Extracapsular Repair for Torn Cranial Cruciate Ligament in Dogs: What Do You Need to Know?

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The extracapsular repair method of stabilizing a dog’s torn ACL is most commonly performed by general practitioners because of its simplicity and cost.

Sometimes, the extracapsular technique is referred to as the “fishing line technique.”

Extracapsular repair techniques have been available for over 50 years and have proven the test of time as a very beneficial surgery for a torn cranial cruciate ligament.

Two surgical procedures, the lateral suture, and the TightRope are the most common extracapsular repair procedures for a torn cranial cruciate ligament.

Extracapsular means the correction and stabilization occur outside of the joint. Extracapsular procedures do not require a cut in the bone.

As mentioned earlier, the most significant advantages of extracapsular procedures compared to TPLO and TTA are cost and less significant complications.

Lateral Suture Surgery

The lateral suture is the simplest technique requiring an incision on the outside aspect of the knee.


The advantages of lateral suture surgery are simplicity, ease of the surgical technique, short operative time, good results, low complication rate, and low cost.

Even if a complication from surgery occurs, the suture can easily be removed and reapplied.


The main disadvantage of lateral suture surgery is difficulty in the proper placement of the suture.

In other words, the suture must be placed isometrically for best results.

In addition, stretching of the suture may occur requiring revision surgery. Stretching is most common in larger dogs.

TightRope Surgery

The TightRope technique is the most recent advancement in extracapsular stabilization and tries to incorporate as many advantages as possible.


The TightRope technique is the strongest extracapsular stabilization implant available today and may perform superior to other extracapsular sutures in respect to suture stretching.

The TightRope technique is also more isometrically placed than other extracapsular techniques.


The cost is more than the lateral suture and slightly less than the TPLO or TTA.

Why Choose Lateral Suture Surgery Over TPLO or TTA?

Less Complications

With extracapsular surgeries, catastrophic failure necessitating amputation or euthanasia shouldn’t be expected.

If complications do occur, complications of extracapsular surgeries are generally not as disastrous.

Lower Cost

Extracapsular techniques are more cost-effective and easier to perform than osteotomies of the proximal tibia.

The bottom line is if you consult with a Board Certified Surgeon, you can likely expect a recommendation of an osteotomy procedure unless the dog weighs 25 pounds or less.

However, the best veterinarians will take into account the owner’s expectations, the dog’s health status, cost-effectiveness, and more to arrive at the best surgical option for clients and their pets.

Powerful Tools to Help Your Dog’s Ligament Challenges

There are many quick and easy changes you can make at home to help your give your dog an edge on easing tendon and ligament challenges.

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