Sylvan Veterinary Hospital

3520 Roselle Ave.
Modesto, CA 95357
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(209) 551–4527
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TightRope® Technique:
Choosing the right Cruciate ligament repair procedure for your Pet

Tightrope

Cranial Cruciate Ligament (CCL) disease is thought to be mostly a degenerative disease of the cruciate ligament in the dog, although traumatic rupture of the ligament can occur in some cases. It is one of the most common orthopedic conditions encountered in dogs, with certain breeds (retrievers, Stafford bull terriers, mastiffs, etc.) being over represented. While numerous techniques have been developed over the years, none have proved optimal in terms of limiting the progression of degenerative changes to the knee joint or avoiding potential complications which may require further surgical intervention.


Current repair techniques center on neutralizing the tibial thrust that occurs with CCL ruptures, during the weight bearing phase. Techniques can be split into two broad categories:

  • Extracapsular techniques attempt to eliminate tibial thrust by approximating the Cranial Cruciate Ligament attachments outside the joint with various types of suture material and anchor points. The TightRope® technique uses a braided material, which has shown to have significantly superior biomechanical properties (start video at minute 21 for biomechanical data) compared to other commonly used suture materials. When done correctly, the TightRope® technique also has the advantage of reproducible accuracy in the reconstruction of the CCL ligament using isometric anchor points, and superior fixation security via bone tunnels. Other “lateral suture” techniques either don’t use isometric anchor points, or use bone anchors rather than tunnels for isometry that tend to have high failure rates (pull out of the bone), particularly as the activity level, weight, and size of the dog increases.
  • Osteotomy (bone cutting) techniques namely the Tibial Plateau Leveling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA) attempt to neutralize dynamic or functional tibial thrust during the weight bearing phase.

So what are the Benefits of TightRope® over TPLO and TTA?

  • TightRope® neutralizes both dynamic and passive knee laxity (tibial thrust), and addresses excessive internal rotation of the tibia. Both TPLO and TTA only address one of the problems, dynamic laxity and not excessive internal rotation.
  • TightRope® has superior biomechanical properties, isometric anchor points, and superior fixation security when compared to other “lateral suture” techniques.
  • Scientific research (start video at minute 22 for scientific research) found TightRope® in head to head comparisons to TPLO to have equivalent clinical outcome in percent of patients reaching full function out 6 months and longer from surgery (94% return good function). Both TightRope® and TPLO had significantly better clinical outcomes than TTA, which was shown to have only 89% return to good function in this study.
  • Research has shown TightRope® to have significantly less complications in both overall rate and severity. Therefore, TightRope® has been clinically proven to have the highest safety to efficacy ratio for CCL stabilization in dogs.
  • TPLO has long been viewed as the “gold standard” for cruciate repair, particularly in the canine athlete and giant breed dogs. When scientific rigor was applied to over 2,500 cases in 43 surgical centers worldwide, it was found that TightRope® was equivalent in clinical outcome when followed out 1 year and longer from surgery, in dogs weighting as much as 200 lbs.
  • The TightRope® technique requires no cutting of the bone and therefore is minimally invasive, far less painful, promoting a quicker surgical recovery.
  • Due to the simplicity of TightRope® and the minimally invasive nature, the repair tends to be more affordable when compared to the TPLO and TTA.

Based off current research, we at Sylvan Veterinary Hospital feel the evidence is clear and compelling for choosing TightRope® as the safest and preferred technique for stabilizing the majority of CCL ruptures in our patients.


Regardless of the procedure you chose, one of the most important aspects for a quick and successful return to full function is the attention to the quality of the post-operative care given in the first 8 weeks. It is very important to keep your pet’s activity controlled and put them through a well-designed rehabilitation program to ensure pain reduction, good joint function, and proper connective tissue healing.

If you would like to find out more how we can help your pet, please contact us.

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Just wanted to let you know that Allie is doing great after Lap Spay on 4-10-12. Took her one day and she was back to normal. What a great way to get a dog spayed- I will recommend it to all my friends. Here is a photo of Allie that I took yesterday in our pasture with California Poppies. I thought it was cute! Thanks again!!
Karin Wickstrom

I have been taking my Beagle, Destiny, to Sylvan Vet for the last 10 years. She has had many medical problems throughout her life. There were times that I didn’t think she was going to pull though, yet, with wonderful Veterinarians like Dr. Tiffany Cardoza and Dr. Kipp Magnussen, she is still here with me today. I am grateful for their expertise in knowing exactly what she needs and for their compassion towards the both of us, in our hour of need. We are very blessed to know that compassionate help is always there. My deepest thanks and appreciation.
DeAnna Bingham

Sylvan Veterinary Hospital has been an important part of our family’s life for several years now. Most recently they helped to preserve our pug Sweetie’s vision with a new surgery technique. Everyone in the hospital works diligently to serve our needs. There is open communication with the front office staff, the technicians and the doctors whenever necessary. Our concerns and questions are always addressed quickly and the doctors are always available to us whenever needed.
Roger and Diane

What a great neighborhood veterinary clinic! I love the convenient hours and boarding facility. They have a nice, friendly staff and team of doctors who involve me in making the right choice for my pet.
Karin Mcknight

I can’t say enough about the miraculous results you can get from laser therapy. I used it for my puppy’s foot wound that wouldn’t hold stitches. The wound was completely closed in three treatments-without a scar! Also, this pup has elbow dysplasia and laser has helped him quickly regain soundness when he played too roughly. And the best part- it’s not expensive. I’m a tried-and-true believer of this technology.
Lee Nudo and Jagger La Grange, CA

Eleven years ago, Dr. Kipp Magnussen saved the life of my young kitten and I was genuinely impressed with his compassion and competence. Over the years I have been extremely happy with the care all the vets and vet techs have provided for my various dogs and cats. In addition, it is a mark of commitment to the highest standards of quality medical care that Sylvan Vet is accredited through the AAHA. I continue to highly recommend this clinic.
Page Riskin, MD

We have been a client of Sylvan Vet for the past 20 years. Just recently, Bodie, our Chocolate Lab experienced a wound to his back that was quite serious. After two months of patience, determination and constant care by Dr. Kipp Magnussen, Bodie has been nursed back to health. Kipp's staff has become family to us. Each and every one of them is kind, friendly and compassionate! Bodie just celebrated his tenth Birthday and is even swimming again. Thank you Sylvan Vet!!
Anita Bauer

I love the doctors and staff at Sylvan Veterinary Hospital for the care and compassion they have given my dogs over the years. From luxating patella surgery to nail cleaning, the care level is the highest. I would recommend them to any and all pet owners.
Pat Osdahl