In responding to questions about types of surgeries to repair torn cranial cruciate ligaments in canines, I’ve come across 3 main types which have been previously discussed on other posts. I just heard from someone who had been looking for information on External Capsular Fixation but was unable to come up with any results, so I thought I’d try to offer a little bit of help.

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).

The extracapsular imbrication (fixation) happens to be the type of surgery that we went with for our dog. At the time that we got the surgery, it was the least invasive procedure. The surgery itself requires an incision in the leg that is a few inches long, but when compared to TPLO or TTA, it is far less invasive in that it doesn’t require any cutting of the bone. Since the time that our dog had her surgery, there has been some advancements in CCL surgeries and there is a new technique available called Tightrope Surgery that was developed by veterinarians at the University of Missouri and it actually mimics some of the procedures that are performed in human ankles. It is still a relatively new procedure, so it may not be widely available yet, but it is said to have great benefits.

If you happened to find this page while searching for External Capsular Fixation, and there actually is a procedure other than what I mentioned above, I’d love to hear about it. Please leave a comment below.

Related Posts

• Lateral Fabellar Technique (Extracapsular Technique) – Cranial Cruciate Ligament Repair
• Cost of Dog Knee Surgery – Are There Options to Reduce the Cost?
• Dog Knee Surgery Costs – Cost of Repairing a Torn Dog Knee Ligament

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.

Related Posts

• TPLO vs. TTA vs. Lateral Fabellar Traditional Technique – Cranial Cruciate Ligament Repair
• TPLO – Tibial Plateau Leveling Osteotomy – Cranial Cruciate Ligament Repair
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)