By TOPDOG

​What Is Dog ACL Surgery or Dog Cruciate Surgery (Lateral Suture Technique)?
There is no doubt that all of the scientific terminology can get very confusing for any pet owner. Currently there are three main surgery techniques that are commonly performed to treat dog ACL tears.
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Here they are:
Lateral Suture Technique or Extracapsular Repair (Outside the Joint)
Tibial Plateau Leveling Osteotomy (TPLO)
Tibial Tuberocity Advancement (TTA)

​On this page we are discussing what is commonly referred to as the Lateral Suture Technique or Extracapsular Repair for the treatment of dog ACL tears.

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Actually there are many different names for this procedure but these are just a few of the most common. Essentially the concept for the surgery is very simple, to stabilize the knee on the outside of the joint by using a single fiber plastic line called a monofilament. This very strong suture or line outside of the joint re-establishes the stability the joint needs when the ACL is torn. This suture is essentially placed in the same orientation or plane that the original ACL ligament was, except it is placed on the outside of the joint. During the surgery a hole is first drilled through the front part of the tibia. Following this, the suture is looped around the small bone called the fabellar bone (also shown above) on the back side of the femur and continued alongside the knee, through the drilled hole in the tibia and then it is clamped together with a stainless steel clip. Generally this surgery technique for repair of ACL surgeries is recommended for dogs less than 50 lbs. That said, thousands of dogs every year who weigh more than 50 lbs also do extremely well with this type of surgery.

What Is The Cost of Dog ACL or Dog Cruciate Surgery (Lateral Suture Technique)?
This particular technique for fixing a torn ACL in dogs is considered the most conservative all of all the approaches. The most important thing is that it addresses the main problem with the dog's ACL injury, it stabilizes the joint. Depending on who does the surgery, meaning a board certified orthopedic surgeon vs. a general veterinarian who has experience with this surgery, the cost can vary significantly. The cost of dog ACL surgery is also to some degree dependent on geographic location. From  research this surgery for dog ACL tear can cost anywhere from $1100-2,500. Again it all depends on region and who is performing the surgery. By far this is still the most cost effective surgery to repair dog ACL injuries.

Where Do I Find a Dog ACL or Dog Cruciate Surgeon?
Again there are many general practicing veterinarians who are skilled at performing this kind of repair for Dog ACL tears.

What Are the Alternatives to Dog ACL or Dog Cruciate Surgery?

As discussed previously there are several alternative surgery options for fixing a dogs ACL tear.

The most common are:

• TPLO (Tibial Plateau Leveling Osteotomy)
• TTA (Tibial Tuberosity Advancement)

There are several things that should be considered when choosing the right surgery. Here a list of the things to consider:

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Age of Your Dog
In some cases, if the dog is on the “older” side, maybe performing one of the more invasive surgery options is a “bit much” either financially or physically. On the other hand if you have a young dog, a TPLO or TTA may be the best option. It is best to discuss this with your trusted veterinarian who knows both you and your dog.
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Size & Weight of Your Dog
As stated previously it is fairly well accepted that dogs less than 50 lbs. will do perfectly fine with the more conservative lateral suture technique for your dogs ACL surgery. On the other hand, dogs over 50 lbs. are recommended by board certified orthopedic surgeons to either have a TPLO or TTA surgery. Again it is best to discuss with your veterinarian who knows your dog best.

Is Your Dog Calm or Active
You may ask yourself why this should be part of the consideration when choosing the right surgery for your dog. The reasoning is this. Surgery is only one part of the equation. What you do after surgery, in many cases, is even more important than the surgery itself. If you have a very active dog who is difficult to control then you have to take this concept into consideration. Would it be better to have your dog “compromise” a less invasive surgery or a more invasive surgery. Obviously a less invasive one. When it comes to the TPLO or TTA surgery, both of these surgeries involve bone cutting and implanting metal plating. If your dog compromised one of the plates then the implications are more significant. On the other hand if your dog had the lateral suture surgery to stabilize the torn ACL then if the dog breaks the implanted suture it is fairly simple to just replace the suture. Again it is best to discuss all of these considerations with your trusted veterinarian.

