As many of you know, we have been struggling for the past few months to help Tucker’s torn cruciate ligament (CCL) heal using conservative management. Unfortunately, despite all of our efforts to change his diet, add supplements, utilize a brace, prescription anti-inflammatory medication, joint-friendly exercise, and LOTS and LOTS of rest, Tucker’s knee has gotten progressively worse since June (at which point he was presenting with a partial cruciate tear). His arthritis is progressing and he now has a positive drawer sign, which is a test done by the vet during which he slides the tibia out. If there is positive forward motion of the tibia it is known as a positive drawer sign and is indicative of a CCL tear.
Since day one we have been weary of surgical intervention due to the inherent risks of surgery and anesthesia, along with our concerns about keeping Tucker quiet for a prolonged period after surgery. After lengthly discussion and multiple follow-up visits with our vet, we have slowly become more comfortable with the idea of possibly pursuing the surgical route in Tucker’s recovery. At our last visit at the end of November we learned that Tucker’s arthritis is progressing, the fluid accumulation and inflammation have slightly worsened, and the joint is getting less stable. With the decision as to whether or not to pursue surgical intervention upon us, and taking Tucker’s age and personality into consideration, we have decided to proceed with surgery.
The extracapsular technique is the one we have chosen to go with, as it is less invasive and requires less recovery time as compared to the TPLO method. Extracapsular stabilization techniques involve stabilizing the stifle (doggy term for knee) by some means external to the joint capsule. Most commonly this is done by placing a large, nonabsorbable suture around the lateral fabella and through a hole in the tibial crest. The suture, monofilament nylon aka fishing leader line, forms a figure 8 pattern around the knee joint, mimicing the action of the cruciate ligament and preventing the tibia from forward motion. It is this forward motion, known as the cranial drawer, that is causing Tucker’s arthritic and inflammatory changes, so the only way for Tucker to truly recover is to take steps to prevent the bone from moving in this manner.
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I have been strugling to find the best way to go for my 10 year old, 17 pound westie, who has a torn CCL. She’s scheduled for TPLO method in two weeks, but I’m worried because she’s not a brave dog, just one who likes to cuddle. This could be worse than walking around on three legs.
Not sure how old this is. Can you tell me how it went? I have a similar situation with my 35 lb cockapoo.
We are considering this surgery vs the TPLO. Our vet says the ECR may only last a short period of time. How is it working for your westie?
Thanks
Hey, My vet told me that both the TPLO and the ECR should last almost forever. He would be more concerned with having to do the other knee within a year or two.
TPLOs are very hard on older dogs, say, older than 7 yrs. old. I’ve seen plenty of them, as I am the one who ends up trying to “rehab” them. Liz, Cert. Canine Rehab Therapist
my white german shepherd is at the vets now for the day for xrays to confirm this. he is 7 yrs old. my husband doesnt want to have the extracapsular surgery but i dont want him in pain. do we have to decide now, a couple of weeks, months or what. is surgery my best option? i am worried also about him going under! what should we do , he is my little baby the first dog i have ever owned myself. also, his black and tan german shepherd (sister) is pacing wondering where he is. they play in the house and outside constantly. how am i going to keep him stable when his sister is hyper? pls help. need some reassurance. maybe i should take him to the university of guelph animal hospital is it is known to be one of the best in canada and is just around the corner?
I’m going through the same situation with my pit bull. Please let me know how things went.
I would never allow a veterinarian to perform TPLO on any dog with a torn cruciate ligament weighting under 60 pounds. I understand there are occasions when TPLO is a necessary choice, especially with larger dogs, but my research suggests it’s rare.
As for my experience, I have a wonderful 11 year old male, 55 pound, pit pull terrier named Clyde. Clyde had torn both back-leg cruciate ligaments 2 years apart form each other.
He was 7 years old when he tore the fist one. He went completely lame. Our surgeon recommended extracapsular repair which we went with. Clyde rebounded from the surgery beautifully walked out of the office and was running again in approximately 4 to 6 weeks.
The surgeon who cared for Clyde 2 years later when he tore the other knee tried to talk us into the much more expensive – and in my opinion – brutal TPLO method.
Clyde was now 9 years old and I thought – considering his age and good response to the extracapsular or (suture) repair – that the TPLO was not a good choice for us.
I insisted that he do the extracapsular surgery – which he did. The surgeon seemed to have much less enthusiasm once I informed him I wouldn’t consider TPLO for my boy.
After the surgery Clyde responded well. However, not as well as he did the first time.
It seems the second surgery leg is a bit more tender on humid days or when he’s run a bit to much. Overall he is doing very well though!.
Clyde is now 11 and is doing fine. Although he has slowed down a bit which is normal given his age.
If your doggy is under 60 pounds and has a torn cruciate ligament requiring surgery.
I recommend the more reasonable and comparatively elegant extracapsular surgery.
Don’t let some brute surgeon saw your dogs leg in two and screw it back together.
All the best and good luck,
John
Our Zia is 8 years old Belgium Shepherd – she weighs in a 80 lbs, although we do now have her a diet… we have been advised by our vet that she has a Cruciate Ligament rupture.. it’s heartbreaking to see her walk on three legs, but our major concern is how to get her help.. Our vet has not recommended a specific surgical procedure, but has advised us of what options are available. there are 3 to choose from: Extracapsular Repair, TPLO and TTA… How does one decide which is best for our furry family member? We want to choose the least tramatic and faster recovery.. any ideas?
Both the TPLO and the TTA require them to cut some portion of the tibia and use surgical implants to keep the bones in place. This changes the angle of the knee and thus replaces the need for the CCL. In my opinion, the TTA, if you have someone who can do it, is the lesser of the two evils – that is, if you choose not to do the extracapsular method. TTA requires less bone to be cut and less recovery time than the TPLO. We just recently had the TPLO done on our 72 lb Alaskan Malamute day before yesterday. I would have chosen the TTA surgery if there was a surgeon in my area that does it. Unfortunately, we would have had to drive 3 hours to Seattle and I worried that if there were complications after the fact, we wouldn’t have anyone to go to. I’m feeling some regret about choosing the TPLO method, however; she’s already putting the leg down and limping on it. My girl is also a pretty mellow dog for a malamute and we were doing conservative management for approximately 6 months prior to this, so we’re used to the routine.
Raven will be 5 years old this month and has been having problems with this knee for a while – they suspected it was a partial tear, but she recently injured it to the point of a complete tear. Whatever you decided, I hope it worked out for you.
Hi Nancy,
I was wondering if you have the surgery yet? I am also looking at the same thing for my baby who is a Border Collie / Pit mix 54 pounds. We are thinking about the Extracapsular surgery, but just not sure… Please let me know…
Thanks!!!