TightRope CCL Surgery

What is cranial cruciate ligament disease?

The cranial cruciate ligament (CCL) is one of the main stabilizing structures of the knee(stifle) joint in the hind limbs of dogs. The CCL is a rope-like structure inside the joint that acts as a static (constant) stabilizer of the knee, preventing abnormal "slipping" of the two bones of the knee joint, the femur and tibia. Its main job is to hold the femur and tibia in proper alignment during all forms of activity.

Deficiency of the CCL is the most common orthopedic problem in dogs and inevitably results in degenerative joint disease (arthritis) in the knee joint. It is referred to as a disease because it is typically the result of a degenerative process in dogs, rather than from athletic injury or trauma. Although it is often noticed after running playing or jumping, the disease has been present for weeks to months when symptoms occur.

What are the symptoms of CCL disease?
  • Limping
  • Holding the hind limb up
  • Sitting with the leg stuck out to the side
  • Stiffness, especially after exercise
  • Not wanting to play or exercise
  • Swelling of the joint
  • Clicking sound when walking

    How is CCL disease diagnosed?

    Your veterinarian should review your dog's medical history and perform a complete examination using tests of the integrity of the CCL including the "cranial drawer" and "tibial thrusts" tests. X-rays should be performed to assess the amount of arthritis present and aid in determining treatment options. Sedation or anesthesia is necessary for making the definitive diagnosis to avoid causing pain to your pet.

    First it is important to know that there is no cure for CCL disease in dogs. The goal for all treatments are to relieve pain, improve function and slow down the arthritis.

    Tightrope CCL was developed two years ago to provide a minimally invasive and improved method for extracapsular stabilization of the CCL. This technique does not require cutting of the bone like the TPLO or TTA procedures, but instead uses small drill holes in the femur and tibia to pass a synthetic ligament-like biomaterial through a small incision to provide bone-to-bone stabilization during healing. The biomaterial used the TightRope CCL is called FiberTape. This is a kevlar-like material that is used extensively in human surgery for many orthopaedic applications. This material has properties that make it stronger and less prone to failure than any other suture materials currently being used for CCL reconstructions.

    Things to remember about your dog's cruciate problem:

    1. Your dog has, or will develop, arthritis associated with the cruciate ligament problem -this will not be cured with surgery or medications so we will need to manage this for the rest of your dog's life.

    2. What you do after surgery is more important then what is done in the operating room - you need to commit to all of the instructions in your discharge summary in order to optimize your dog's outcome.

    3. After surgery complications or subsequent problems can occur- the overall complication rate TightRope CCL is currently 18.6% with 9.5% requiring further treatment these include.

      • Infection - 4.6%
      • Instability - 2.%
      • Meniscal - 2.2%

    4. The very best things you can do to to minimize the chances and effects associated with the above are:

      • Keep your dog at an ideal weight
      • Follow the discharge instructions exactly
      • Keep your follow up appointment
      • Continue wellness care with your regular veterinarian.