Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)

When it comes to caring for our pets, we all want the best possible option, however, most veterinarians will have a single method that they prefer to perform, thus leaving you to find another vet if you do not agree with having a specific CCL surgery. Prior to committing your dog to a surgery, you’re going to want to find out what option your veterinarian will perform, the recovery time, what percent of normal activity level will the dog return to when fully recovered, etc. Of all the surgery options, I’d say that any would be better than going without the surgery (see my post on my friend who did not get the surgery for his dog), but in the end, the choice is going to be up to you – the dog owner. Without the surgery, your dog will have an unstable stifle (knee) joint, and will probably show lameness terminally.

Cranial Cruciate Ligament (CCL) Surgery Options

  • Traditional Repair – Lateral Fabellar Technique
    This technique is typically recommended for smaller dogs (we went with this option on our 60lb pit bull). With this technique, a monofilament nylon cord of about 80-100lb tensile strength is passed from the lateral fabella to the tibial crest, in what was explained to me as a figure 8 pattern, basically wrapping the knee joint to eliminate and prevent joint instability (drawer movement). Scar tissue will, over time, develop around the joint, which will further stabilize the joint, but will also begin to restrict range of motion.
  • Tibial Plateau Leveling Osteotomy (TPLO)
    The TPLO CCL repair technique is generally recommended for larger breeds of dogs, as well as active dogs, such as agility dogs. This technique is also thought to cause less degenerative arthritis around the stifle joing. Key things to note about the TPLO surgery are a quicker recovery time, better range of motion, less arthritis and a return to athletic (working) activity levels. TPLO surgery involves cutting the bone and slightly rotating it before re-attaching it with a plate. By rotating the top of the bone, less pressure is put on the joint.
  • Tibial Tuberosity Advancement (TTA)
    This is a new, less invasive option to the TPLO surgery, but will not be an option for all dogs. Since this surgical option is less invasive, it allows for a quicker recovery time. TTA also puts a cut in the tibial bone, however it shaves off the front of the bone and extends it with a spacer. Also like the TPLO surgery, the TTA option depends on the angle of the stifle joint and is not recommended for dogs with a steep angle in the stifle.
  • Tightrope Surgery (Tight Rope Surgery) (Updated June, 2009)
    Tightrope surgery is a very new procedure that is based on a similar procedure performed in human ankles. It is far less invasive and is performed through small incisions in the skin, and woven through small holes drilled in the bones of the stifle joint. Tightrope surgery is an arthroscopic procedure and thus far seems to have very positive results.

As you can probably tell, each option has advantages and disadvantages, and all options should be discussed with your veterinarian after x-rays are taken of your dogs knee joint.


  1. Kristi says

    Hello! My dog has torn her ligaments in her knee and now I am trying to decide what surgery option to go with. I was wondering how well other dogs have done after full recovery from the Traditional Repair –Lateral Fabellar Technique. Does your dog have full use of the leg/joint?

  2. says

    Hi Kristi –

    Thanks for commenting, and sorry to hear about your dog. We had the traditional repair done and our dog is doing great. She is about 2 years out from the surgery and she gets around fine. There is some stiffness on occasion and she has a small hitch in her step when walking mid-speed, but she can run like she used to and gets around just fine with everything else.

    Please let me know if you have any other questions, I’ll help to answer them any way I can.

    • Todd says

      Thanks for your post,
      My 70 lb Yellow Lab needs knee repair. How many lbs was your dog and what age at time surgery?
      Thank you.

  3. Steve says

    Our 6 yr old choc lab had the traditional ligament surgery on her rear left knee at the age of 12 months.The repair and recovery went fine and she has been active and pain free for 5 years. This past Sunday the knee ligament on the opposite leg gave out just as predicted by our vet 5 years ago. She is tentatively scheduled for the traditional surgery tomorrow. My wife and I are concerned as to whether her intially repaired leg can handle the stress from the recovery from the new surgery. We will be discussing this with our vet today. The cost will be approx. $2000 ( somehow this did not increase over the years). So we have an upset wife, upset kids and a numb Dad and Dog 4 weeks before pheasant season opens here in Calgary. your thoughts are appreciated…sk

    • Rob says

      Did you get the surgery done on the second leg? If so how was recovery and the strain on the good leg? I’m in the same position and worried the leg fixed 2 years ago can’t handle the extra use during recovery.


  4. says

    Hi Steve –

    I often wonder the same thing when I see our dog stand on her one leg that had the surgery while using the other leg to scratch her underside. It always makes me a bit nervous, but from my understanding, they use an 85lb+ test line around the joint to replace the ligament. Always tough to keep an active dog inactive, best of luck!

  5. Matt says

    Hi Steve,
    We have a 4 1/2 yr old yellow lab that was just diagnosed with the torn ACL. We’re looking at the both the TPLO and the tight rope options. I too am a bird hunter and want to get her back out someday. I assume since it was a few years back that your dog underwent the TPLO (or bone cutting / plates-pins) survey. Without much information on the new surgery, we’re leaning toward the TPLO. Any thoughts or comments?

    • Todd says

      My 11 year old, 70lbLab needs CCL repair.
      Which method did you use and how are the results?
      Any advice is appreciated
      Thank you,

  6. Nicole Marie says

    My dog is 9, in great shape, and has most likely ripped his CCL.
    I don’t know about this surgery… anesthesia, meds, sedatives…not what I would like to do- and how often does this surgery really work?
    What can anyone suggest? IF i don’t opt for surgery, what can I expect?
    He seems to be pretty happy on 3 legs for now…? Thanks for all your help and advice:)

    • Todd says

      I am in your shoes now and wondering what to do. Can you share your experience with me and my 11 year old Yellow Lab. We appreciate it.

  7. Andrea says

    I have a 3 year old pitbull mix, 65 lbs, & she was diagsnosed with a mild tear in her cruciate ligament in both knees about 3 months ago. 2 days ago she came in from outside (I’m sure from squirrel hunting) and could not walk. All day and night she cried and I had to carry her, which was also painful for her. Now, just 2 days later she is walking, but not putting any pressure on her right back leg. I’m scared that she has torn it completely and I’m unsure of what surgery is best, if she did tear it. I’ve been researching for 2 days and have had so many mixed reviews. Any help and prayers for my best friend would be highly appreciated.
    God Bless!


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