Lateral Fabellar Technique (Extracapsular Technique) – Cranial Cruciate Ligament Repair

The Lateral Fabellar Technique, or Extracapsular Technique, is a common surgery performed on dogs to stabilize the stifle (knee) joint after a tear or rupture in the cranial cruciate ligament (CCL; misspelling cranial crucial ligament). Normally, the cranial cruciate ligament (CCL) prevents backward-forward movement (drawer movement) of the stifle joint. Untreated instability in the knee/stifle joint due to a turn/ruptured CCL can result in a tearing of the meniscus as well. When it tears/ruptures, the stifle joint becomes unstable and the dog suffers lack of mobility, lameness or loss of use and is subject to chronic and progressive arthritis in the stifle if untreated.

In a Lateral Fabellar (Extracapsular) procedure, heavy suture material (monofilament nylon cord) is passed from the lateral fabella to the tibial crest in order to eliminate joint instability (drawer movement). It is this nylon cord that will act as the CCL ligament in the future by holding the joint together and keeping it stable.

The lateral fabellar surgery will not stop the progression of arthritis that is already present in the joint. Your dog may have some stiffness of the limb and may have some lameness after heavy exercise.  Chondroitin sulfate and glucosamine may be given to help with stiffness.

Typical downtime and rehab:

  • First 2 weeks, dog should be crated and only let out on a leash to go to the bathroom.
  • After about 2 months, lameness should decrease significantly, but it was recommended by our veterinarian to keep our dog crated still.
  • After 3 months, our dog had regained full use of her leg.


  1. Heath Pelletier says

    After 2 months in a crate, I think my dog (austrailian cattle dog) will need to be placed on psych medication.

    Knee will be in great shape, however will start chasing parked cars….. when allowed to!

    (in the process of researching canine CCL tears)

    As a licensed athletic trainer, these protocols are a lot more conservate than human ACL rehabs.

  2. says

    Definitely agree with you Heath… much more conservative. Probably due to the fact that you can’t tell a dog to go 25%, or to not move laterally, etc.

    Best of luck with your dogs recovery!

  3. Heath Pelletier says

    That’s a good point.

    We have surgery scheduled this wednesday, TTO procedure, hoping for an excellent recovery!

    Thanks for the response.

  4. kim says

    My 8 yr old Husky had extracapsular acl repair on 7/19/2012 and is now having an odd complication that my vet has no clue of the cause or how to fix.

    She did well for the first two days in the leg wrap but after the leg wrap came off the severe spasms started. It happens when she is sleeping or just laying around. The entire leg, mostly the thigh and groin area, will tighen up and spasm causing her to be in excruciating pain, tuck the leg really hard under the belly, she screams blood curdling screams, her eyes roll into her head, she pees a little, claws at everything, buries her head and tries to pull her body away from the leg. The spasms wont stop until we grab the thigh and straighten the leg. To try to prevent this we’ve been sitting with her holding her thigh 24 hrs a day but some spasms will be so strong that holding the leg isn’t helping. The Tramadol and Metacam are not touching this pain nor stopping it. Anyone else have this kind of issue and if so, did you find a cause or a fast fix?

  5. Jonathan says

    Sigh, I have the same issue with my parent’s godlen retriever at the cottage. it is so hard to get them to slow down. Just when they are getting a little better they rush off and get hurt again.I am so glad to hear scar tissue may save the day.


  1. […] My first thought was that there was simply a misunderstanding between the patient and the veterinarian. External would imply that there wouldn’t be need for surgery, possibly just a brace or stabilizer that would be worn by the dog. After doing a little bit more research, I am pretty sure that this person meant Extracapsular rather than External Capsular. If that is the case, then that opens up the door for the very common Extracapsular Imbrication surgery (also known as the Lateral Fabellar Technique). […]

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