SubscribeTightrope Surgery in the Treatment of a Dogs Torn Cranial Cruciate Ligament
In reading this blog, you’ve probably come familiar with the 3 main types of surgeries used to treat a torn or ruptured cranial cruciate ligament in a dogs stifle joint. The problem with these 3 main types of surgeries is that they are fairly invasive, large incisions, bone cutting, etc. This may soon be a thing of the past with some of the advancements in medicine as vets and doctors are now using techniques from human surgeries. This new surgical method, called Tightrope CCL Surgery is far less invasive in that it is performed through small incisions and small holes drilled in the bone. A recent University of Missouri press release details this new procedure.
Technique Used in Human Ankle Injuries Modified to Treat Dogs’ Knees
MU veterinary clinician-scientist develops a minimally invasive method to treat torn ligaments
June 16, 2008
COLUMBIA, Mo. – A common sports injury in human knees is even more common in dogs. Each year, more than one million dogs suffer from cranial cruciate ligament (CCL) deficiency, which is comparable to the anterior cruciate ligament (ACL) injury in humans. The common method of treatment by many veterinary surgeons involves cutting the tibia bone to stabilize the CCL-deficient knee in these dogs. Now, a new minimally invasive technique with less severe complications than previous methods has been developed by a University of Missouri College of Veterinary Medicine researcher.
Unlike humans, CCL injuries in dogs typically do not occur because of a single trauma to the knee but are the result of a degenerative process that leads to early and progressive arthritis. For this reason, and the unique biomechanics of the canine knee, techniques used to repair the injury in humans do not work well for dogs. The new technique, known as Tightrope CCL, is modified from a technique used in human ankles and allows placement of a device that stabilizes the CCL-deficient knee through bone tunnels drilled using very small incisions. MU veterinarian James Cook worked with Arthrex Inc. from Naples, Fla., to develop and test the Tightrope device for dogs.
“Other current techniques require major surgery that involve cutting the bone, which can potentially lead to severe complications, such as fracture, implant failure and damage to the joint,” said Cook, professor of veterinary medicine and surgery and the William C. Allen Endowed Professor for Orthopedic Research. “This new technique is minimally invasive, relatively easy to perform and cost effective compared to other techniques. The dogs in the preliminary trial study experienced fewer and less severe complications with outcomes that were equal to or better than those seen with the bone-cutting technique.”
Cruciate ligament tears are five times more common in dogs than humans and cost U.S. pet-owners more than $1.3 billion each year. The new technique is not for every dog. Because surgeons must be able to drill tunnels in the bone, dogs must weigh at least 40 pounds for the Tightrope CCL method to be feasible. In addition, dogs that cannot follow a physical rehabilitation protocol after surgery and dogs with limb deformities are not candidates for this technique. The 10- to 12-week rehabilitation period is very important for any surgical technique for CCL deficiency in order to optimize successful return to pain-free function and reduce complications, Cook said.
“The times the Tightrope CCL technique has failed are when owners did not give their dogs the full rehabilitation period and let their dogs run, play or traumatize the joint before the knees were ready,” Cook said. “A successful operation is dependent on postoperative care so that the dog can heal well and build muscle for long term function. The Tightrope CCL technique is designed to allow this to happen with less surgery and less risk of a major problem arising, and so far, it has been successful.”
The original article can be viewed here.
If any of you readers have had any experience with tightrope surgery, we’d love to hear about it in the comments. It’s still a relatively new procedure, so there really isn’t too much information available on it yet, and there seem to be even fewer stories from our readers (unfortunately). As I learn and hear more from our users, I’ll add new posts and updates about the applications of tightrope surgery, the costs of tightrope surgery and the recovery and rehab procedure involved with tightrope surgeries.
Related Posts
- Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)
- Cost of TPLO Surgery – Cost to Repair Torn Cruciate Ligament in Dogs
- Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs
- Cost of TTA Surgery for Cranial Cruciate Ligament – Cost of Knee Surgery for Dogs
- Conservative Management as a Cranial Cruciate Ligament (CCL) Treatment Option
[...] 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 [...]
[...] TightRope [...]
Hello. My 6 year old malamute is scheduled for Tightrope surgery this coming Wednesday. I am curious about any tips and advice for the recovery period, I assume it won’t be that easy. Any help would be appreciated.
Thanks,
JH
Hi Jesse -
Unfortunately, I haven’t heard of too many people who have had the tightrope surgery performed on their dogs being that it is still a relatively new procedure compared to the others available.
