Non-surgical treatments are usually unsuccessful in canine ACL tears due to the chronic biomechanical stress as seen in the illustration in the anatomy of an ACL tear section. Surgical options are broken down into replacement techniques and biomechanical repairs. Fishing line used to replace a torn ACL has been used for decades and in our opinion is an antiquated technique. More recently better material and placement techniques have been proposed. This newer replacement technique is called the Tightrope Technique.
The tightrope technique involves a special type of suture material, passed through bone tunnels has been described. This replacement technique is called the tightrope procedure. The material is stronger than any other material available and the placement using bone tunnels, positions the material in the most ideal orientation. At Colorado Canine Orthopedics, we have had the opportunity to perform the tightrope technique on a select group of patients. Although the technique may be indicated in some dogs, we feel other techniques yield better, more reliable results in the majority of canine patients.
The two current techniques addressing the underlying biomechanical instability in a canine ACL tear are the tibial plateau leveling osteotomy (TPLO) and the tibial tuberosity advancement (TTA). The TPLO, which changes the angle of the tibial plateau, has been popular for nearly 20 years and has a high success rate (about 95% of dogs return to 95-100% of normal). The TTA is a technique that changes the relationship of the patellar tendon and tibial plateau angle via an osteotomy (bone cut). The TPLO is the more widely accepted technique..
Dogs undergoing tibial plateau leveling osteotomy (TPLO) have a good to excellent prognosis depending on the degree of osteoarthritis at the time of surgery. Implant failure is extremely rare. By far the majority of dogs return to a full active life style although over time some degree of osteoarthritis (OA) is inevitable. Most surgeons, including CCOR surgeons believe the TPLO is the best weapon we have to slow the OA process. Dogs with untreated ACL tears virtually always develop debilitating OA.