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).
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.
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.