I’d love to hear updates from you as I’m sure many of our readers would as well.
Best of luck, and I hope that you’ll keep us posted.
Thanks!
Hi Kenneth,
Thanks for responding. I would assume that the tightrope recovery is similar to that of the Lateral Fabellar Technique and TPLO, albeit not as long as of a recovery period for the TPLO. It is my understanding that the TTA is more or less an improved upon LFT procedure.
I am trying to figure out what my best options are for keeping the dog off its feet during the recovery period. How to handle when the dog needs to “go outside”, how much time should the dog literally be of it’s feet, should I use a crate, etc…
Thanks again.
Jesse,
How much are they charging you for the Tightrope surgery? We cannot afford the TPLO surgery for our lab mix and I’m looking at this as an alternative option.
Kim
Kim,
They quoted it between $2,800-$3,500. I’m picking him up tomorrow (the surgery went well) and I’ll let you know what the final cost is. Keep in mind though I went with a board certified surgeon so I know it is a bit more. This seemed to make the most sense, especially with a relatively new procedure like the tightrope.
Jesse
I wanted to let everyone know our tightrope surgery has so far been a sucess. Out the door, including meds it has cost about $3,300.
The recovery has proven to be difficult, mostly to keep him from running and jumping around. The first few days after the surgery he didn’t use the leg at all but now, 7 days later, it seems to feel better and is being used with full weight to walk around. My goal is to keep this to a minimum which hasn’t proven to be easy.
I’ll follow up again in a few weeks but so far so good.
Jesse
Glad to hear it’s going so well! We have ours scheduled for next Wednesday. I will be glad to get it over and get her on the mend!
[...] Tightrope CCL – new type of surgery, seems like the best choice but don’t know where to get it done as of right now, it seems the costs is between the Extracapsular and TTA. [...]
My very active 100 lb Newfoundland Golden Retriever mix had tightrope surgery in Jan 2009. She experienced several complications. The rope slipped and she had to have a second surgery. After that setback, her kneecap went out of place and she had to have a third surgery. During the 3d surgery, she had a bonespur and bone fragment removed. Shortly after the 3d surgery, she tore the other acl. It is 12/2009 and she holds up the leg that had the surgery. She will use the leg with the torn acl to limp around. My surgeon moved to Florida. I plan to take her to my vet this weekend for an xray and an exam.
My 64 lb. 7 yr old boxer had tightrope surgery Thanksgiving week 2009. She just had her 8 week checkup and the surgeon gave her a clean bill of health. We did keep her lying down except for potty breaks for 8 weeks. It was a chore, but we knew we had to do it. The surgeon said we can now gradually introduce her to her normal routine. She is thrilled that she can move about, but overexcited about being “normal” again, so we are keeping some restrictions on her for another 2 – 4 weeks. The surgeon said there should be no after effects. We are thrilled with the results!
Hello guys. Bonnie my golden retriever mix (70 lbs) is set for tightrope surgery next wed feb 24th. We went trough two different surgeons for opinions and they all recommended the external capsular surgery which is the traditional way to go. I however wanted to do research on options. I came accross tightrope and found a certified vet in Illinois that has had success. We decided to do tightrope as it is less invasive and according to all the research I’ve done it has less complications than the other methods. Bonnie is a very active dog and she completely ruptured her ligaments and she is only walking on 3 legs. Our other dog is feeling the stress as we limit Bonnie’s mobility. Overall I also read that recovery time with tightrope surgery is not as long as with other methods. I hope it works out as it breaks my heart seeing her hopping around unable to play. I will keep you all posted.
Hi Teresa -
Thank you for the update on your dog Bonnie. Please keep us posted on the surgery and the recovery. I get many questions on the best type of surgery, and I don’t personally know anyone who has gone through the tightrope procedure yet, though it sounds like a great option (and one that will be used more and more).
If you think of us, please let us know about Bonnie’s progress after surgery.
Thank you, and best of luck!
