. I believe conservative treatment should be the first choice in humans as well as our best freinds.Surgery is always an option just not the first. For some reason this treatment tenent has been lost in the veterinary community. Also,instructions can not cover every eventuality and common sense needs to be executed where appropriate. This brace was a miracle for my dog but obviously no treatment surgical or conservative is viable for every dog but there are far fewer risks with brace treatment than surgical treatment.

      1. I am certainly not dissing the brace, we bought it because we saw soooo many success stories on the brace. I should have called the vet we got it through to see if there were any other options or if they had any suggestions of how to help her use the brace.

        Sadie is a very head strong dog so I don’t know if anything would have helped. I appreciate your input, and apologize if I gave the impression that it was a problem with the brace or the brace’s fault.

        Sadie walks and runs all the time, she has learned how to do it without pain. She is an amazing girl and a blessing.

        Best wishes!

  87. @ years ago my Ridgeback was slammed into a tree by a very large dog while they were playing. At that time she tore her ACL but we didn’t know it. I went thru hundreds of dollars and 3 -4 vet opinions. Finally had a TTA after 1 1/2 years. Could not believe the success!!!!! YEs, there was slow recovery. I have little money , so hit savings to give her the best. now she needs her other ACL done, XRays and an exam have confirmed it. As soon as the snow goes she will get the TTA!!! I am not messing around. The recovery is slow but manageable. Yes, I have another dog also, so have to keep managing their dynamics.

  88. We had tplo surgrey for Blaze and he is doing great its been hard keeping him from doing the things he loves but I hope its all been worth it Blaze goes to the vets on Tuesday for his check up I hope he gets the all clear . There is only one thing I have noticed that when he walks fast I think his hips are cracking has anyone had anything like this happen to their pet?

  89. Today Nikki is 133 days post op. He still occasionally toe touches, doc said sometimes it never stops. He still doesn’t “square sit” – that leg lays down beneath his belly. Doc said some dogs continue to sit that way because it felt better when it hurt before surgery and now they continue to do it. Day 103 doc said I could take the mattress off the floor and put it back up on the platform, 21 inches. Day 117, Doc said he can run off leash. He may be ready, but I cant wrap my brain around the concept yet, it will be sometime before I can. The physical therapy was grueling, for me that is. For the first 2 weeks, it was stretching, bending and massage and ice for 20 minutes out of the hour. Which hour? Every hour. Then starting week three, ten different exercises, with all the repetitions, held for so many seconds, 3-4 times a day. It seemed like there was no time for anything else. By the time one round was done and I did one or two things, it was time for the next one. And the walks. At first, it was three 20 minute walks every day. Doc kept increasing it until it was three 60 minute walks every day. Day, night, it didn’t matter what time it was. In the rain (dumb), during blizzards (fun) and when it was 10° (really dumb). I walked him so much, I got an injury – I pulled a hamstring. He flys up the stairs and jumps onto the bed. I still cringe every time. Still going to the pool once a week. So far, so good, he said keeping his fingers crossed. At this point, you’d never know he was injured and had surgery. Yeah baby!

  90. I live in MAss. Surgery for TTA is about $3800, plis xrays and extra therapy. After much serching and thought I had a TTA done. My Ridgeback was only 2 1/2 and alreaddy had arthritis. I listened to all the argument s both pro and con, and the TTA was perfect. I am in my 70’s with little money, but the welfare of my dogs comes first. Now the other Cruciate has gone, and she will have the TTA for the other leg. Recovery for all is very painful that first week. They cry and are stoic, but then it is a management matter. I made a ramp of two 2×10 and supported them together and put indoor ourdoor carpeting on top(staple gun). She had 6 stairs to go up and down, It worked like a charm.
    Good Luck. I will answer any questions I can,
    NAncy F

  91. Hi, I live in columbus, ohio and just got back from the vet hospital with my 7 year old yellow lab bear to confirm my fears, he has a partially torn CCL. Main reason this is such bad news is that we’ve already been through this once!

    Rewind 5 years ago – Bear is 2, starts to noticeably limp every time he plays hard, take him to vet several times, take some x-rays, finally send us to the specialist, specialist looks at him and within what seemed like a minute says “yep he’s tore his ccl, needs TPLO surgery, that will be 2500 bucks” – being that bear was 2 then, really had no choice but to do it.

    Surgery went well, other than our dog looked like something from a horror movie with all those staples. Oh and lets not forget the nice parting gift that they tell you..”40% of all dogs that tear one leg, do the other” – me: “awesome, thanks for that postive note as my dog hobbled into my truck” He was weight bearing in 2 days I would say, and had no complications, and was back to playful normal dog in months.

    Fast forward back to today. Before heading in to the consultation appointment I had done my research. Read much that says TTA is less invasive, less expensive, quicker recovering. This all seemed good and seemed like the route I wanted to go. My regular vet had even confirmed with me last week that even though my dog had TPLO first time, it wouldn’t matter if he did TTA in other leg. However, after meeting with my surgeon pretty much everything turned out to be not true according to him. First off, he said TPLO is not necessarily more invasive. Since this time my dog has a partial tear, instead of a complete rupture like lastime, it would not be as invasive this time (he stated they wouldn’t have to open up the joint as much) He said with both surguries dogs would be weight bearing within 24-48 hrs. And finally, the kicker, both procedures cost the same! This was the biggest dissapointment for me.

    So he suggested sticking with the TPLO for us. Mainly because our dog had such great success with it before. Today he completely checked over the leg that had the TPLO and he said there was no swelling or fluid anywhere which most dogs eventually show signs of. When I asked which he did more of and prefered his response was that he’s done TPLO for 12 years now, and TTA for 6. He couldn’t count how many he does a month, but obviously a lot since there was a dog there from 2 states away to see this specific surgeon (apparently he’s one of the best in the Midwest).

    Bottom line: a little disappointed to find the TTA costs the same, cause it sounded like a good alternative to the TPLO, but sounds like we’ll be goign with the TPLO again, and oh by the way the time the price is 3100 (inflation right?) So I’m up to around 6 grand just in my dogs rear end! Good thing he is so cute…

  92. Today is postop day 150. Four days ago, I let Nicky off leash. I was watching him as closely as he watches a Kong stuffed with peanut butter. For no scientific reason, I did it in three sessions, 3, 6 and 9 minutes, back on leash in between. He began to trot a few times and each time I involuntarily hollered out his ‘stop what youre doing’ command. So he never got past 20% of top speed for more than 15 seconds. Towards the end of the last session, I saw him actually hold the surgical leg up and hop because he wouldnt let it touch the ground. Well, that was the end of that for the moment. I called the surgeon the next day and he said its not uncommon for the dog to be a little sore at this point which didnt sound right because he moves faster than that keeping the soup bone away from Java in the living room. He said to keep him on leash for another week and observe him closely. Nothing to report since, all systems nominal, will advise…

    1. Bryan, Have been reading your posts and my female golden had TTA surgery on March 17. She still has her 22 staples and seems to be getting around very well. So far I have been very pleased with the result. Her recovery will be complicated by the fact that I have another male golden retriever and I am having problems keeping them from playing. Did you know prior to the procedure recovery was going to involve physical therapy? My doctor hasn’t said anthing about that at all. Was not given any instructions as to icing the knee or exercising it, maybe I’ll get further information when she goes back late this week to have the staples removed. I’m glad for your posts so that I know what is ahead as far as recovery goes.

      1. Susan, my jaw dropped when I read your post. Wow. It’s ALL about the recovery. At least your dog didnt take out his staples by himself! I was like a drill sergeant with it all. Yes, it was difficult with the two dogs. I took mine with me when I left the house and confined one of them when he couldnt come. Always felt bad about that. I listened for any sounds of commotion and yelled a stop command immediately before I even got to the room they were in to calm things down. If he got too spunky (feeding time) I put him on the very short leash attached to dinning room table. I dont know your situation, but dont let her get around whatever you block the stairs with. One jump up on the couch could be a disaster. I walked him without the other dog.

        My jaw dropped when I read your post. Wow. It’s ALL about the recovery. At least your dog didnt take out his own staples! I was like a drill sergeant with it all. Yes, it was difficult with the two dogs. I took him with me when I left the house and confined one of them when he couldnt come. Always felt bad about that. I listened for any sounds of commotion and yelled a stop command immediately before I even got to the room they were in to calm things down. If he got too spunky (feeding time) I put him on the very short leash attached to dinning room table. I dont know your situation, but dont let her get around whatever you block the stairs with. One jump up on the couch could be a disaster. I walked him without the other dog.

        Again, I really am shocked no one said anything to you about PT. I was given instructions on exercises, first 2 weeks, then the next 3 weeks. I started the stretching and PROM the 2nd or 3rd day post op. (Passive Range Of Movement) The pool (5 weeks post op) is pretty expensive so I started with 2X a week, then just one. I think when its all done, the swimming is great and its fun swimming with my dog but I think walking is the poor man’s pool. I spent $840 over 3 months. I think its very worth it early, when theres exercise without weight on the leg. And on pool days, I got the day off from all the walking because its a lot of exercise, he’s beat afterward.

