Frequently Asked Questions About TightRope CCL/ACL Repair in the Canine Patient
Richard Lanier DVM / Dana Sweeton DVM
Q: Why is the TightRope technique for canine ACL/CCL repair getting so much attention.
A: We all want the least invasive procedure that resolves the initial problem and gets the patient back to normal mobility as fast as possible. Claims are that the implant is very strong and resists implant failure. The other aspect is that in it’s extracapsular position it has a very low profile, which reduces postsurgical discomfort and promotes rapid healing.
Q: How soon after the injury should the surgery be performed.
A: We like to do the surgical repair as soon as possible. In time there is damage to the meniscus and fibrosis to the joint capsule, making the surgery more difficult and return to normal activity lengthened. This does not mean it cannot be done. We have repaired ACL ruptures months after the injury and had good results.... We much prefer doing them right away. Both Dr. Richard Lanier and Dr. Dana Sweeton have performed hundreds of Tightrope ACL procedures on patients from 15 lbs to over 180 lbs (as of 2018).
Q: What about costs?
A: Tightrope appears to provide the best stability for the dollar. The average surgery cost is around $3,600.00. The cost may vary based on patient size, pre-surgical radiographs and blood analysis. Payment plans are available through our association with Care Credit.
Q: How is the patient immediately after surgery.
A: Most patients are discharged the next day. There are no bandages and only an incision lateral to the knee. There is normally little or no swelling. Surprisingly there is also very little discomfort. Patients are discharged with similar mobility as they arrive and in a day or two have some weight bearing.
Q: What is the recovery time.
A: We like to remove the stitches at day ten. Many patients will have 50% usage by this time. I also like to re-evaluate at 30 days. Most patients are in the 85 to 90 percent range at this time. We encourage short leash activity for 6 weeks. Obviously the torque on the implant is related to the mass and speed of the patient, so control of activity is important.
Q: What tests are required prior to surgery.
A: Obviously confirmation VIA palpation and the demonstration of the laxity of the joint. Normally a lateral radiograph of the stifle, VD pelvis, lateral lumbar and a complete blood chemistry panel including CBC. This can be done by the referring veterinarian or in-house at the time of admission for surgery.
Q: What about anesthetic and medication for discomfort
A: An IV catheter is place and the patient is induced with Propofol. An endotrachial tube is placed followed by isoflurane inhalation anesthesia.. Cardiac, respirator, and oxygen levels are monitored throughout. Antibiotics and medication for discomfort are infused prior to surgery and repeated post surgically. During surgical closure a new medication is injected into the surgical closure area that eliminates any discomfort for three days.
Q: How long does the surgery take.
A: Normally the patient is in surgery and recovery for about 3 hours. This can vary in regards the the size of the patient and the degree of injury.
Q: What about post surgical medication?
A: Antibiotics for about 10 days is essential along with meloxicam for discomfort and inflammation. Again.... Patients seem to tolerate this procedure well and have little discomfort.
Q: I have interest in this procedure for my pet and would like to talk with someone first.
A: We encourage you to call 586.264.4621 and discuss this matter directly with a doctor or one of our surgical technicians.
Q: This is still a new procedure and very few provide the TightRope ACL repair. I live a some distance away. Can it still be arranged?
A: We recently had a client/patient travel 10 hours to our facility. Patients are admitted in the am and discharged the following morning. Because the surgery is well tolerated, the patients travel well.