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Willow Creek Pet Center

TPLO and TightRope® Surgery

What is cranial cruciate ligament disease?

The cranial cruciate ligament (CCL) is one of the main stabilizing structures of the knee joint in the hind limbs of dogs. The CCL’s main job is to hold the femur and tibia in proper alignment during all forms of activity.

Deficiency of the CCL is the most common orthopaedic problem in dogs and results in degenerative joint disease (arthritis) in the knee joint. It’s considered a disease because it’s typically not a result of an athletic injury or trauma.

Symtoms of CCL include:

  • Limping
  • Holding the hindlimb up
  • Sitting with the leg stuck out to the side
  • Stiffness, especially after exercise
  • Not wanting to play or ecercise
  • Pain when the joint is touched or moved
  • Swelling of the joint
  • Clicking sound when walking
What are my treatment options?

While there is no cure for CCL disease in dogs the goals for all treatments are to relieve pain, improve function and slow down the arthritis.

Nonsurgical treatement entails rest and nonsteroidal anti-inflammatroy medication for 6-8 weeks. Once the initial pain and inflammation have subsided, a strength-building excercise program should be initiated. However, the success rate is not high and typically only small dogs weighing less than 30lbs may have a good long-term result.

The most common surgery techniques are:


Tibial Plateau Leveling Osteotomy (TPLO) is one of the “bone cutting” techniques and is designed to change the anatomy of the knee so that is no longer “slips” without having to try to replace the function of the CCL. A plate and screws are inserted to stabilize the cut bone during the healing.

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TightRope® CCL

TightRope® CCL was developed a few years ago to provide a minimally invasive and improved method for extracapsular stabilization of the CCL. This technique does not require cutting of bone like the TPLO procedure. Instead, it uses small drill holes in the femur and tibia to pass a synthetic ligament-like biomaterial through a small incision to provide bone-to-bone stabilization during healing.

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