        1. Oh Susan. Bryan is so right that it’s ALL about the recovery! Pain management, icing the area, ROM range of motion exercises, deep tissue massage and if you can get it physical therapy.

          I have 2 dogs with TTO’s. Believe me it has been a challenge. I put boxes on my couch so the wouldn’t jump up. I walked them one at a time… and believe me you do a lot of leashed walking. No leash free activities as it is so easy for them to forget themselves. A simple soft tissue injury can set them back 6-8 weeks in their recovery.

          Raven is active but more sensible and reasonable. We did weekly cold laser treatments and an underwater treadmill at the PT center. Otherwise? We walked! And walked and walked! Somewhere around 4 months, she was approved for trotting. So we walked and trotted. At 6 months she can run. But it truly took that long. The swimming Bryan mentioned, is excellent. Any under water activity works so well. There is less stress and weight in the joint, while the water’s resistance makes the muscle work hard.

          My boy Stetson is brilliant but far more impulsive, sustained some soft tissue injuries despite what I could do to prevent him from it. He was leashed or tethered when he sustained them and i was right there with him. A flood displaced woodchuck came under the fence and alongside my shed where he’d hoped to make a new, drier home. Tho tethered for a potty break,Stets went ballistic! It doesn’t take much! It set him back 8 weeks… no lie!

          It IS all about the recovery, Susan. Do all you can to prevent the stairs before your dog is ready. Be vigilant about their attempts to play together. Keep the leash handy and do your leashed walks. You start out small. A few houses down is enough for a beginning then 5 minutes then 10. Take it slow and always cut back if there is lameness. Pain management is so important.

          Stetson is on tramidol (pain) and meloxicam (inflamation) in part, due to his excapade with the woodchuck. He was unable to take either the Deramaxx or the Rimadyl due to stomach problems. His recovery will obviously take longer… 8 months instead of 6. Use a leash. Check your area for a PT center. If not, and many areas do not, walk, walk, walk… on lead. If you find a place to swim, all the better! Good luck!

  93. Again I had a ridegeback who had the TTA surge

    y last year. I had another dog, and KEPT THEM APART!!!! Just get some gates. This Ridgeback has to have another surgery done on this leg. Braces only delay the process. I had swimming as the post op therapy, but there are several kinds. Strongly recommend it. Just because they are walking on it doesn’t mean they don’t need careful rehab afterward. Do not let the dogs play together.
    I know I sound stern but I am trying to be common sense and realistic.

  94. My poor baby went back for her 6 week check yesterday, and it hasn’t worked. She has managed to move the plate and screws. they kept her in, and she now has had the operation again. So here we are back to square one. I am so gutted for her. We did everything possible to keep her quiet and calm, but she is a young and boisterous Shepperd/Rotti mix and it clearly wasn’t enough.

    1. I’m going through the same thing. My dog is a miniature poodle and tore his ligament. He’s 15yrs. old!! but in very good shape. He’s having surgery this Thursday and I’m scared to death. The vet reassured me he will do fine. The surgery will be preformed by an orthopedic doctor. I wish you the best.

  95. My dog tore her ACL on Monday. She will be 12 in May; she is an American Staffshire Terrier and still extremely active with the exception of a touch of stiffness after a long walk or ball session.
    I was advised no exercise, leash for potty breaks etc. I take it as bed rest for a human. Keeping her on “bed rest” is extremely difficult. She has never been kenneled. I purchased a pet yard and block her into a small area and supervise her.

    I am very concerned about TTA surgery (if required) on a 12 year old.

    Anyone have a success story with a dog of her age? She is the perfect dog I love her so much. I want to do all I can but is surgery the right thing?

    1. I would have a long discussion with a Vet you really trust. Consider a brace for an older dog. Ask him/her. And if your current Vet is just a convenient Vet, don’t hesitate to ask another Vet. If you have a University nearby, check with them. Talk to someone about limited funds, if that is an issue. Lots of them will work with you. Good luck.

      1. Think about Woundwears ACL brace. It’s very effective and is much less expensive than surgery especially for older dogs.

  96. Susan – this is the second time Ive been here since you made your comment. The first time was the same day you made it. Apparently the comment I spent none too little time on didn’t even post! WTF? Im am SO pissed. I feel awful that you never saw it. I dunno, maybe Im just retarded. I don’t know how much of my 2¢ is pertinent at this point. When I read your post, I was shocked the vet never talked to you about PT. I was blown away that your dog’s recovery had been potentially jeopardized, through no fault of your own and furious at that vet for being so irresponsible, ignorant or both. Maybe he’s the retard.

    So it’s been 3 weeks since the surgery. Please tell me she is doing well. I don’t know at what point her recovery is at, so for the benefit of others, I will repeat a couple of things from that (attempted) post. Im guessing that some of them may not apply anymore. Securely gate the stairs. To save $, I used cardboard, duct tape and velcro. They opened and closed and fit my stairs perfectly. Remove or block any chairs or couches; one hop up onto the couch can be disasterous. Walk, walk, walk. I think of it as the ‘poor man’s’ water treadmill/pool. It would have cost me more to do the treadmill (travel), Im glad I didn’t do it. I did absolutely everything, big and small, to stack the deck in Nicky’s favor; IMO, you cant do too much. Oh, and get a new vet. Please update, I dearly want to know how she is doing.

    Mandy – that’s heartbreaking, I cant even imagine. I was completely paranoid that at any moment something bad was going to happen so I was OCD about not letting Nicky hurt himself, it was a police state. When he was getting too revved up, I put him on a very short leash that was around a leg of the dining room table. Sedation is an option if its really, really bad.

    Cathy – search this site for Conservative Management. Sometimes Extra-capsular surgery will work which is less invasive.

    1. Thanks Bryan. My Girl is doing OK after her 2nd op. The first time she had very little bruising or swelling, but this time because they had to re-open the wound, she looks as if she has been hit by a truck. She is coping well though and is already walking on it better than the first time, so I am really hopeful that she is going to succeed this time. I love her so much and hate to see her in pain, but I know it will be worth it in the long run when she can enjoy her walks again and chase the squirrels.

    2. Bryan, This is first I have been back to site too. Pippi went back to vet for recheck 3 weeks after and they seemed very pleased with progress. She also goes back this comming Monday. Did question at 3 weeks regarding taking her for short walks and was advised it was too soon and that it was still okay for her to go out into fenced back yard off lead. Still not allowing the two dogs to play and they are actually pretty compliant. In the end, I really do think that every vet does what they think best and what has worked for them. I have much confidence in my vet, at least for now. Thanks so much for commenting back and I’ll try to update when we get home on Monday.

    3. Coco is doing great 2nd time around. Although the operation seemed much worse than the first time, she is recovering much quicker. All bruising has gone and she is walking really well 3 weeks in. She still struggles to assume the position to do her business, but gets there in the end. I would definitely recomend some sedation. The reason it didn’t work the first time, was because she couldn’t be kept quiet. This time, she has a couple of pills morning and evening, and she is totally chilled, without being out of it. Feeling really positive this time.

    4. Few days shy of 5 weeks post op. Saw vet today and he is pleased with way she is walking and placing weight on leg. Vet is still suggesting that she remain relatively quiet. No chasing balls or rough play with the other dog. Currently no walking recommended. Next visit back is in 4 weeks for an x-ray and manual exam. Hope I can continue to keep her quiet that long. Have to do some traveling and am concerned with kenneling her. Afraid that someone else won’t understand the rammifications of running and rough play.

  97. Thanks Bryan – We have an appointment on Tuesday with our local University Vet Hospital so I can learn more about the injury/options. At this point I feel a brace may be the best option for my perfect angel :). At her age I am unsure surgery is the best option. Plus the recovery time…..she has never been kenneled, I strongly feel this will stress her out and put her in a depression.
    Trying to keep her from moving the past few days has been extremely hard. She is extremely active for a dog who is almost 12 year old.
    I recently was laid off from my full-time job and only work PT at a local animal shelter which is a good thing due to I have been home with her so I haven’t had to kennel her. However I work this Sunday all day UGH what to do???

    1. Got a walk-in closet? Or use a bathroom – make her comfortable – bed, water, DVD player etc. Then there’s very little real estate to run around in. Whatever it takes, no matter how inconvenient or seemingly unfair to her it might seem. Its for her own good.

