ACL Repair

ACL Repair

Repair of Ruptured Cranial Cruciate Ligament (ACL) by TightRope Ligament Replacement

Just as in the human knee, the most critical stabilizing structure in the canine knee is the cranial cruciate ligament (CCL). The primary function of the CCL is to prevent forward thrusting motion and inward rotation of the tibia during weight bearing and to prevent hyperextension of the knee.
When the CCL is ruptured or partially torn, the abnormal, forward thrusting motion and inward rotation of the tibia during weight bearing results in an unstable, painful knee and ultimately, in debilitating, degenerative arthritic changes in the knee joint.

The newest procedure for repairing a ruptured CCL by ligament replacement is the TightRope Ligament technique. This procedure has been developed by James L. Cook, DVM, Ph.D., Diplomat of the College of Veterinary Surgeons. This procedure has been proven in over 200 knees and has been shown to be highly effective.

The TightRope CCL technique is minimally invasive and more cost-effective in comparison to the TPLO or TTA. The data suggest that TightRope can be successfully performed in medium, large and giant breed dogs resulting in outcomes which are comparable or better than TPLO or TTA. A MiniTightRope is also available for toy and small breeds.

The TightRope CCL counteracts the forward tibial thrust and inward rotation resulting from CCL damage while providing an optimal joint range of motion.

This procedure mimics the natural cruciate ligament functions, perhaps better than any other procedure developed to date.

The TightRope Ligament is produced by Arthrex Vet Systems. It is an ultra-high strength, flat, smooth, braided, ribbon-like ligament composed of a multi-stranded long chain ultra-high molecular weight polyethylene (UHMWPE) core with a braided jacket of polyester giving it unsurpassed strength, virtually eliminating ligament breakage. The ligament provides an ultimate load of 225 lbs, approximately three times the strength of 80# nylon ligaments currently in use for CCL replacement. This procedure provides our clients another option when a less invasive, less radical and somewhat more cost-effective procedure that does not cut bone is desired by the pet owner.

St. Francis Hospital for Animals

10709 Kettering Drive

Charlotte, NC 28226

For general information, questions, appointment requests, call us at:

(704) 527-2030 Email Us: Facebook Yelp Instagram


Monday 7:00am - 7:00pm

Tuesday 7:00am - 7:00pm

Wednesday 7:00am - 6:00pm

Thursday 7:00am - 6:00pm

Friday 7:00am - 6:00pm

Saturday 8:00am - 12:00pm

Sunday Closed