Cruciate Repair: TPLO, CBLO, Extracapsular

At Nachbar Veterinary Hospital we perform CORA-based Tibial Plateau Leveling Osteotomies (CBLOs). While we have the ability to perform TPLOs we recommend CBLOs as they have a higher success rate for our patients and more even distribution of weight on the tibia. We believe the CBLO is the new gold standard for patients.

CBLO surgery works to reduce the slope at the top of the tibia, so when the dog is weight-bearing, the femur rests on the tibial plateau rather than slipping backwards and pushing the tibia forwards. CORA stands for (center of rotation of angulation). The tibial plateau is leveled, but the cut in the bone is dome-shaped and does not enter the joint, as in the TPLO. The osteotomy is stabilized with a bone plate sized to your pet and special screws.

When you schedule with us, Dr. Nachbar will review with you his recommendations for repair and a customized surgical plan for your pet. Many factors go into deciding what surgery is best for your beloved pet: cost, activity level, age, the weight of your pet, etc. We recommend coming in for a consultation so that he can discuss the options and decide together what is the best choice for your pet.

Extracapsular Repair

An Excap is a technically more straightforward procedure than CBLO/TPLO to treat a cruciate rupture. As in the CBLO/TPLO surgery, the damaged cruciate ligament is removed, damaged portions of the meniscal cartilage are removed, and any bone spurs are smoothed. A heavy monofilament synthetic suture is then passed around the stifle joint to provide stability while the stifle heals. Depending on several factors, this option may be sufficient for your pet.

What happens if I don’t do surgery?

Since the knee is unstable without an intact cruciate ligament, the wearing between bone and cartilage becomes abnormal and the joint develops irreversible degenerative changes. Pain and lameness will persist, and the opposite leg becomes stressed. While therapies may help, surgery is the only thing that can repair your pet’s leg. Please contact your veterinarian or come in for a consultation to find out the best option for your dog.

Rehabilitation

Rehabilitation after surgery is essential in helping your dog recover better after surgery. Your dog will be restricted to a leash only and minimal activity for 8 to 12 weeks, slowly building up activity afterward. We recommend that our patients undergo a 6-treatment therapeutic laser series that helps speed healing and reduce swelling after the surgery. Your pet will receive laser treatments after the surgery.