  98. Wow! I’ve seen so many different experiences from this board that I’m glad I didn’t read before hand. For me, there was no question. I could afford the surgery, Savannah was only 7 and was a very active and happy Golden. I couldn’t bare to watch her limp through the rest of her life or to know she’d be in significantly more pain as she got older. I trusted my Vet. She’s excellent and practically minded. I’d lost a job the year before to cancer. That cost me $3000 just getting him diagnosed. Plus some money for alternative treatments (acupuncture intended to ease the pain and other medicines intended to slow the bleeding.) When I believed he was no longer smiling and was in pain, although if you didn’t know him, you’d never know, I let him go. My girl hurt herself while I was away on business just shagging a ball in our backyard. She was getting around on 3 legs when I got home. My Vet said, best bet for recovery was the TPLO, although it generally costs a little more than TTA. She recommended the best ortho in the area and I saw him in 2 days. The worse part was getting her home. It cost about $2,300, I think. She shows no sign of it now. She was hesitant to jump for a long time, now she jumps in our out of my SUV, she jumps to get attention and she’s still shagging balls in the backyard. She’s just doing it alone these days. Her sister is not a retriever and has no interest in running after a ball. 🙂 I had insurance and they tell you once one goes, expect the other will go. Insurance cancelled us. She is probably too old to get any other insurance. After I lose these two, I think I’m changing to smaller dogs who are less likely to have this issue. I think the choice can depend on your finances, your dog – including size and temperment. We did T/T at home – morning and night. I was very diligent but really she thought we were just playing. I wish anyone facing this much luck. I really cannot imagine not having surgery for a younger, otherwise healthy dog. I personally had a total knee reconstruction for what they call a typical “football injury.” I wish my recovery had gone as smoothly.

  99. I live in santa barbara, ca. today my dog just got a TTA performed. $4900-5700 for the pre op blood work/x-rays, staying the night, surgery, staying a second night and follow up ( 2 more x-rays at week 3 and 8 which are each $155). Then I need to get a Kennel for my dog $150, so total it runs about $5500-$6200. Where are these places that are so cheap!? It costs $1000 to remove her lipomas a few months back

    1. tom, what breed is your dog? Larger dogs cost more than smaller dogs. You have $800 and $700 ranges. What is that? Why the second night and the kennel?

      General Update:
      Nicky back on leash for a week. Vet said sometimes the dog just has to work it out. Day 1, he ran a little and started to hop again. Vet said for 5 days, restrict it to 15 min warm up walk/15 min run/15 min cool down walk. On day 5, when we got home he started toe touching which he hasnt done in at least 2 months. Didnt want to jump up on the bed and when he did, I could see his good leg was doing most of the work. By the time the vet called back (2 days) I didnt see anymore toe touching. We decided to give it a few more days before I would take him back for an exam. Oh joy 8(

    2. Our beagle had a TTA on one leg done in downstate Illinois by our vet for approx $2000 and then 6 months later had a TPLO on the other leg in Dallas, TX for $3000 done by a specialist. She is doing really well with both legs (granted, her first surgery was almost 2 years ago).

      As for the price, I am sure it is like plastic surgery. The doctor’s education/specialization, location and clientele play a part in how much they charge. In short, if they can justify charging more, they will!

  100. Ok just got my girl home. I was crushed seeing her on the gurney. Too weak to do anything. She didn’t even eat and they cook fresh turkey and rice for the dogs. $5400 for the TTA and meds. 2 more follow ups w X-rays $155/ea.
    Dog hasn’t eaten more than a few bites all day but drank lots of water. She hasn’t even been able to go to squat to do her business. Hasn’t even peed all day.
    At this point I wish I’d looked into alternatives but it was a complete tear of her ‘ACL’.
    The surgery really kicked her ass. She just has enough energy to flop her tail a bit to show she’s happy when I try and feed her or give her water. Dr said she needs to be in a crate for two months!!! First he’d said 3 weeks.
    I’ll update if it was worth the suffering in a few weeks/months when she’s healed.

  101. Bryan,
    Thanks for your feedback. Last year I had to separate my dogs due to my younger boy was having issues with his back legs (not ACL); he has joint issues in both back legs. Anyway I had to keep him quiet, no play etc. My perfect girl who is now almost 12 with the ACL injury was placed in a bedroom. She did not like this at all….for the first time in her entire life she caused damage. She scratched at the door and pull pieces of wood from the door with her teeth, pulled the siding around the door off etc. I came home from work to half the door being gone.
    Unfortunately, placing her in a bathroom or walk in closet may not cause her to hurt herself. I think a kennel will be my only option I just hope she doesn’t hurt herself trying to escape.
    Wish me luck!

    1. Tom, you didnt state what breed/weight she is. Why the second night at the hospital? She is still on pain meds, she’s got to be. My dog was on the Fentanyl patch for another 4 days counting the day he came home. Different dogs (and people) have different reactions to opiate pain meds. She wont even be close to being herself until after the meds are discontinued.

      Cathy – I can only speak for myself but like I said, whatever it takes. Have you considered talking to your vet about sedation? A little valium can do wonders.

  102. Hi Bryan
    Lab mix.
    She’s on the patch. I’ll take it off her tomorrow. 4 days. Like you’d mentioned. I also give her pain meds 2x a day. I can give it up to 3x but she’s coping ok and doesn’t seem to be too uncomfortable. I think the sedation meds are very useful as well. They all seem to screw with her appetite.
    2 nights in hospital. First day she had her blood work. Next day they did surgery early. Following afternoon they released her.
    They have a tech w dogs at all times and cook warm fresh foods as well. But seemed a lot more responsive before I paid than after.
    Was in yard for 45min last night w dog. She wanted to squat but of course couldn’t. Finally she just gave up and I brought her back in. She ended up relieving herself while laying down poor girl. I really hop she heals soon. 2 months in a kennel sounds excessive for a dog to need to endure but if the vet says it. I’m not risking my dog by cutting the time short.

  103. Hi All,

    I had a Rottweiler who had the TPLO sugery done on one leg and then a year later the other ACL tore and she had her second TPLO surgery. A year after that she had gotten an infection in the bone and needed to have the screw removed. A month later she died of stomach bloat. She was my baby and was SO hard.

    I now have a new Rottweiler and she is 18 months old and tore her back right ACL. Partial drawer. I now know she needs surgery. I am torn between the TTA and the TPLO. The TPLO was $3000 the first go around and $3800 the second time and $1500 with the infection.

    My brother had the TTA performed on his mix breed who is about 50-60 lbs. The second leg went just months after the first leg.

    After seeing both surgeries the TTA seemed less invasive with a shorter recovery time. Plus the TTA was only $1500 per leg.

    I am very torn which is the best way to go. My girl already had cataract surgery at 6 months old and I was also told today she has a mild case of hip dysplasia! With all these surgeries I am flat out broke. Do I go with the TTA surgery which is 1/2 the cost where I live? Is it a better surgery? Are they more or less likely to have the ACL tear in the other leg with the TTA?

    Any advice would be great! My Sydney is about 80 pounds.

  104. Please don’t forget Woundwears A-TRAC Dynamic ACL bracing. It is a less expensive, less traumatic alternative to try before turning to surgery. Sometimes it’s all you need to correct the tear. Applying it can be challenging but WELL worth it for the results you can get. Remember surgery should always be a last resort.

  105. I would highly recommend checking out Orotho Pets and also Eddies Wheels. I have an Amstaff that has complete bilateral ACL tears and she walks fine in her stifle braces from Ortho Pets! I am also looking at getting her a cart from Eddies Wheels to give me more options! Because of my moral beliefs and financial restrictions (i work at the local shelter making min. wage) this is the route I went and have gotten a good outcome. Research the “conservative method” for more information. Also don’t forget about supplements, physical therapy, and NSAIDS!! 🙂 Good Luck to you and your kiddo 🙂

  106. What is the difference between a TTO and a TPLO? We are not looking at a TTA due to the dog’s size.

  107. Always consider ACL Bracing as an alternative to or after surgery to help with recovery. See the comments under bracing and visit for information. Not all injuries need surgery.

  108. I have now undergone 3 TPLO surgeries on 2 dogs over the last 6 years. The most recent was about 3 weeks ago. I have had successful recoveries and my girl was bearing weight on her bad leg the very next day. I researched both, in my area the 2 surgeries are roughly the same price. I have paid $3300 on the first one, $4000 on the second and $3900 on the third. I went ahead with the TPLO this last time because I was very comfortable with my surgeon and I did not like the place nor the surgeon who performed the TTA in my area. Not sure if this helps but I have always had good outcomes with the TPLO with the surgeon I used.

  109. I have a 2 1/2 year old 82lbs Golden Retriever who had been favoring his rear left leg for a few weeks. Brought him to the surgeon today and was informed that he has a completely ruptured ligament. Our vet specialist said that he suggests the TPLO surgery if the tibial plateau angle in more than 18%. If it is 18% or less there then suggests the TTA. Nevertheless, he also recommends this because of the size and activity level of the dog. I believe the thought behind this is it eliminates the forces that cause ligament rupture. Any thoughts?

    1. Some surgeons perform both surgeries and go case by case. I have read (TPLO) that they say The tibial plateau should not be leveled to 0 degrees or less as this will strain and potentially tear the caudal cruciate ligament. One research study indicated that dogs that had a postop tibial plateau angle between 2 and 14 degrees clinically did very well. I have also read that the TTA procedure should not be used in dogs that have a steep tibial plateau.

      Hopefully your pups menicus is OK. Good luck to you. I am in my 3 week of post op and she is doing wonderful! Although the daily physical thearapy is very time consuming!

