We recommend Tibial plateau levelling (TPLO) or Tibial tuberosity advancement (TTA) for the treatment of cranial cruciate ligament injury. These techniques change the geometry of the tibia to amend the forces that are responsible for the instability- resulting in an early return to function in all sizes of dog, even very active or large/giant breeds. The majority of dogs are expected to weight bear the day after surgery.

Placing a restraining suture to promote functional fibrosis, is also available but tends be be reserved for small dogs and cats. Support provided by the prosthetic suture diminishes after several weeks. As patient size increases there is a much greater risk of premature failure with extra capsular techniques -which can result in persistent instability and lameness. Small dogs with very steep tibial plateau angles (terrier breeds) do much better with TPLO.