External Capsular Repair

The most traditional surgical treatment for canine cruciate ligament (CCL) injuries is external capsular repair. Most commonly performed on smaller dogs, this type of knee surgery in dogs involves opening up the knee, or stifle, joint to examine it, and removing the injured ligament. If any part of the meniscus is damaged, we will also remove that portion. A hole is then drilled in the tibia, one of the major bones in the leg, and a strong suture is passed through this hole and around the fabella, a small bone behind the knee, in a figure-eight formation.


The purpose of this suture is to prevent the tibia from moving forward and causing further injury. We are able to both tighten and strengthen the stifle joint with the suture, which eventually causes fibrosis, or a build-up of scar tissue. Although we often think of scar tissue as something to be avoided, it is beneficial to the dog in this case. This tissue will eventually stabilize the dog's knee joint, since the ligament is no longer there to play this role.


There are some disadvantages to this type of knee surgery in dogs. External capsular repair does require an extended recovery time, so it is not ideal for all dogs. The scar tissue can take up to six months to completely form, and it can be difficult for many dogs to avoid excessive activity during this recovery. High-impact activity can delay the healing process and even re-injure the CCL. We perform this surgery with an excellent success rate, and would be happy to discuss whether this option is a good fit for your dog's needs.

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