Sign in to continue reading this article

Not registered? Create an account for free to read full articles on

To access full articles on, please sign in below.

Busy? Sign in Faster. Sign into with your social media account.

This image gallery reviews some surgical options for cranial cruciate ligament (CrCL) injuries in dogs, including the lateral fabellotibial suture (LS), tibial plateau-leveling osteotomy (TPLO), cranial tibial closing wedge ostectomy (CCWO), and tibial tuberosity advancement (TTA).

References and author information Show
  1. Witsberger TH, Villamil JA, Schultz LG, Hahn AW, Cook JL. Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs. J Am Vet Med Assoc. 2008;232(2):1818-1824.
  2. Kowaleski MP, Boudrieau RJ, Pozzi A. Musculoskeletal system: stifle joint. In: Tobias KM, Johnston SA, eds. Veterinary Surgery: Small Animal, vol 1. St. Louis, MO: Elsevier;2012:906-998.
  3. Wucherer KL, Conzemius MG, Evans R, Wilke VL. Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. J Am Vet Med Assoc. 2013 May 15;242(10):1364-1372.
  4. Bergh MS, Sullivan C, Ferrell CL, Troy J, Budsberg SC. Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. JAAHA. 2014;50(5):315-321.
  5. Duerr FM, Martin KW, Rishniw M, et al. Treatment of canine cranial cruciate ligament disease. A survey of ACVS Diplomates and primary care veterinarians. Comp Orthop Traumatol. 2014;27(6):478-83.
  6. Pozzi A, Hildreth BE 3rd, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg. 2008;37(8):749-755.
  7. Dillon DE, Gordon-Evans WJ, Griffon DJ, et al. Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease. Vet Surg. 2014 May;43(4):446-50.
  8. Hunter DJ: Risk stratification for knee osteoarthritis progression: a narrative review. Osteoarthritis Cartilage 2009;17:1402–1407.
  9. Hulse D, Hyman W, Beale B, et al. Determination of isometric points for placement of a lateral suture in treatment of the cranial cruciate ligament deficient stifle. Vet Comp Orthop Traumatol.2010;23(3):163-167.
  10. Anderson CC 3rd, Tomlinson JL, Daly WR, et al. Biomechanical evaluation of a crimp clamp system for loop fixation of monofilament nylon leader material used for stabilization of the canine stifle joint. Vet Surg. 1998 Nov-Dec;27(6):533-539.
  11. Tonks CA, Lewis DD, Pozzi A. A review of extra-articular prosthetic stabilization of the cranial cruciate ligament-deficient stifle. Vet Comp Orthop Traumatol. 2011;24(3):167-177.
  12. Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract. 1993;23:777-795.
  13. Slocum B, Devine T: Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair. J Am Vet Med Assoc. 1984; Mar 1;184(5):564-569.
  14. Lafaver S, Miller NA, Stubbs WP, et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg. 2007 Aug;36(6):573-586.
  15. Ramirez J, Barthélémy N, Noël S,  et al. Complications and outcome of a new modified Maquet technique for treatment of cranial cruciate ligament rupture in 82 dogs. Vet Comp Orthop Traumatol. 2015;28(5):339-346
  16. Samoy Y, Verhoeven G, Bosmans T, et al. TTA Rapid: Description of the Technique and Short Term Clinical Trial Results of the First 50 Cases. Vet Surg. 2015 May;44(4):474-484.
  17. Yeadon R, Fitzpatrick N, Kowaleski MP. Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog. Surgical technique, radiographic and clinical outcomes. Vet Comp Orthop Traumatol. 2011;24(1):18-26.
  18. Marsolais GS, Dvorak G, Conzemius MG. Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs. J Am Vet Med Assoc. 2002;220(9):1325-1330.
  19. Romano LS, Cook JL. Safety and functional outcomes associated with short-term rehabilitation therapy in the post-operative management of tibial plateau leveling osteotomy. Can Vet J. 2015 Sep;56(9):942-946.
  20. Gordon-Evans WJ, Griffon DJ, Bubb C et al. Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. J Am Vet Med Assoc. 2013 Sep 1;243(5):675-680.
  21. Krotscheck U, Nelson SA, Todhunter RJ, et al. Long Term Functional Outcome of Tibial Tuberosity Advancement vs. Tibial Plateau Leveling Osteotomy and Extracapsular Repair in a Heterogeneous Population of Dogs. Vet Surg. 2016 Feb;45(2):261-268.

Mary Sarah Bergh

DVM, MS, DACVS, DACVSMR Iowa State University

Mary Sarah Bergh, DVM, MS, DACVS, DACVSMR, is associate professor of orthopedic surgery and director of the Canine Rehabilitation Center at Iowa State University. Her clinical and research interests include rehabilitation therapy, joint replacement, arthroscopy, treatments for cranial cruciate ligament disease, and sporting injuries. A graduate of University of Wisconsin, Dr. Bergh completed an internship at University of Pennsylvania and a residency in small animal surgery at The Ohio State University.

Material from Clinician’s Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Up Next