  110. Can anyone recommend a vet that performs TTA surgeries in the East Bay, CA (Pleasant Hill, Concord, Walnut Creek) area?
    My 5 year old American Bulldog suffers from arthritis in the hips. Due to this, she has favored one leg more then the other which resulted in a torn ligament that now requires either a TPLO or TTA. After reading up on both of these surgeries, I want to opt for the TTA due to the fact that it’s a little less of a surgery on her then the TPLO and I’m also hoping it will be cheaper.
    Any advice would really help. Thanks.

  111. Consider bracing as an alternative. Visit bracing on this site and you will read some dogs healed without surgery and it also offers support on the legs. Visit and see some of the wonderful stories.

  112. Hi all. Nysa will be at the six week mark with TPLO on Wednesday. She has been doing great. She is allowed 2 or 3 20 minute walks a a day. Some of you may remember she is very dog reactive but I found a really isolated place to walk and that has been fine. She has, however, in the past two days, jumped up on her hind legs-dog walked by the house, visitor came in (ignoring my sign to call first%%@@##). I may just be paranoid but now she seems stiff. To worry me more I took a tic off her 🙁 Guess just wondering what folks think of the exercise level and should I test her for tic borne disease. We go to PT tomorrow so I wil be at the vet. The most paranoid Mom in the world thanks you…


  113. Wow. You are allowed walks already. Our surgeon says they can’t do anything until 8 weeks Post Op. My Sydney will be 6 weeks this Thursday. She is to be crated 24/7 except for physical therapy and 5 minute potty breaks.

    I hate that she is locked up for so long. I have actually made her a pin so she has a little more room then a crate.



  116. Hi Cathi and Nancy-thanks for responding. Cathi, did your pup have TPLO too? My understanding is they are able to do more, sooner, with TTA. We had a friend, however, who was like you Cathi. Nothing for six weeks and then just water therapy. Another friend, like me, started up in ten days with PT I must say Nysa now seems fine We go to PT shortly so I will see what they say-what torture! Thank you both so much and hope your pups continue to do well

    1. This is my second dog, 3rd knee having the TPLO surgery with the same surgeon since 2006. We are to keep them crated for 8 weeks with PT 2-3 times a day using PROM. Passive Range of Motion on the ankle, knee and hip one week post op. I had to ice her knee 3 times a day for the first week. They are also allowed out of the crate for potty breaks. On July 14th she goes in for her 8 week post op and at that time I can begin doing short leash walks 2-3 times a days starting with 5 mins each walk. Then slowly increasing it as long as she does well up to a mile over the next few weeks.

      She has done wonderful. She was bearing weight on her leg the day after surgery when I brought her home. She is 22 months old and very high energy so she hasn’t been too happy about being cooped up. I let her out of the pin when I am home and can sit with her and she sleeps in her own bed at night by my bed. I kind of barricade her in so she can’t get out.

      Our 10 month old pup isn’t too happy about not being able to play with her but what can you do. Surgery was our only option because of her size, activity level and it was a complete tear.

      Good luck with your pup. Its always interesting to see what other surgeons say about recovery techniques. I do all her PT at home myself.

  117. Well Nysa actually got a great report from the PT and vet. They say it is not unusual for them to exhibit some discomfort from time to time as they recuperate. I am so relieved! They say there is only a 2 cm difference in the measurements of her right and left leg-so the muscle is coming back. Today is 6 weeks and I think I see a glimmer of light at the end of this tunnel. Another question-when did you all resume leash walks with other dogs? No play, just walking. Thanks all 🙂

  118. Anyone have any RECENT (2011) cost estimates for TTA or TPLO for Dogs and Cats in Maryland? I am saving up, as my dog tore her cruciate 2 weeks ago and my vet recommended a consult there yesterday. Thanks..

    1. I just had TPLO surgery for my Golden, Cooper 4 1/2 weeks ago. I live in Vermont and the surgery was done by a specialist. The consult and surgery was $3,584. He has to go back at 8 weeks for x-ray which will cost approx. $200. So the total for me was just under $3,800.

  119. Its not MD but FL where I had Sydney’s TPLO surgery done. She just had her 8 week post op appointment yesterday and she is 90% healed. She is doing wonderfully! Here is a breakdown on my costs:

    Reg Vet Visit with xrays: $ 277.00
    Consult W/Surgeon/blood work:$ 240.00
    Surgery: $3,987.00
    8 week post op xrays: $ 240.00
    TOTAL: $4,744.00

    Good luck! I had insurance on her and cancelled it 3 months before she tore her ACL. I was beating myself over it. I now have insurance on both dogs through ASPCA. $10 a month per dog. It only covers accidents but should anything happen it will pay out about $2000. Also pre existing conditions are covered after they have been healed for 6 months. So should something happen with that same knee a year from now they will cover it.

  120. Consider the alternative of ACL bracing. has an ATRAC Dynamic Brace which can heal ACL tears in a lot of cases and is a much more conservative and cheaper option. There are also testimonials on the successes on this site and Woundwears site.

  121. It has been almost 2 years since my dog tore her cruciate ligament. She is a German Short Haired Pointer and was about at the time. We were torn by the different surgery choices and cost of each, but the need to keep this very hyper dog still for 3 months was beyond our imagination. We drug our feet trying to decide what to do, giving her Rimadyl and Glucosamine in the meantime. After about 4-5 months Lola started running around like her old self. We have continued to give her 1/4 a Rimadyl and a Glucosamine daily and she is amazing. She runs, jumps, spins, climbs trees to try to get birds. When I had her at the vet he was so impressed and commented on how successful the surgery had been. Was he surprised to learn we never went through with it! My neighbor has a similar story with a 9 yr old chocolate lab. We were both dealing with the decision at the same time and both dogs got better without surgery! My advice is if you can keep your dog comfortable with Rimadyl and Glucosamine, take a wait and see approach.

    1. Hi Lisa,
      Do you mind sharing approximately how much those meds would cost (say monthly)?
      Thanks for the information.

      1. Carlos,

        About $30 or $40 a month. The kicker is, even WITH surgery I’ve been told most dogs end up with arthritis and need the meds as they get older. Rimadyl is about $1 per day but we are giving her 1/4 a tab a day and it is working. I buy Glucosamine Condroitin at CVS rather than from the vet. Lola is 8 1/2 now and everyone thinks she is still a “puppy.”

    2. My dog has severely deformed rear legs. She’s been on deramaxx and glucosamine/fish oil for the 4 months that I’ve had her. the cruciate injury not only is making it VERY difficult for her to even stand (due to malformed other legs), let alone have ‘quality of life’. She drags her hurt leg and is causing sores and ulcerations. She’s not happy. I’d rather have 8 weeks of post op care and a more comfortable dog than 4-5 months of continued pain, muscle atrophy, and heartache. It’s the 3rd week now and things are getting progressively worse.

  122. You can get Rimadyl cheaper through but you do need a prescription. Price will depend on size of dog because dosage goes by weight as with any meds. Novox is the generic for Rimadyl and I have also used that. Its is also cheaper.

    Cosequin DS is a good glucosamine. The dogs love it because they are in little tablets which they think are treats.

    Glyco-flex is also just as good but some of my dogs have been picky and didn’t like it. But it is cheaper.

    I usually check vetdepot, jefferspet & kvpet when ordering products to see who has the cheapest and who has free shipping.

    One of the labs had a partial tear about 7 years ago. We kept him crated for 6 weeks and he did heal. However arthritis set in and he will limp anytime he runs and has done this for the at least the last 2 years. It is true, partial tears can somewhat heal. Scar tissue will form around the ligament and thats what holds it together but arthritis will set in. Thats why they say you shouldn’t wait, get the surgery asap so the arthritis isn’t too bad. A complete tear will never heal on its own, surgery is the only option and you need to do it asap so they don’t mess up their meniscus. That is very painful.

  123. Just like in human ACL tears, bracing is a great alternative for dogs. Look at Woundwears site for testimonials and options.

  124. /to the lady with the dog dragging her leg. How would you like to wait for her to make the decsions for you to have an operaation. Get it done now!!!! my dog had 2, yes, I was scared!!! She is wonderful now.

    1. I have the consult tomorrow. Other factors are a huge issue in making this decision, so I’m not ‘making her wait’, ok? I’ll pay with 4 credit cards if I have to, but she’s got cancer and heartworms too, so ‘making her wait’ is something I had no choice but to do unless I wanted to risk killing her.

      1. Poor Girl! ACL, Cancer and Heartworm?? How old is she? My last Rottie had her second surgery at 8 years old. Then she died a year later from stomach bloat. I was heartbroken! She was my baby. My new Rottie will be 2 next month and has already had cataract surgery and a TPLO surgery. :o(

        1. I adopted her knowing she had heartworms and did a surgery to remove multiple masses from her mammary glands that ended up being malignant adenocarcinoma. I got her 4 months ago, but I think she’s about 6-8 years. It’s hard to tell because her teeth are sawed flat. So this ACL (which I’m hoping it is, and not something worse) has happened right in the middle of her HW treatment. It’s not recommended to do surgery till 4-5 months down the road, so I’m just worried. I love her so much. I’m sorry to hear about your baby girl. They do have a surgery where you can tack the stomach to the abdominal wall to prevent that from happening, though I haven’t seen many dogs that have had it done..

