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Cranial Cruciate Ligament Part 2 - Repair

There are three different surgical techniques commonly used to repair ruptured Cranial Cruciate Ligaments. The Extracapsular Repair, TPLO and TTA. Your veterinarian can advise you on which would be the best procedure for your pet.

Extracapsular Repair
In this procedure a strong nylon line is placed to hold the stifle in place. The suture will eventually break, but by that time the dog has formed scar tissue enough to hold the knee in place without the extra support of the line. During the surgery the knee joint is opened and inspected and the torn cruiciate ligament removed. After the procedure your dog will require at least 12 to 16 weeks of restricted exercise and rehabilitation. This procedure is typically considered in small to medium sized dogs or geriatric/older patients.

TPLO (Tibial Plateau Leveling Osteotomy)
In this procedure the biomechanics of the joint are changed. The knee joint is again opened and the damaged meniscus and cruciate ligament inspected and removed as needed. Then a section of the tibia bone is cut and rotated to change the angle of the joint and create greater stabilization. Special metal hardware is placed to hold everything in place. Typically these dogs are toe-touching by 10 days post surgery, but again restricted activity and rehabilitation exercises are required for12 to 16 weeks. Most patients are back to normal activity 6 months after surgery. This procedure is typically considered in young, very active and large breed dogs.

TTA (Tibial Tuberosity Advancement)
Similar to the TPLO, in this surgery the tibial crest where the patellar ligament attaches is cut and repositioned using titanium implants and bone grafts to stabilize the new angle. The recovery is similar to that of the TPLO and it is also recommended for young, large and very active dogs. Which of these two surgeries is better? Whichever one your surgeon is more comfortable performing. Studies have shown that the results at one year post-operative seem to be the same regardless of which procedure is performed.
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