Article Release: Issue 28
Release Date: June 25, 2025
Written By: Karla Hojas, Marketing Director, and Dr. Tomas Infernuso, DVM, DACVS

When it comes to cranial cruciate ligament (CCL) injuries in dogs, pet owners are often faced with a big decision: TPLO or Lateral Suture? At Animal Surgical Center, we guide our clients through this choice by thoroughly assessing the patient’s size, age, activity level, and the extent of the injury.

To help shed light on these two common orthopedic procedures, we’re breaking down the key differences—plus real stories of two recent patients: Melo and Harry Winston.

What Is TPLO?

Tibial Plateau Leveling Osteotomy (TPLO) is one of the most advanced and effective surgeries for treating cranial cruciate ligament ruptures—especially in large, active dogs.

Rather than replacing the torn ligament, TPLO changes the biomechanics of the knee. The procedure involves cutting and rotating the tibia (shin bone) to create a new angle that stabilizes the joint during movement, effectively eliminating the need for the cruciate ligament.

Ideal For:

• Medium to large breed dogs
• High-energy or working dogs
• Patients with complete ligament ruptures

What Is Lateral Suture Stabilization?

Also called Extracapsular Repair, Lateral Suture surgery uses a strong nylon-like suture placed outside the joint to mimic the function of the cruciate ligament. It’s a less invasive procedure that doesn’t involve bone cutting.

Ideal For:

• Small breed dogs under 20 lbs
• Older or low-activity patients
• Pets with partial tears or less joint instability

Why We Recommend PRP and Gel Therapy

Both of our featured patients received Platelet-Rich Plasma (PRP) and biologic gel therapy as part of their surgery. These regenerative treatments promote healing, reduce inflammation, and improve recovery outcomes—especially for orthopedic surgeries. At ASC, we integrate these modalities whenever possible to support long-term joint health.

Case Study 1: Melo (TPLO Surgery)

• Patient: Melo, 3-year-old Bulldog Mix, 22.3 kg
• Presenting Concern: Limping on the right hind limb
• Exam Findings: Positive cranial drawer, joint effusion
• Surgery Date: June 10, 2025

Procedure: A routine TPLO was performed, along with a partial medial meniscectomy. A 3.5 mm locking plate was used for stability, and PRP + gel therapy supported her post-op healing.

Recovery: Melo is doing well and scheduled for her 2-week recheck. Her prognosis is excellent.

Case Study 2: Harry Winston (Lateral Suture)

• Patient: Harry Winston, 8-year-old Morkie, 6 kg
• Presenting Concern: Limping, suspected ACL tear
• Exam Findings: Positive cranial drawer, mild hip dysplasia, MPL grade 1 on opposite limb
• Surgery Date: April 11, 2025

Procedure: Lateral suture repair was completed using 40# nylon, with supportive PRP and gel. No meniscal damage was found, and joint degeneration was mild to moderate.

Recovery: At his 2-week recheck, Harry Winston was comfortable and eager to be active again. He also completed several sessions of laser therapy to aid recovery.

Which Procedure Is Right for Your Pet?

There’s no one-size-fits-all answer. Our surgical team will evaluate each pet individually and recommend a treatment plan based on:

• Weight and build
• Age and lifestyle
• Severity of the ligament injury
• Joint stability and overall health

Final Thoughts From ASC

These surgeries restore mobility, reduce pain, and bring pets back to their playful selves. Whether it’s a bulldog or a Morkie, the goal remains the same—help them heal and thrive. With modern tools like PRP and personalized care, we’re seeing better outcomes than ever before.

If your dog is showing signs of lameness or knee pain, don’t wait. Early diagnosis and treatment are key to long-term success.

With Compassion and Care,
The ASC Team