  125. Well, thanks for the help guys, but it turns out her mammary cancer has spread to her bones (specifically the leg she’s dragging), spleen, spinal cord, and gall bladder. No amount of bracing or surgery is going to make it better. I’m going to keep her comfortable with pain meds until she doesn’t enjoy life anymore, then I’ll let her go. My heart is breaking.

  126. I am so sorry about your loss.

    That’s what makes the ACL issue so great. It is repairable. I’ve lost a beautiful boy to cancer. Our TPLO experience was so good, that our biggest problem was holding Savannah back. I had to walk her on a leash in the back yard to keep her from running around. We did exercises early on, before she was weight bearing. And, yes, do find the surgeon who has done 100’s of these. Like anything else, they get better with experience. Savannah has zero problems from the surgery. She’s getting older now; she’s a 9 year old Golden. But she still chases cats and squirrels in the yard and keeps up with her smaller, younger sister in games of chase. She still loves to snag balls, although not for as long as she would go when she was 3 and 4. Of course, I love her to death. I spent over $2,000 on it. But as Mastercard says, “Priceless.”

  127. Hi everyone.. I am a week away from my 2.5 year old Aussie/Golden mix’s first TPLO. She is going to have her second TPLO 2-4 weeks after the first. She has two partial tears and the vet (we took her to a canine orthopedic surgeon.. our journey can be seen here: said that if we do both legs now, she’ll have the best chance for a long happy, active life. I’m just trying to tell myself that it is the right decision to do this to a dog that, other than soreness and slowness in getting up after exercise, doesn’t really exhibit any major symptoms of injury.

    Someone tell me doing two TPLOs while they are still partial tears is the best option for her.. I think I will feel more confident if someone who has gone through it tells me and not the vet who wants to make some money.

    Thanks and hugs to everyone else going through this!

    1. The surgeon we picked has done 5,000 TPLOS with <1% complication rate. He's pricey ($7,000 for both surgeries), but like Denise M. says, they're priceless.

  128. Nicky is one year post op today. When I throw the first tennis ball, he still rockets off the line. I started handing him the first ball so he doesn’t put so much ‘torque to the ground’ before he warms up. Sometimes I catch him holding the leg up in the air. But he puts it down and seems fine. He prefers the steps up to the bed now he doesnt levitate straight up into the back of the truck; needs a little running start. He toe touches frequently, I get the impression he’s just doing it out of habit most of the time. Stairs are no problem. Every now and then he limps on it for no apparent reason, (yikes) I feel feint and then it goes away a short time later. Im sure he has some arthritis in that knee which is almost a given in dogs with this injury/repair. I have to remember he is (gulp) getting older. All things considered, it goes in the WIN column.

    1. Glad to hear Nicky is doing well. He sounds a bit like my first Rottie who had the first knee done at 6 years and the second knee at 8 years. She already had quite a bit of arthritis. I put the surgery off on the first and second knee which I regret now. My Sasha passed away at 9 years old from stomach bloat.

      I now have my second Rottie named Sydney. She tore her ACL in April and I had her TPLO surgery done within 2 weeks. She is about 5 months post op and you would NEVER know she had surgery or any kind of injury. She just turned 2 on October 25th.

      I know my girls were different ages but I truly believe waiting only makes things worse and Sydney’s recovery was so successful because of her age and not allowing the arthritis to set it. When I took her in for her 2 month post op the techs and surgeon had a hard time telling which knee it was. I’d say thats great success.

  129. For my own dogs, I tend to agree. Mine are so active and athletic. They would have only lost good muscle had I waited.

    I am glad to hear Nicky is doing well, and has resumed an active life. Small changes in the daily picture are adjustments all can live with. I’d be interested in your current arthritis regimen.

  130. I noticed my 1.5 year old Pitt/Coonhoud mix (68 lbs) was limping a few weeks ago. I took him to my normal vet, and he xrayed him and everything. Told me it was his hips…which he does have arthritis in, and that if he didn’t do immediate surgery he would have to have a total hip replacement by the time he was 3. I decided to get a second opinion from another vet my family has used (this one removed the ball off of my basset’s femur, and she is still extremely active). He looked at the xray and did an exam and came to the conclusion that it was a cruciate tear and that my pup should have the TTA (which is what he specializes in).

    I am torn between doing the surgery and not, largely in part because most people are saying the other leg gives out the same way in two years or so….I don’t have that kind of money….The vet that is TTA specialized has done over 50 of the surgeries in the past few years, but I am still hesitant.

    My original family vet told me that due to the arthritis in my pup’s hips already (genetics….) that he would have to take 1000mg of glucose every day for the rest of his life….so I am giving him elaborate! drink mix with milk to boost his natural calcium.

    Does anyone have any special advise for me? I am having to make the decision in the next few days…and I’m really nervous. I will not crate, but I will leave him in a small room while I am gone.

    1. Becca,

      Do you have any specialist surgeons in your area that do TTA or TPLO’s? Also, is it a partial or complete tear? If it is completely torn you should do the surgery in my opinion.

      My first Rottweiler had problems when she was a year old, the vets kept telling me oh just crate her for several weeks she probably just tweaked something. Finally after on and off problems and about 5 years later she got really bad. I think she had a partial tear and then it completely tore later down the road. Her arthritis had set in and even after the surgery I had to limit her exercise because she would get sore. I just keep thinking if I would have had the surgery done when she first injured it she would have had a better/less painful life. I too gave her glucosamine. About a year later the other ligament tore and we had our second TPLO done.

      With my current Rottie who just turned 2, I only waited 2 weeks (maybe less) from the time of the injury (complete tear) and the surgery (TPLO). She is 5 months post op and shows NO signs of ever having the injury. I do pray she never hurts her other leg though. Pet Insurance is a good thing. I now have it on both of my dogs.
      From what I have read TTA and TPLO are both good surgeries. Some surgeons just have more experience with one or the other and that is why they do it. In my area both surgeries are about the same price.

      Good luck. I hope everything turns out.

      1. Cathi,

        Thanks for the response! I do have a specialist who does the TPLO and I am meeting with him next week. I don’t know if it is a partial or a complete tear but either way all the dr.s I have seen want me to do a surgery. I am nervous largely in part due to my pup’s age……any advice on how to overcome parent anxiety????

        Thanks again,

        1. You said your pup is 1.5 years old? That is the same age as Sydney when she had her surgery. I thought how am I going to keep her calm during the recovery! She is a very active girl. Truth is they seem to know they shouldn’t be over doing it. I also kept her separate from my 1 year old lab, who was 6 months at the time. But Sydney does well with her obedience so if I say down and stay she will down and stay.

          I made a pen for her in our bedroom. The crate I had was my labs so Sydney was just too big for it. The ein was about 4 feet by 4 feet. Just big enough that she could stand up and turn around. I think her being able to get up and down helped with the healing process. You don’t want any big blankets in there, nothing that they could trip over or get tangled up in and hurt the injured leg or tear the other ACL.

          You want to make sure the area they are in is small enough that they can not really do much of anything. One slip, or jump or run could put you back at square 1!

          I played games with Sydney. I would put a treat in my hand behind my back and have Sydney laying in front of me. She had to paw the hand she thought the treat was in to get it. When she pawed the hand I would open my hand. If the treat was in that hand she got to eat it. She caught on quick though to paw the other hand if the one she picked was empty. lol

          You can also get the kongs and put peanut butter in there. You can freeze it to make it take longer to get out. Deer antlers are also great. They do not splinter or stain and take a long time to get small. Since the dogs are inactive you want to watch how much you are feeding them so they don’t gain more weight and make the recovery harder.

          Just follow the doctors instructions, do the PT and the PROM (Passive Range of Motion) techniques. I did all of Sydney’s PT at home and like I said when she went in for her 2 month check up the surgeon had a hard time telling which leg had the surgery. She was 90% healed.

          Good luck, I am sure everything will go just fine. Kepp us posted. :o)

    2. Becca,
      My Golden, Coop was a bit older then your Pitt/Coonhoud mix when he was diagnosed with a completely ruptured cruciate ligament. As with you the regular vet said his hips were bad; however, the specialist I went to didn’t think his hips were that bad at all. I ended up scheduling him for TPLO surgery. After the surgery I questioned myself if I had made the right decision. He seemed so sad at all the medication he had to be on to keep him sedated and calm. The limping around and not being able to play broke my heart.
      It has now been almost 5 months since the surgery and it was the best decision I ever made. He is now an active dog who can keep up with his buddies. Before he would be in to much pain to run and play like he should be able to at such a young age.
      Personally believe it comes down to a quality of life issue for the animal. At such a young age they should be able to run and play without pain. I wish you two the best because it is a very hard decision to make and the cost is a huge decision making factor. If you can afford it you and your dog will be better off in the long run.

