My dog has a torn ACL. How do I choose between TPLO and LSS?

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. A TPLO would be the most appropriate surgery based on Bella's size but I have had several patients that have not undergone surgery and developed severe arthritis in the affected knee and had difficulty walking on the leg. Unfortunately, the arthritis tends to worsen and the pain can become much worse in an untreated knee. There are other options for correcting a torn ACL but may not be the most appropriate for Bella. The lateral suture technique is much more affordable, requires less time to perform (less time under anesthesia) and stabilizes the knee. I've used this technique in much bigger dogs than Bella and they have never failed. There is always the chance that the repair may fail with the lateral suture with a dog Bella's size or bigger but it will stabilize the knee. I would discuss this other option with your veterinarian. I would consider doing something the stabilize the knee so that Bella is more comfortable. I hope this helps guide you in the right direction. Please let me know if you have any other questions or concerns and I would be more than happy to help you further. Please take the time to mark this question as helpful or not as it helps us to improve on the quality of our answers to other pet owners. Thank you kindly!

No, you aren't making a bad decision at all! Your vet wouldn't have agreed to that surgery if it was a bad choice, it wouldn't have been an option. Plus, it's great he sounds confident that Penny will do well! Recovery time is long! At least six to eight weeks. I hope this helps!

Hello, sorry to hear about your cat. The ACL or CCL (interchangeable) is a ligament in the knee that prevents the lower leg from sliding forward. Unlike humans, there isn't a direct replacement of this ligament in dogs or cats. There are several surgeries to address a torn ACL however, and it involves putting an implant (a plate or a high load resistant suture). If using a plate, one must surgically cut through the bone and change the angle of the knee, where as a lateral suture is less invasive than this. The success rate is high and complications are low with either surgery, but they do carry a moderate price tag. The TPLO (which cuts the bone and uses a plate) is typically more expensive than a lateral suture. For more in depth information, you may consult with an orthopedic surgeon about this disease. They can assess Winky Boy and give you a better recommendation for him and which procedure is best considering his age and normal activity. Hope this helps and best of luck.

I believe the main difference is that dogs don't understand that they just had surgery. You can't explain to a dog that they need to take it easy, and if their pain is well managed (which is hopefully always the case) they will try to use a leg normally. A TPLO involves cutting the bone and then placing a plate, and a young exuberant dog can easily bend a plate or cause screws to back out of the bone running in the yard for a couple of minutes. Some surgeons will have owners do some physical therapy soon after surgery, but these are usually non-weight bearing passive range of motion type exercises.

It is true that he will put more weight on his other limbs and that is why 40-% if dogs tear the other. I would also encourage you to start him on fish oils to reduce inflammation as well and a chondroprotectants such as dasequin. Surgery is the absolute best option to reduce the development of arthritis. Happy healing!

Hello, and thanks for your question. There is no single right answer to this question, and you may get different answers from different veterinarians. My own thoughts, without knowing all the details about Lola, is no - I probably would not recommend that you pursue the operation in this case. The surgery will help stabilize her knee, but it won't reverse the damage from arthritis. The recovery period can be really hard on dogs with other orthopedic issues, and older dogs heal slower. Also, her small size works in her favor, as small dogs definitely fare better than large dogs without surgical correction of a cruciate tear. All of these factors to me would add up to the benefits of surgery not outweighing the down sides. I do encourage you to have a frank conversation with Lola's primary vet who knows her best - or even request a consult with the surgeon. Most surgeons will be pretty frank about how much improvement you can expect. I have had patients pursue cruciate surgery in their older years - but typically it's my older patients who are still quite active, who I expect to do well through recovery. From your description, I'm not sure Lola would be in that category. I hope this helps! I know it's not an easy straightforward decision and I can tell you're trying to make the best choice for her!

The answer to your question really comes down to her examination and your goals. It is possible for a cruciate ligament to be partially torn or fully torn. If it is fully torn, the knee is unstable and surgery is the best option to stabilize the knee and slow down the development of arthritis in the joint. If the cruciate ligament is only partially torn, you can see signs like you have in Hambro where she seems pretty normal unless she injures the cruciate ligament again with high activity. For a large dog who is young, partial cruciate ligament injures are often problematic because they inhibit dogs from being able to play normally without being painful, but it sounds like Hambro has done well for 6 months. Another consideration is that if she has a partial tear, she may completely tear the cruciate ligament in the future which will necessitate surgery. There is also a potential complication of cruciate injuries that involve a tear in the meniscus. If that happens, she will be consistently lame and will need surgery. Unfortunately, only you can decide on the right answer for Hambro. Surgery provides the best possibility for return to normal activity without lameness, but certainly isn't without potential risks and complications. I have attached a handout on cruciate ligament injuries below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1975 Finally, if this is a partial cruciate injury and you would like to avoid surgery, I would recommend trying to find a rehabilitation veterinarian to help you with physical therapy exercises to strengthen Hambro. They will also be able to give you a second opinion. Hopefully you can find a vet in the UK at this site. http://www.caninerehabinstitute.com/Find_A_Therapist.html http://www.caninerehabinstitute.com/action.lasso Good luck! I hope that was helpful. Thanks for using PetCoach.