It’s extremely common for dogs—especially older and overweight dogs—to rupture their cranial cruciate ligaments (CCL). This ligament is found in the knee and its human equivalent is the anterior cruciate ligament, or ACL. When a dog ruptures this ligament, their knee joint becomes unstable and they will limp on the affected limb. Because CCL tears cause such significant mobility issues for pets, it’s important to get these injuries treated as quickly as possible.
At Gateway Animal Hospital, we offer orthopedic surgeries, including cranial cruciate ligament repairs, through our partnership with Dr. Alphonse, a traveling veterinary surgeon who performs these specialized procedures at our hospital. Dr. Alphonse performs tibial tuberosity advancement (TTA) and other CCL repair procedures, as well as surgery for medial patellar luxation (MPL). For dogs that would benefit from tibial plateau leveling osteotomy (TPLO), we can provide a referral.
Our veterinary team works with Dr. Alphonse to determine the preferred surgical approach for your pet. The best option will generally depend on your pet’s size, age, and individual condition. These specialized surgeries are performed by Dr. Alphonse rather than by all of our veterinarians.
Tibial Tuberosity Advancement (TTA)
The TTA procedure can be considered for many dogs with CCL disease. We may recommend a TTA for our orthopedic patients, and although studies have suggested that the TPLO (Tibial Plateau Leveling Osteotomy) may result in better long-term function than the TTA, the TTA may still be chosen for certain dogs. These dogs may include poor TPLO candidates or dogs with multiple knee problems (concurrent patellar luxation and CCL disease, for example).
Dr. Alphonse may recommend a TTA after a full assessment of your pet’s history and condition. The tibial tuberosity is stabilized using special implants in a manner that aligns the patellar ligament perpendicular to the tibial plateau. If a TTA is not the right choice for your pet, we can provide a referral for a TPLO.
Tibial Plateau Leveling Osteotomy (TPLO)
A torn CCL results in painful instability of the knee joint. The Tibial Plateau Leveling Osteotomy (TPLO) method of treating a torn CCL alters the geometry of the knee joint to make the joint stable. It involves making a cut in the tibia or shin bone and plating the bone in place.
Once the bone is healed, the repair is permanent. Most dogs return to weight-bearing on the affected leg soon after surgery, but their activity needs to be partially restricted for six to eight weeks while the bone heals in place. It is a highly effective procedure and is often recommended for larger dogs.
TPLO surgery is not performed by Dr. Alphonse at Gateway Animal Hospital. If this procedure is recommended for your pet, our team can help coordinate a referral.
Extracapsular (Lateral Suture) Repair
Extracapsular, or lateral suture, refers to a repair that is performed alongside the knee joint. After the knee joint has been inspected and damaged tissue cleaned up, a strong suture is placed on the outside of the joint that runs in the same direction as the original CCL. This suture provides stability in a very similar way to the CCL before it was torn. Although this method of repair can be performed on any dog, it tends to be best for dogs under 20 pounds.
A period of restricted activity is required after this surgery.
Medial Patellar Luxation (MPL) Surgery
Dr. Alphonse also performs surgery for medial patellar luxation (MPL), a condition in which the kneecap slips out of its normal position. This can cause intermittent limping, skipping, or difficulty walking. Depending on the severity of the condition, surgery may be recommended to improve kneecap stability and help your pet move more comfortably.
To schedule an orthopedic consultation with our veterinary team and learn more about the procedures available through Dr. Alphonse, call us at 727-577-6500.