      1. Cathi & Cheryl,

        Scooby went in this morning and the dr. is going to do a TPLO this afternoon. I should have news about whether it was a partial or complete tear, but I’m still stuck at work waiting to hear he made it through surgery. Thanks for all the info, and the support! I am hoping that with rest and time he will be back to his totally physical self and playing in the back yard with the others.


        1. Hi Becca,

          The waiting is the hardest part. We are 6 weeks out on our 2.5 year old Aussie Mix’s left leg and 1 week out on her right- both TPLOs. I actually took my meds I have for flying both days Scout went in for her surgery to calm myself down 🙂 Just remember, the first few days are the worst. If you pick Scooby up tomorrow, he will probably still be disoriented from the anesthesia so don’t be surprised if he is a little vocal and ‘different.’

          If you have a canine rehab facility, definitely go when it is time. We did the water treadmill 4 times between Scout’s first surgery and the second and we plan on starting again when she gets her staples out next week. It really does help.. so does the low-level laser if you facility has it.

          Scout had two partials, both torn 50% and even though we are still really close to the surgeries, I’m happy we did them. She’s young and will have a long life of fun and running that she may not have had if we didn’t do the surgeries. Best of luck and remember, everday gets better, keep your head up. 🙂

          If it helps, you can follow Scout’s recovery on it shows how fast they progress post-op!

        2. Becca,
          I have to agree with Kristen the first few days are the worst. I remember thinking what did I do to my little boy. It broke my heart to see him drugged up, but in the long run it was the best thing I could have done for him. When Coopie came home he would not eat so I made him a bland diet for the first week. Brown rice, steamed chicken and carrots with a spoonful of plain yogurt. That seemed to make him a little bit happier under the circumstances. Also do not be alarmed if Scooby does not have a BM in the first week. This was something that really alarmed me and I called the Dr. about this a few times. They said it was due to a combination of the medication and the position the dog has to be in to take a dookie. Other than that good luck to the two of you. The next 4 weeks are going to be a bit stressful, but it only get easier. Soon Scooby with be like a brand new puppy. That is the pay off.

          1. Good points Cheryl… since we are on round two, we learned a few things for the second go… #1 give your pup a tablespoon or two of pumpkin with his food until he does a #2. It really helps to speed up the process in a natural way. Make sure it is pumpkin, not pumpkin filling. Also, we fed Scout wet food mixed with turkey burger and her regular dry food to make it more appetizing for her. She loved the change of pace and we got a #2 on post-op day 2 this time around!

  131. One greatly deminishes the chance of the other knee tearing thru active physical therapy.  My vet and PT claim that once the surgical leg is built back up to within 1/2″ of the other side, your dog stands no greater chance of tearing the other side than before he tore the first.

    Personally, I don’t believe partial tears should wait.  They most often become full tears anyway.  So what have you gained?  More time for the muscles of that leg to wither and atrophy.  IMHO the sooner the better.  Keep the recovery down to 6 months instead of longer.

    That said, the decision is totally up to you.  And in some ways there are no wrong answers.  You know the activity level of your dog.  You can decide for yourself.  There are many advocates for conservative management, and knee braces.  Consider absolutely everything and go with your heart… and finances. 

    I had the surgery on 2 dogs, just 9 weeks apart!  Both are recovering right on target.  Raven is about 4 months in.  She is almost fully recovered, just half an inch to go… and she had a 3″ differential.  Good luck with your decision.

    1. Lucy, I give Nicky Kirkland (Costco) extra strength glucosamine 1500mg/chondroitin 1200mb, one a day. $25 on the site but I think it was cheaper in the store. In my research, that was the cheapest way to go for this supplement, mg/$. I give it to him with his fish oil cap in a lump of creme cheese or peanut butter.

      Becca, my surgeon said he was 98% sure it was a complete tear but he wouldnt know for sure until he opened the knee. It was a full tear. Like Cathi said, do the PT and PROM, and be religious about it. After 6 weeks or so, consider water therapy, either treadmill or pool. One good thing about the pool was I was in the pool with Nicky doing the exercises and swimming with him was pretty cool (but not cheap).

  132. Hi all. Curious is anyone can recommend a surgeon in the Los Angeles/Orange County area of California. I have an appt Tues in Tustin for my 6.5 year old Great Dane, Stella. I’m almost certain she’s torn her left ccl. Stupid me for throwing the tennis ball for her after the rain. I’m dreading this process because I work too much and I’m not sure how to handle the aftercare and recovery.

    I sure want Stella to be comfortable and her old self again.

    1. Sorry to hear about Stella, Alicia. Does your regular vet have a recommendation as to a qualified surgeon? That would likely be your best bet. My two tore crutiates 9 weeks apart, last year during “monsoon” season here in NY.

      Mine both had the TTO and I am very happy with the procedure. Dane size dogs do best with TPLO’s, TTA’s, or the TTO. It will take 6 months to build those thigh muscles back up, equal to the other side.

      The first few post surgical days are most worrisome. A sling will come in handy! (stairs, getting in and out of the car for appointments, initial leashed only potty breaks, etc) I grip wrapped gel ice packs to thighs periodically to diminish swelling. Your vet will have the dog on an antiinflamitory and pain meds.

      Gradually, you will begin leashed only walking Stella. My first walks were just a few houses down and back, 2-3 times daily Distance gradually increases. In this area, animal PT is available, so mine had the advantage of an underwater treadmill once a week for 10 weeks. Keep walking your dog. My PT didn’t want the dogs running before their thigh measurements (lo-mid-hi) were nearly equal. Many opt for adding swimming.

      My best wishes for Stella’s surgery and rehab. It’s worth it in the end. As you said you want to see her enjoying life again.

  133. Ladies,

    Scooby had to undergo a second TPLO for this other side which was only partially torn, but thankfully it was fixed before it torn completely. He is now a year and change out from the first surgery, and 8 months out of the second surgery. He still gets some stiffness if it is super cold outside, but I have never been more grateful to y’all or the dr.’s I found who helped him through all of this. Everyone finds it so hard to believe when I say that my dog has metal plates in his legs, largely in part because he runs and cuts like a herd dog and can run like a greyhound now. Wishing everyone’s pup the same kind of amazing recoveries!


  134. […] is doing really well seven weeks later. Here is a good article that describes the twprocedureses. TPLO vs. TTA for Cranial Cruciate Ligament Repair Duke and Freckles at their country home Reply With Quote Reply to Thread […]

  135. My lab had TPLO surgery approx 2 years ago… “lame” leg first, second leg went lame a month later so surgery on second leg was about 6 weeks after. Total cost at Cornell was around $10,000

    I can NOT express the need to take it easy for at LEAST a year after the surgery. My dog had to use a sling to go anywhere and when she appeared to be improving we were letting her do more within 4-5 months after surgery and one day we woke up and she couldn’t walk.
    The vet x-ray’d and THANK GOD she didn’t break or injure the surgery site, but she was so swollen that we had to re-do pain medications, etc, and then take it easy for months. At one point we believed the surgery had been a failure because of our inability to follow directions and take it easy.

    DO NOT PUSH YOUR DOG TO DO ANYTHING STRENUOUS FOR MONTHS. To this DAY she is not allowed to catch frisbee’s or do any type of vertical running, etc, because of the possiblity of re-injury. She is taken for daily walks/jogs around a local flat field, and so far so good.

  136. Have any you you heard about using bracing in addition to conservative Management?? I used a brace from woundwear and actually had great results with it and do not have to do surgery now! I am so thrilled after seeing the cost as well as how invasive the procedures are and the recovery. If anyone is looking for a great alternative check out woundwear’s a-trac brace.


  137. My 1.5 year old, 80 pound Akita just had TTA surgery on both knees at the same time. Afterwards, it is amazing because only after two days, she walks as if she never had surgery! The doctors precautioned that I have to keep her kenneled for a few weeks; it can be very deceiving to just let them walk freely based on how well they are doing.

    I am so glad I chose TTA over TPLO. Also, I am very upset at the various Vets I spoke to who stood by so firmly that TPLO had the same recovery as TTA. I learned that many of the Vets who promote TPLO so hard is because they don’t perform TTA and TTA is lost revenue for them because it costs much less. It cost me only $3200 for both knees with TTA surgery!

    In the end, it all makes perfect sense. Just looking at images of the two procedures, TTA is obviously less invasive; of course a less invasive surgery is going to show much better recovery!

    All in all, don’t let these Vets on the forums lie to you that TPLO is even close to being similar in recovery to TTA. They are just protecting their wallets or being stubborn to not adopt the more advanced TTA.

  138. My 4yr old Germansheperd had TPLO surgery in Sept. of 2010. He was a competition level Schutzhund III. I was told recovery would be complete and he would be as good as new. and able to resume his sport.
    He developed an infection on the hardware (screws & plate). Much pain, swelling, he never healed right. The hardware was removed 6 months later. My dog has never been whole again. Even now, if he runs after a ball too hard, he limps for a week. I must be very careful how much excercise he gets. Anything strenuous puts him lame.
    I would not recommend TPLO. Wish I chose something less invasive.

