University of Missouri veterinary clinician-scientist develops a minimally invasive method to treat torn ligaments

A technique used in human ankle injuries has been modified by MU Veterinarian, Dr. James Cook, to correct cranial cruciate ligament (CCL) injuries in dogs. Dr. Cook created the technique as an alternative to the common TPLO (Tibial Plateau Leveling Osteotomy) which involves cutting the tibia bone to stabilize the CCL-deficient knee. The new minimally invasive technique comes with less severe complications and a shorter recovery time.

The new technique, known as Tightrope CCL, is modified from a technique used in human ankles and allows placement of a device that stabilizes the CCL-deficient knee through bone tunnels drilled using very small incisions. MU veterinarian James Cook worked with Arthrex Inc. from Naples, Fla., to develop and test the Tightrope device for dogs.

The procedure involves cleaning up joint tissue and meniscus, protective cartilage at the knee joint, and stabilizing the knee ligament by inserting a “tightrope” into the leg through a small incision. Then, the veterinarian drills through leg bones and anchors the device to the bones. The ‘TightRope’ is a low profile system comprised of a FiberWire loop made of either stainless steel or titanium which is tensioned and secured between metallic buttons.

“It really just replaces the function of that ligament by going through bone tunnels, and it’s a really nice suture device that we can place with very small incisions,” Dr. Cook said.

“Other current techniques require major surgery that involve cutting the bone, which can potentially lead to severe complications, such as fracture, implant failure and damage to the joint,” said Cook, professor of veterinary medicine and surgery and the William C. Allen Endowed  Professor for Orthopedic Research. “This new technique is minimally invasive, relatively easy to perform and cost effective compared to other techniques. The dogs in the preliminary trial study experienced fewer and less severe complications with outcomes that were equal to or better than those seen with the bone-cutting technique.”

Cruciate ligament tears are five times more common in dogs than humans and cost U.S. pet-owners more than $1.3 billion each year. The new technique is not for every dog. Because surgeons must be able to drill tunnels in the bone, dogs must weigh at least 40 pounds for the Tightrope CCL method to be feasible.  In addition, dogs that cannot follow a physical rehabilitation protocol after surgery and dogs with limb deformities are not candidates for this technique. The 10- to 12-week rehabilitation period is very important for any surgical technique for CCL deficiency in order to optimize successful return to pain-free function and reduce complications, Cook said.  The surgery costs between $2,200 and $2,400.

If you would like more information, please contact:

James L. Cook
Comparative Orthopaedic Laboratory
University of Missouri
900 East Campus Drive
Columbia, MO 65211
(573) 882-7821
cookjl@missouri.edu