My 5 and 1/2 year old Doberman has had this tight rope surgery just 5 weeks ago after a complete rupture of his cruciate jumping off the sofa chasing his friend the cat. The worst part was getting him out of the car the night of surgery but within 2 days he’d mastered the art of walking in three legs and was even trying to put his leg to the floor. The only mistake was his pain relief. I’d followed the surgeon’s instruction but he actually needed more pain relief by the third day when his swelling was at the maximum. He was taking Tramadol and Myloxidin which has now been decreased although he is still taking them. From then on he’s been making a steady recovery. He can now stand on that leg to pee and he is on 15 minute walks 3 times a day. This has increased from 5 minutes, 3 times a day in the first week. He also has to be on a lead for toilet breaks in the garden. (although he did escape once but came back quickly and calmly for half a sausage.) Luckily he’s a very calm dog but I am sleeping downstairs with him for the next 4 months at least but that’s just us! I have to work on his weight as because of a recent diagnosis of Hypo thyroidism that has been hard to control. Thankfully he loves brocolli, brussell sprouts and apples chopped and put into Kongs for treats but he still has his sausage for his pills.
The operation cost £4500 that also included X-rays for both Knees and Hips and a Von Willibrands test as he’s a Dobermann and we didn’t need any nasty surprises! I hope he continues to make good progress. He has regular update checks included in that price and might need hydo therapy but we’ll see. He’s not keen on water, unless its a warm shower. Hope this helps anyone having to go through this. Just do exactly what you vet advises and take it slowly as they’re so precious.
Hi Jan -
Good luck with the recovery. Please keep us posted as to the recovery, and if you’d be interested, I’d love for you to share your story on our site. We don’t yet have any full tightrope surgery and/or tightrope recovery stories.
Best of luck, and let us know how it all turns out.
Take care.
I’ll keep you posted Kenneth. Please do share this info. I hope others find it useful.
Take care.
I’m curious about the weight of your doberman Jan. I have a Akita mix who did something to her knee, I know something’s torn we just don’t know what yet and I’m waiting for an appointment with a orthopedic surgeon. She weighs close to 100 pounds and def needs to lose weight, this is probably what caused her tear even though she only needs to lose about 10 pounds. Anyways, I’m researching the different surgeries and since the traditional one isn’t an option for her size I’m curious if this one is an option for bigger dogs. I’m not a fan of putting foreign objects in her but the less invasive it is the better. How large is the incision? how long did the surgery take? I appreciate any help you guys can give me.
I want the best for my little girl and want her on the road to recovery as quickly as possible 
I have 5 year old Boxer that has a torn cranial crutiate and this is the first I have heard of tight rope surgery. Does anyone know if it is available in New England
Hello Everyone,
I am happy to report that Bonnie’s surgery went great. The incision was about 7 inches. She had surgery on Wed 2/24 and today she started putting weight on the leg. The toughest day was definitely the first one because she was completely out of it and was not able to even get up. My husband and I needed to hoist her up a towel. However, she has been recovering extremely well. The vet was even surprised that she is doing this well this qucikly. I am so happy overall with the surgery and glad we went with tightrope.
Hi Tam,
My Doberman weighed 123 pounds at the time of surgery. His surgery lasted 1 and half hours with x-rays etc. The scar is about 5 inches long at the front of his knee and has healed well. He only had large plaster dressing on for 3 days.
We have had a very painful set back associated really with his weight. His weight has increase quite a bit over the last 2 years as he has a thyroid problem which we’re just getting his levels correct now. He had just been increased to 20 minute walks 3 times day. After 3 days he developed pain when getting up and down. I took him back to the surgeon but it wasn’t his knee surgery that was the problem but the hip above it. He has strained it exercising. He’s on 5 Tramadol twice a day and 40 mls of Myloxidin and a drastic weight reducing diet of 100grams of dried food with mixed raw veg (Brocolli, celery, carrots, cucumber and half and apple.) NO Treats!!! Its hard. He has 20 pounds to loose to get down to the correct weight for Dobermans here in the UK. I am so upset as he is still in pain but the surgeon says the weight reduction and pain management will work but it will take a couple of weeks to settle.
You say your Akita is 100 pounds. Is that the correct weight for her? If not start the diet. I have to say apart from this set back the knee surgery seems fine. Hope that helps and good luck. xx
Hi again Tam,
If you can get this link it shows you the procedure. I am sure my surgeon mentioned putting in 2 tightropes to form a figure of eight under the joint. I’ll confirm that on the 15th March when we go back but it seems that might be something he does for bigger dogs to support their weight as well as another dog of equal size landing on them on play. His view was it’s less invasive than the traditional approach which sounded awful. To much bone cutting for me!
Good luck
Jan xx
http://www.arthrexvetsystems.com/de/produkte/upload/TightRope-CCL-Guide-VLT0004A-compressed.pdf
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