What is Cranial Cruciate Ligament Disease?

Like the TTA and TTA 2, this method makes a linear cut along the front of the tibia (“shin-bone”). The front of the tibia, called the “tibial tuberosity” is advanced forward until the patellar tendon is oriented approximately 90 degrees to the tibial plateau. This is simply another way to accomplish the same orientation as the Tibial Plateau Leveling Osteotomy (TPLO). This orientation renders the knee stable, independent of the role of the cranial cruciate ligament. The TTA Rapid has shown equal results to the TPLO in healing time and long-term limb function.

Unlike the TTA and TTA2, this method uses cortical screws to lock the titanium cage device in place making it incredibly stable. The honeycomb structure of the device is similar to how cancellous bone is structured and is more biocompatible than previous TTA devices. An artificial bone graft is placed in the surgical site to quickly stimulate bone growth and has a rapid healing time of 8 weeks. In addition, this method can be used in all sizes of dogs from toy to giant breeds. Like with the TPLO, we prefer this method to the Extracapsular Repair in active dogs, young dogs, dogs over ~ 40 pounds, and dogs that have a relatively stable knee to start with. The TTA Rapid demonstrates superiority to the extracapsular suture repair resulting in a more isometric fixation and better range of motion in the knee.  

This procedure is also called “Ex-Cap suture” and “lateral fabellar suture stabilization.”  This treatment is a traditional surgical treatment used to stabilize the stifle after a torn CrCL. The concept of this procedure is to replace the function of an incompetent cranial cruciate ligament with a heavy monofilament nylon suture placed along a similar orientation to the original cruciate ligament, but outside of the joint (the actual ligament is inside the joint). The suture needs to stabilize the tibia (“shin-bone”) relative to the femur (“thigh bone”), while allowing normal knee movement, until organized scar tissue can form and assume the stabilizing role. 

This technique tends to have a little bit too much “give” for an active dog as well as medium to larger breeds (>40 lbs), but it works reasonably well in small breeds and inactive dogs. Postoperative care at home is very critical and involves strict activity restriction for ~ 4 months. Premature and excessive activity risks complete or partial failure of the stabilizing suture that can render the surgery a complete or partial failure. Post operative healing takes 16 weeks.

 Hero Brace

We understand that not every patient is a surgical candidate. When surgery is not an option, we offer the Hero Brace as an option to help your companion play again with minimal invasion. This process entails specific measurements and 3D casting of your pet’s affected leg to create a custom brace. This brace is meant to be worn daily to help to support the limb in the correct geometric positioning, which relieves pain and increases stability. 

Acupuncture and Cold Laser Therapy

Acupuncture is an ancient Chinese medical modality that utilizes small needles to stimulate the nerves in and just below the surface of the skin.  The stimulation of these points can treat pain, inflammation and the flow of energy to promote healing.  While acupuncture cannot necessarily heal a torn cruciate ligament, it can be used to reduce the pain and increase mobility.  Your veterinarian will place needles in local points around the knee, as well as points along meridians that can stimulate various effects in the body.  Acupuncture can be combined with herbal therapies as well as cold laser to help treat cranial cruciate disease.