​Financial Considerations
This is an obvious one. There is a huge diversity in overall cost when it comes to choosing the best surgery for your dog. The cost can vary from $1100 to upwards of $4500 depending on the surgery type and who is performing the procedure. In the end the TPLO or TTA are going to be more expensive surgery options than the lateral suture technique but they may be a better option for your dog. Again it is best to discuss this with your veterinarian.

Post Surgery Physical Rehabilitation or Therapy
No matter which surgery option you choose, all of them will require some degree of post-surgery therapy.
That said hands down there is no substitute for professional therapy provided by a certified canine rehabilitation practitioner or therapist (CCRP or CCRT). These individuals have specialized knowledge and understanding on how to improve your dogs healing time dramatically.
Degree of Joint Disease ie. Arthritis
The purpose of mentioning this is to reinforce the importance of x-rays or radiographs prior to ACL surgery for your dog.
There are three x-rays that we believe are mandatory prior to ACL surgery in dogs:

X-ray of Lower Spine
X-ray of Pelvis (ie. Hips)
X-ray of both Stifles (ie. Knees)
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The reason this is so important is that often this x-rays can provide substantial insight into why your dog tore their ACL in the first place. For example: A dog may have hip dysplasia of the right hip and then blow the left ACL due to compensation. The important point is that it is so important to know the entire picture of what you are dealing with.

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Access To a Board Certified Orthopedic Surgeon
In many cases around the world, pet owners do not have access to board certified veterinary surgeons. These individuals have specialized training in surgery for a minimum of 4 years after graduation from veterinary school. They are an unbelievable resource to the veterinary community but due to geographic location limitations in many cases these specialized individuals are simply not accessible. That said there are many general practicing veterinarians who have developed the skills and confidence to perform many of these procedures.

Is Conservative Management a Good Option for Dog ACL Injury?
 There is no doubt, no one wants their dog to have surgery. Not only do we not want them in pain, often many pet owners are scared about the risks of anesthesia and surgery itself. On top of that, with all the information on the internet many pet owners are lead to believe that conservative management is a viable option for the treatment of dog ACL injury. There is no doubt that in some situations, conservative management is a great option and in fact in some cases it is the only option. This is especially true for older dogs who tear their ACL’s and the risk of surgery or even the cost of surgery is prohibitive at this point in their lives. Here are the facts and something to consider when exploring conservative management as a treatment option for your dog. If your dog only has a partial tear and with the help of medications and natural joint support your dog uses its leg comfortably, then conservative management is a logical choice.

The Key to Success for Conservative Management of dog ACL injuries is this:
Follow the same guidelines as if your dog had already had surgery. Meaning understand that full recovery can take up to 6 months.
Consider making an appointment with a certified canine rehab professional for best result. Most of these facilities have cold laser therapy which can really make a huge difference in helping these dogs heal faster.
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Start your dog on a comprehensive joint health supplement therefore providing the joint with all the natural ingredients to promote the joints health.
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**Important** Understand this important fact:
Dog ACL tears are a structural problem, therefore surgery is the best treatment option to stabilize the joint and provide the most long term comfort for your dog. It is always best to discuss these options with your trusted veterinarian.

​What Do I Need to Know About Dog ACL Recovery?
The first thing you need to know is that full recovery takes upwards of 6 months. No matter what anyone says, it takes 6 months in order to regain the strength and muscle mass in the surgery leg. It is amazing how quickly they lose muscle mass in the injured leg in such a short period of time of not using it. We also all know it is easier to lose than gain muscle. Most pet owners don’t believe that it take a while. That said, your dog is going to be doing amazing and walking on the leg well before 6 months, obviously. The reason why we feel this is so important is that our goal is twofold really:

• Help educate pet owners about what they can do to strengthen the surgery leg
• Prevent future injury to the other hind leg, or any other body part based on compensation.

Veterinarians estimate that anywhere from 30-50% of dogs who tear one ACL will tear the opposite legs ACL within a short period of time. The reason why this number is so high is that many people don’t have an understanding about the importance of post-surgery physical therapy, therefore are not doing anything to strengthen the leg.

What are the Complications of Dog ACL Surgery?
As with any surgery that involves anesthesia there are always the potential of complications. That said it is also a fact that modern day anesthesia really is extremely safe and the risk of anesthesia does not outweigh having the surgery. As with any surgery there is also always the risk of infection but again it is not all that common.

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