  139. My 70 lb 3 year old Akita had theTPLO surgery 6 weeks ago. Doing great until the knee started making a popping noise. Took her to vet and she broke the line. My Akita loves to wrestle, jumps and runs when we get home and will not kennel. We had carpet installed in the living and confined her. She thought she was healed and we could not control her going nuts when we got home. She had her second surgery 2 days ago. She is still at the vet. Our vet refuses to sedate her. I requested small amt of Xanax just to keep her calm for 12 weeks.he flat is refusing. I am in no way trying to use Xanax for my benefit. I have seen it first hand this dog feels better and we can’t control her when we get home. We tried caging her and she chewed on the cage,broke her nails and whined and howeled all the time. If she blows the knee out again I will put her down. I will not keep subjecting my dog to painful surgeries and a life of pain just to have her with me. The money is not the issue. Does anyone have experience with sedating their dog thru this recovery? I also don’t mean knock the dog out or make her a zombie. Just enough to have her chill and not want to jump.

    1. Not sure what you mean by “broke the line”? Are you sure it was a TPLO and not a MRIT? I have a 75lb pit with a TPLO. Her recovery took more than six weeks, but she can run and do what she used to do now. In fact, she had both knees torn when I rescued her–left seems to be holding up with no surgery as it was only a partial tear. Anyway, I imagine that a TPLO “breaking” is not common..?

      Maybe look for a new vet?

      1. Agreed. It was traditional repair not TPLO. My dog, like yours, is doing very well some 6 months post-op TPLO. He had traditional repair and it failed; TPLO saved him!

    2. i doubt any vet would agree to sedate a dog for recovery, actually. At the same time, it is more of a training issue. I understand the broken nails and howling, if she’s never been taught about crates.

      Something you can try: I had a male foster once who’d NEVER been crated and fought it with everything he had. It was not an option. He was an unknown dog in my home with two other dogs. Night time would be in a crate no matter what.

      I shouldered him into his heavy duty, cable tie reinforced crate. It was behind my couch. I sat on the couch (with 1/4″ meat and cheese dices) and let the wild rumpus begin. It did.

      I rewarded every nanosecond of silence with a treat, dropped into his crate. He bucked like a wild bronco and made much noise. But every second he relaxed or was quiet, another treat dropped in. The moments became longer. It was dawning on him and maybe he was getting tired.

      Then along with the rewards I began adding words. “Good boy. Quiet.” and “such a nice boy.” “You can do this.” “it’s not so bad.” Treat and words together! Every moment of calm, every moment of silence, or both. I kept it up less than an hour.

      He was an intelligent boy, and was figuring it out. Finally, finally, he was getting it. I threw in a whole handful of treats! All at once. YUM! He laid down. Another handful. I kept praising and rewarding. Then when he was wholly quiet, he came out… on lead.

      Your dog is certainly bright enough for this. Together you can do it.

      Another technique, would be to leash her to you in the house. That way, she isn’t getting into trouble hurting herself, you know exactly what she’s doing. It works for portions of the day when you want to give her a bit more freedom than the crate.

      Some people like varikennels which are solid resin rather than wire. This night be a consideration in view of her scratching and breaking nails. it does make the dropping treats in more difficult tho. But it’s something you can consider.

      Gosh it would be a real shame to put a dog down… because she doesn’t like her crate.

      My foster boy? Became my rescue. He’s lounging flat on his side next to the couch, but he is OFTEN lounging in his open crate. Yes! It’s true! I’ve had him 4 years now. Brilliant. Had the TTO surgery, and doing agility.

      It can be done… both the crate acclimation and successful and full recovery. Be determined.

      1. Lucy, I had to comment on your thoughtful reply to Sara who was contemplating putting her dog down. Training is the issue. It has been 3 years since my 5 year old golden had surgery. She was very active and I had a 3 year old male who loved to play with her. We managed and although she still has stiffness if she does too much I would have NEVER considered putting her down! Hopefully Sara will have change of heart!

    1. This site is great! Bryan, I am so happy I found all these great sites and did lots of research. My dog recently tore her ACL and I did not want to do surgery, she has way too much energy to be quite for 12 weeks after surgery. I looked for alternatives and found bracing as an option. I found several types and liked the idea of a soft brace as well as not having to cast my dog. I found a company WoundWear that made a brace called the A-TraC Dynamic Brace. I decided to go with it and hoped it worked. I was so happy to see the quick results, when only a few days after putting it on my dog started to bear weight and start walking better. Within a few weeks we were going to decent walks and she was looking great. I used in continuously for about 8 weeks and then took it off. She is doing great now and I still put the brace on for our walks and trips to the dog park. She actually gets excited when I put it on because she knows it means walk time! I am so happy I went this route and did not put her through surgery. Anyone who is trying to look for options should check it out. Go to


      1. Yeah Sandy!
        Any route that avoids invasive, expensive surgery should be explored. she may be sound enough to resume a normal, happy life in six months. Soft tissue take a long time to heal, but I have heard of many cases that they can heal on their own enough to have a happy life.
        good luck,

  140. My germanshepherd had tplo surgery in 2009. I chose this procedure because he was a competition level schutzhund dog. I thought he could possibly resume his career. Wrong.
    He did have a complication in the form of staph infection on the hardware. All hardware had to be removed 9 months after surgery.
    Although he is mostly sound, he could never hold up to the quick starts and protection sequence the sport demands. He did earn an FH (tracking title) and later retired to wilderness search and rescue which is just a lot of trotting, but even that is too demanding on his leg. He comes up lame after heavy work. I do have him on a glucosamine, chondriton supplement. It does help.

    If I had to choose again, it would be the traditional rebuilding of the joint. I would not go for the tplo or tta. We love our dogs and want what’s best, but there are no miracle fixes that will restore your friend to his original perfect condition.

    1. I’m so sorry you had such a devastating experience with your dog. I do however have personal experience, and can truthfully say my experience(s) have been different. My Cocker, was not a competition dog, he was small and 11 years old at the time he had a TTA. He did very well. No one would have known over the following 6 years that there had ever been a problem. But that is, as I say, non competitive.

      My Rottweiler’s both had TTO’s within a few weeks of each other owing to flood related injuries. These are my competitive agility dogs. Both TTO’s were followed up with PT (underwater treadmill) one for 10 and the other for 15 weeks. Both returned to FULL agility competition and remain completely sound today. This was a few years ago. My girl now age 9.5 is retired from all but occasional demo’s. My male is only 5.5 and still competes.

      Once an injury of this magnitude has been sustained, each owner is faced with decisions. Given your experience, I duly understand reluctance to do a TPLO or TTA again. Hopefully I will never be faced with another such decision. But if I were, I would do the TTO and PT again in a heartbeat! Our results were excellent, and I’d be willing to take the chance.

  141. Hello 🙂

    I have a 9 1/2 years old Rotti, she blow out her knee cap about a year ago. according to the x-rays she has a partial tear of her acl. My vet wanted to do the surgery right away. I told him i need time to do my research & think about how i can come up with a large sum of money . i seeked few opinions, 2 vets suggested the TPLO and 1 surgeon suggested TTA or LATERAL SUTURE Technique, both surgery’s looks really invasive & painful!! my heart is torn as to whether i want to put my rottie in a really painful surgery where the recovery time is much longer since she is 9 1/2 years old. or do I keep her on glucosamine & pain medication for the rest of of her life? I’m dreading the moment she gets home & she’ll cry’s herself to sleep & i’ll be helpless- I’ve read enough about the surgery to know what they will do to her, but I’d like to know exactly what i’ll be putting my ratti through from the moment they get home to after recovery.
    if she was younger i wouldn’t even think 2x about going through with the procedure. but she is 9 1/2 years old. what kind of life am i giving her where the recovery time is 2-6 months? we all know rotties don’t live that long. my fear is, if i go through the surgery & she’ll only live to be 10 or 11 if not more- she’ll spend most of that time recovering from the surgery & that’s if she she doesn’t blow out her other knee.
    has anyone had experience with a TPLO surgery on an older dog? any information would be GREATLY APPRECIATE it!!!

    1. Hi there,
      If it was *just the partial tear, I would say wait it out, as I predict that a big Rott prob isn’t as active in jumping around and such and would heal enough for a normal lifestyle by 3 weeks rest… but I don’t know what the “blown out knee cap” involves.

      My dog was 6 years old when she had TTA and 7.5 when she had TPLO on the other leg. I didn’t notice a difference in recovery time. I will say though, that my doctor said that the type of surgery (TTA or TPLO) depended on the curvature of her leg and that determines which surgery is best. Same doc did both. I have heard that the TPLO is better for the big dogs. My dog is a 40lb mutt who will likely live forever (or at least until well over 15. She is 10 now).

      1. Hi Jenny!
        Thank you so much for responding!
        By “blown out knee cap” i meant that there is a partial tear on ACL. The surgeon recommended to TTA or Suture later technique, If i do end up going through with the surgery- what should I expect the couple first night when i bring her home? or overall, how was the journey? is your pup ok? did she heel properly?

