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Lateral Fabellotibial Suture
- 'Lateral Suture'

This procedure is one of several surgical therapies that may be recommended to address a CCL Injury.

Lateral Suture to repair CCL injury

What is the purpose of a lateral suture (LS)?


The goal of the lateral suture (LS) is to treat the abnormal instability of the knee joint.


How will the surgeon complete the lateral suture?


This procedure involves making a bone tunnel in the top of the shin bone (tibia) and suturing a strong synthetic material through this tunnel and around a small bone attached to the lower thigh bone (lateral fabella). The aim is to temporarily stabilize the knee joint after cranial cruciate ligament rupture until the body can lay down enough scar tissue to better stabilize itself.  Eventually, the suture stretches out and does less to stabilize the joint, however by that point, the scar tissue is strong enough to resist much of the abnormal motion of the knee joint. For this reason, it is very important for the dog to be strictly cage rested for 4-6 weeks after surgery, and undergo rehabilitation therapy to keep the muscles surrounding the knee strong.

If a meniscal tear is present at the time of surgery, a meniscectomy is performed to treat this source of pain as well to remove the damaged fragments.


What are some of the benefits or challenges of a lateral suture?


Research is unclear as to whether or not LS surgery improves long-term outcomes in dogs over meniscectomy alone, with some dogs showing benefit and others none.


This procedure is not suitable for large breed dogs, and is ideal for smaller dogs (under 30 pounds) found to have profound rotational instability of the knee joint after cranial cruciate ligament injury. Your veterinary care team will examine your pet to determine if LS is a suitable option for treatment.

What are some of the risks of a lateral suture?


Risks of this surgery include premature implant failure and implant infection. Following post-operative rest protocols are crucial to maximize chances for a good outcome.


  • E-collar at all times for 2 weeks, until skin incision check

  • Pain medication and antibiotics will be prescribed.

  • Post-operative activity restriction is crucial for normal healing

  • Weeks 1-6: strict kennel rest, leash walks only

  • NO off-leash activity allowed​

  • Weeks 6-12: increasing duration of leash walks, swimming​

  • Enclosed, off-leash activity allowable

  • Medical management is continued after surgery to maximize patient outcomes and support long-term joint health.

  • Like humans, animals benefit from post-operative rehabilitation exercises. You can perform some exercises at home, or have your pet seen by a veterinary rehabilitation clinic to strengthen muscles and speed recovery

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