Tight Rope Knee Repair

Torn Cranial Cruciate

Knee Repair.

Yes , we do the Tighrope! Call us to get basic info. 503.665.1194
 Dr. Merle and Dr. Becky Marks are the first veterinarians in Oregon trained to do this procedure . The technique is an innovative approach created by Dr. Cook at MSU and the Arthrex company in Naples, Florida.    

The Tightrope CCL repair surgery is the newest surgical option available for dogs with cranial cruciate ligament injury.  Unlike in humans, canine CCL tears and damage generally takes place over a period of months or years, rather than being associated with a single traumatic event.  Because of the nature of these injuries, and their degenerative process over time, this new procedure focuses on a technique used in human ankle joints using bone to bone fixation in a minimally invasive way. Watch the Animation Video

Tightrope Knee Repair
Tightrope Knee Repair
Canine Knee Injuries

In dogs the most common back leg injury is the tear or rupture of the Cranial Cruciate Ligament (CCL). In humans the ligament is named the Anterior Cruciate Ligament.You may have heard of football players injuring the ACL; this is the same injury in dogs. While cats can have this injury , too, it is more common in larger dogs. They may be exceptional athletes that  have experienced a trauma. For example a Border Collie  in a pasture might  land a foot in a mole hole. However, the more common scenario is the overweight dog who gets limited exercise.Then he gets thrown a frisbee or chases a squirrel and the hind quarters are not synchronized with the rest of the body. The knee takes a quick twist and the CCL bears the brunt of the momentum. The ligamental cord may fray or it may fully become detached from the bone. Lameness is usually immediately observed. If the injury is a tear (fray) the dog may improve with prescription antiinflammatories, nutritional support,  weight loss and rest. Yet, this is now a weakened area of the body and often gets injured again.

The canine knee is a complex joint. The knee contains 13 ligaments which articulate the joint. Ligaments attach from bone to bone which keeps the joint stable, positioned and flexible. If the CCL is injured the knee is not weight-supporting due to isometric forces and due to pain. In addition the other rear leg may now be overworked and can experience the same injury. General conformation can contribute greatly to the knee health. A dog with poor hip conformation may walk differently to compensate and hold the knees at a more stressed angle .

Tight Rope Knee Repair
x-ray of Tight Rope Knee Repair

The diagnosis involves a complete lameness exam, sedation and radiographs. You may elect to postpone surgery if the CCL is torn but often surgery is needed several months later. The surgical correction is recommended when the CCL is ruptured. There are several surgical repairs techniques. The Tightrope CCL surgery uses a  unique fiber tape and drilling small holes to isometrically stabilize the joint. The TPLO  decreases the tibial thrust in the knee anatomy . The TTA counteracts the abnormal cranial thrust by helping the muscles rebalance the joint. The latter two procedures involve an osteotomy which means bone is cut and repositioned. In all surgeries the joint is evaluated to check for meniscal trauma and ligament fragments.

Oral medications are used to control pain and inflammation for the first week after surgery.All of the procedures have extended post-operative recovery . The dogs will not use their leg for several weeks and need extended rest and a schedule for physical therapy at home.  Weight loss, nutrional support and regular exercise are important for complete success.

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