        1. Ok gotcha. People call it different things, I guess!
          My dog did great. I was very serious about following the guidance from the vet. No stairs, no letting her jump (when they start to feel better a little better and less drowsy on pain meds after about 4-5 days). I carried her to the lawn to go to the bathroom and carried her back in the house. For a big dog, I suspect you’ll use the towel method under her body to help support. I kept her in her kennel/cage when I wasn’t home for probably a month and sort of quarantined into one room as she progressed. The hardest thing is keeping them calm and off the leg, and doing the therapy. I downloaded the free guides on this site, too. Do that now so you can see the guidance and timeframes to give you an idea about how long it could take. (My dog healed faster than the guides predicted but she is smaller than yours). I even took her to the dog therapy pool. Keep in mind that my dog is SUPER high energy and I had to do something. I actually very lightly sedated her for the first couple weeks using acepromazine from the vet. (Was told bendryl sometimes works,too). This sounds pathetic to people who aren’t obsessed with their dogs, but I also slept on the floor next to her in the living room so that she wouldn’t have to be in her kennel all night and didn’t get lonely. I was afraid she’d try to jump on my bed if I took her to my room.
          Overall, the first surgery was rough for me. The second one wasn’t as bad. Maybe because I knew what to expect and wasn’t as worried. There is a lot of swelling, and it gets worse looking before it gets better. She is like-new, though and it happened pretty soon after surgery (like maybe 3 months?) I seriously can’t stress enough though that I very honestly did every single thing that was suggested to me and started her back on activities very slowly. Leash all the time, even in the yard. My thoughts were if I was spending that much on surgery (twice!) I’m going to make sure it works. And it did. Other notes I can think of: my dog had her incision glued, not stapled, both times. She is one of those feisty pups that won’t let a vet touch her, so we didn’t want to have to deal with getting anything removed afterward. The glue held fine. They will shave your dog’s entire leg, inside and outside. It looks like a giant hamhock and seems totally unnecessary. Less traumatic if you know about it going in 🙂 . The incision goes along the entire inner leg for both types of surgeries, plus they shave one of the front paws in about a 4″ section for IV, etc. Your dog will be drowsy. Very drowsy. If you go through with it, have someone go with you to pick the dog up at the vet after surgery (which will be the next day or two days later). You’ll want to sit with them wherever you put them in the car (unless you use a kennel in the back of a car or something typically). They don’t put a cast on the leg, it is just out there. It seems weird. your dog will toe-touch on the bad leg immediately and hop on 3 legs initially… this is one reason why they are so likely to injure the other. My dog was a frisbee dog so she had partial tears in both knees for a long time. I held off for about 6 months on the first one. The second one, I took her in immediately and had them do the surgery because I knew she’d be happier. She is! THey didn’t give a discount on the second surgery, though. Ha! Ask about opening a Care Credit account. 6 months no interest. My dog’s first surgery was $3250, plus about $200 in xrays prior. Post-op meds and follow-up appts were included in that. Second surgery was $3500, same situation. I had it done in Annapolis, MD. I used the “Glycan Aid with HA factor” post-op (those are expensive) and kept her on antinflammatories for a while, too, as she would get sore after playing. If you come up with more Qs let me know and I’ll try to help. I have a couple friends who had very good experiences with the same surgeries, too. A doberman and a pit mix. Hope that helps!

    2. I’ve been thru this 4 times with 3 dogs. My Cocker Spaniel was 11! I did the tightrope proceedure and he was happily scampering about until he was 16.

      My Rotties had TTO’s after we had some flooding in our area one year. They slipped (9 weeks apart… rain was aweful!) Anyway I did the surgeries on both: They were such active dogs, competitive in agility, and I couldn’t picture them not going to full tears with CM. They were far to active and having them each in a brace, or limiting their activity only to succumb to eventual surgery didn’t make sense.

      I’m glad I did! Today they are as active as the ever were and happy. They are nearly 6 and 10 now.

      How actives your 8 year old? Consider whether or how much restrictions would impact her life. If she’s be “just fine” with limited activity or a brace, then manage conservatively. Recovery can be slow and some things are permanent. This is for the rest of her life. She may always have to have some anti-iinflamitory pain med and glucosamine.

      If she is used to a more active life, then you can opt to allow her that happiness. It takes 6 months minimum to fully recover. There are pain meds and anti-inflamitories during that time. The only thing they are on now is the glucosamine… because I want them on it. They don’t take anything else. Some of those drugs are hard on the stomach. Stetson is very sensitive, more so than Raven.

      There’s nothing wrong with either decision. Think it thru: She’s 9. How active is she? What would give her a good quality of life? Meds cost $$, but you have that either way, tho there’s a glimmer of none eventually with surgery. Does your vet have a payment plan option? That would be a consideration.

      You love your dog. You want what is best for her and affordable for you. Best wishes with your decision.

      1. Lucy,

        I have been doing the tightrope extracapsular surgery since 2009, approximately one year after Dr. James Cook put his extensive research into practice at the University of Missouri. In a comparative study of over 2500 tightrope repairs, 1/2013, published in the ACVS (boarded surgeons) journal, one year positive outcomes between TPLO and Tighrope were statistically the same at close to 95%. That means that no surgery has a better result and, more importantly, neither tightrope or TPLO has a good to excellent outcome 100% of the time. I attended my fourth or fifth wetlab on anterior cruciate repair recently at Oregon State University. I have personally performed 300 tightrope repairs. Therefore, you can safely assume that I have seen many (if not EVERY) of the complications associated with the tightrope repair.
        I routinely refer dogs with a tibial plateau angle of over 30% to an ACVS boarded surgeon for a TPLO. Rottweilers and Newfoundland’s will more than likely be closely examined for referral. There is, however, no upper weight limit on the tightrope repair in the dog. There were over 1 million tightrope implants in people before the first dog got one.
        Personally, I would much rather treat the disease medically. With very few exceptions we will likely try medical therapy upon initial exam for hind limb lameness. I will not discuss radiographs until the dog proves that I have to look into the lameness more deeply. If there is a total rupture the knee is unstable. Without surgery, the body will try to lay down connective tissue to immobilize the knee. The usual pre-existing osteoarthritis then gets much worse. We recommend surgery at this point.
        In my hands, it seems like close to 50% of the acute unilateral hind lameness cases respond to medical therapy. If we have to look into the case more deeply, and tightrope surgery is performed, our cases many times go home on day 4 or 5 with a slight limp. They are put on a regimen of twice a day walks the first day home from the hospital. Results as Lucy had with her cocker spaniel are the rule than the exception, regardless of the dog’s weight. Tightropes are routinely used in human medicine for ankle, elbow, and shoulder repair.

        Hope this helps,

  142. Had TPLO done on 14 mo. old Lab. Cost $4200.00. Has been hard to hold him down . He was used to field trial training 4-5 days a week. He still favors the repaired leg seems to stiffen up after laying down. walking does not show much limp. Going to get first xray since operation I hope all looks well . If things look good how long before I can return him to training and hunting ? It’s been 8weeks since the TPLO procedure.

    1. Joe,
      To the best of my knowledge it takes a full 12 weeks for the connective tissue to gain strength. This part cannot be repeated and is why with both TPLO and Tightrope it is a critical period. You can always get range of motion and muscle strength at a later date. While tightrope is less invasive and about half the cost of a TPLO, the end result at 1 year is about the same (not statistically significant).
      It takes a minimum of 6-12 months to gain close to full healing with either technique. Active labs of less than 3 years are a challenge to all of us. It is the most difficult post-op situation and, seemingly, a catch 22 to owners. Why isn’t he back to normal after an invasive surgery? It sounds like your dog is well on the way. That being said, my greatest issue is about 12 weeks post-op when the dog feels better than he should, over does it, and tweaks something. Am I hurting him by not letting him run? You will only hurt him if you let him have his way, especially in the first 12 weeks.
      Remember, range of motion and muscle strength can be worked on after the initial 12 week period.

  143. these prices look a bit low in the article, but appears the article is old 2010. i’m the least expensive vet i know of, and my ‘extracapsular’ repair price is 700-900.00, but that includes 3-5 days hosp/rehab, 12 laser treatments post-operatively, medications, 4 recheck visits, etc. very, very few of my clientele can afford tplo, even at the above prices. arizona is sickening with the prices the specialists charge now, as are california, washington, and i don’t even want to talk about the east coast. granted, i still live in a double wide trailer, so…

  144. My 1 yr old 80 lb boxer, Gus, has to have surgery on both knees because of torn CCL’s. We are not going to have both knees done at one time. Now comes the decision on which surgery to choose??? I’ve read a lot of articles and have seen a specialist who only performs TPLO’s. I am on the hunt for a surgeon who can do both and who will give me an option. I’m not too keen on the TPLO because it is sooo invasive and am leaning more toward the TTA but am worried that if an infection sets in, then the TTA hardware is more invasive to remove. Does anyone have any experience with infection of a TTA surgery?? Any guidance or recommendations are welcome!!!

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