Cruciate ligament disease is the most common orthopaedic condition in dogs and often requires surgery. 

Our surgeons are highly experienced in cruciate ligament surgery and frequently perform TPLO, TTA and extracapsular suture procedures to manage this injury.

Before deciding which surgery is best suited to your pet, our surgeons will consider your pet’s individual needs and proceed to X-ray your pet’s knees, which enables them to assess your pet’s own ‘biomechanics’: a factor that influences what is likely to be the ‘best option’ for individual patients.  

Tibial Plateau Levelling Osteotomy (TPLO) Surgery

TPLO is the most advanced surgical procedure for managing cruciate ligament disease in dogs. This surgery involves cutting the tibia using a curved saw blade and then rotating the cut portion to change the alignment of the bone, thereby removing the tension upon the cranial cruciate ligament.

Whilst complex, this surgery has been shown to offer predictable outcomes, especially in larger and more active dogs. We believe that our TPLO service offers excellent value and quality. We have invested heavily in the very best DePuy Synthes TPLO plates and implants, and together with our Hospital status, standards and track record, we are offering a premier TPLO service in Scotland. 

Tibial Tuberosity Advancement (TTA) Surgery

TTA is another technique that changes the geometry of the tibia to alter the biomechanical forces within the stifle, and may be recommended for your pet’s cruciate ligament disease.

Similar to TPLO, rather than stabilising the instability that occurs when the cruciate ligament ruptures, this technique creates “dynamic stability”, where the joint is stable when the patient is weight bearing due to the adjustments made to tibial alignment. The decision on whether to recommend TPLO or TTA for your pet is based on assessing your pet’s individual needs, and biomechanics of their knee joint.

Extracapsular Stabilisation 

This technique places a suture on the outside of the joint to help reduce the instability that occurs as a result of the cruciate ligament being torn.

This surgery helps stabilise the knee while scar tissue develops, with this scar tissue giving the long-term support to the knee joint. This technique tends be reserved for smaller dogs and cats. The support provided by the prosthetic suture decreases after several weeks when the suture may stretch or break, but by this time there should be adequate fibrosis (scar tissue) around the joint to provide longer term stability.

As patient size increases there is a higher risk of premature failure with this technique - which can result in persistent instability and lameness. In addition, the fibrosis that occurs may reduce the movement of the joint and this to can cause problems.

For these reasons, small dogs with very steep tibial plateau angles (small terrier breeds) and larger dogs often will do better with TPLO.  

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