'Tightrope' surgery for anterior cruciate ligament rupture - what to expect?

[SDTGisAnEvilWolefGenius]

Ddog2 is going into the vet hospital on Wednesday for ACL surgery - she has fully ruptured one ACL and partially ruptured the other. They are doing something called a Tightrope procedure - basically a braided suture is drilled through the bones of the upper and lower leg to stabilise the joint whilst scar tissue forms that will support the knee long term.

She is going to be on cage rest, with very gradual mobilisation, and then at 6 weeks post op, they will decide when to do the second knee - and we will be back to cage rest again - which she is going to hate.

Has anyone had this surgery done on one of their dogs, and if so, is there any information or advice you could give us?

Thanks in advance!

How much does she weigh?

Ditto VetNurse, it's only something I would consider for a small dog.

I have had dogs that have had TTA and TPLO surgery and have recovered well. They have needed crate rest and restricted exercise for about 3 months but are now as good as new. Tightrope surgery I thought had been replaced generally by the above options but I am not a vet so am probably talking rubbish.

All I would say is do make sure you see a specialist orthopedic vet as they will have more options and approaches available for your dog.

The gold standard is TTA or TPLO for this sort of injury, but these are very expensive procedures and so many practices still offer surgery such as over-the-top or Deangelis. The evidence is that the eventual outcome is similar regardless of the technique, but TPLO patients seem to be more mobile more quickly. For heavy dogs whose other cruciate is at risk of rupture, this is a really significant benefit. In your case OP it sounds like both cruciates are affected anyway.

Presumably your vet has gone through all the options available and offered you referral if required. You definitely don't need a specialist for this surgery, although many GPs do refer these days.

VetNurse - she weighs about 32kg, I think - though it may be a bit more as lack of exercise has made her gain a bit of weight (though we have switched her to light food, and cut down the amount quite a lot).

We saw a specialist orthopaedic veterinary surgeon at the Glasgow vet hospital, and he recommended the tightrope procedure - if I understood him correctly, it is a more conservative procedure, and he thought ddog2 was a good candidate for it - and we could move up to a TTA or TPLO if the tightrope didn't work.

He he surely you didn't see David Bennett at the Vet School? He called the TPLO the totally pointless leg operation! That was because eventual outcomes were comparable with other techniques, but I've never agreed with him.

If you've already seen an orthopod then I'd take their advice, as you have. Be prepared for a long recovery period and think about mental stimulation for the test period - throw away food bowls and use Kong toys instead. Claire Arrowsmith's book Brain Games for Dogs is a good read for inspiration on how to entertain them!

If I remember correctly - I saw David Bennett and Noel Fitzpatrick having a very "interesting" debate re TPLO and TTA's that would explain things Crap

With the foster dog that had tightrope part of his rehabilitation was up hill walking to take the strain off his knee but build up muscle. He was a small dog so we used to walk up a hill carry him down and do this for 15 min walks several times a day - (he needed to have TTA in the end though )

No, not David Bennett - Cameron Broome. I was impressed by him - tbh, I went in thinking TPLO/TTA were the only options, so I was a bit thrown by the extra option of tightrope surgery, and Cameron was very even-handed in discussing all the pros and cons, but he did seem to think that tightrope was a valid option for our dog.

She is definitely too big for me to carry her back downhill, muttynutty, so we will have to work out another way round that.

It was a long time ago SDT so probably the advice has changed now - I remember it being good for my thighs though.

This video .

Our dogs were sorry for themselves for the first day and in discomfort - I slept with them for the first night home. They both slept a lot to start with which was great as it was easy to keep them rested. After a while they were back to normal and recovery was consistent but did need managing. They needed restricted exercise but in small amounts and frequently so needed a bit of planning. Now though both are great and fighing fit and competing in dog sports so all good

I hope all goes well and she is soon fighting fit again - it is a horrid time when our dogs are poorly

Thank you for the link and the reassurance, muttynutty.

Well - we took ddog2 in to the vet hospital at 8.30 yesterday morning - it was dark and teeming with rain, so driving through the Glasgow rush hour was really fun - especially on the way home - we got there in about half an hour, but took over an hour to get back home.

And then, just after lunch, they rang us - when they'd anaesthetised ddog2 and shaved her leg for the surgery, they found a skin infection none of us knew she had, and couldn't take the risk of open surgery - especially as they'd be drilling into bone - if infection gets into bone, it can be really hard to get rid of.

So we had to go and get her back - which meant another drive through Glasgow's rush hour, in the dark - and the weather was even worse this time (at one point I couldn't see where I was going at all, the rain was so bad - we all had to stop for a moment until the worst passed).

So my poor girl has, as far as she is concerned, been starved, denied breakfast, driven through Glasgow in the dark, seen the V-E-T, been abandoned by me at the V-E-T, had an injection and a sleep - all so she could have a really bad haircut!!

She's come home with a course of antibiotics, and a special shampoo - she's going to need shampooing every other day - and is due to go back in next Thursday, when they'll see if the infection has cleared, and if it has, they will do the operation - if not, I guess we will have more antibiotics and reschedule again.

Poor thing - she is definitely not comfortable, and she is really missing her walks and runs, and I just want to get started on the process that will end with her being able to have her fun again - it is going to take at least 3 months as it is, with them having to do both knees.