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Location - Carnation, WA 98014


Lateral Suture


What is an Extracapsular Technique?

An extracapsular technique is another method for repairing a torn ACL ligament in the knee. This procedure aims at mimicking the function of an ACL using synthetic nylon suture. The suture is passed around the back of the knee and secured to the front of the tibia. The intent is to stabilize the knee long enough for scar tissue and healing of surrounding tissue to occur.

Potential Complications

One of the down-falls of this procedure is that it isn’t as strong of a repair as a TPLO. For smaller dogs this procedure can be appropriate. For larger dogs, the stability of a TPLO would be indicated.

Some Potential Complications:

Suture Breakage or Stretching

This happens usually as a result of the dog being too active during the postop period. If the nylon line breaks prematurely before healing has had its chance to occur, the knee will become destabilized again. If this happens, a second surgery may be indicated. A TPLO may also be a better option in the patient who has broken their suture.

Swelling or Seroma Formation

Once again, this usually happens when the dog is too active.


Proper after care is essential to the success of an extracapsular repair surgery. It is essential that you keep the patient on a leash at all times outside of the house. No running, jumping, or playing with other dogs is allowed. Stairs are also not allowed.

Even in the backyard, the patient should be on a leash. It is generally ok to have the dog off leash inside the house, but be sure that there is no running or jumping onto furniture. It is not advisable to leave the patient loose in the house while you are gone.

The following are guidelines to be followed for the next eight weeks following this surgery:
Week One
Incision care: An e-collar should be worn consistently for the first 14 days after surgery. The dog should never lick it’s incision. If you see swelling, redness, or discharge see your veterinarian right away.
Cold packing: For the first three days after surgery, ice the incision for 5 minutes twice daily. A cold pack can be made by wrapping a bag of frozen peas in a clean damp towel.
Warm packing: After three days of cold packing the incision you should switch to warm-packing twice daily for the next three days. A warm pack can be made by placing a clean sock filled with rice in the microwave for 1-2 minutes. Be sure to wrap the warm pack in a thin towel in order to avoid burns.
Passive Range of Motion: Begin this just a few days after surgery if the dog can tolerate it. To do this, gently extend the hip so the leg sticks out behind the dog and hold it for about 5 seconds in extension. Next, bring the leg forward gently to flex the hip joint. You will need to do this 10-15 times 2-3 times a day. This exercise can be done while holding the dog, or while the dog lays on her side.
Massage: Gently massage the thigh and gluteal muscles for about 5 minutes twice daily.
Lease walks: Start taking your dog for 5-10 minute walks. Do this even if they aren’t willing to use the leg yet.

Physical Therapy Exercises


Have dog sit then call it so it stands and comes to you. Repeat 10 times twice daily.

Figure 8 walks

Circle to left and to the right 10 times twice daily.


Lift front legs off the ground and “dance” with your dog by holding him there gently for about 30 seconds. Do this a few times a day.

Uneven surface walking

Have the dog walk over a wobbly surface back and forth 10-15 times twice daily. Good surfaces like this can include a thick foam mattress, an air mattress, a bunch of blankets, a line of pillows etc.


Swimming is great physical therapy for dogs. If you have swim therapy be sure to take advantage of it as much as you can.

More Information

For more information on aftercare please see the Lateral Suture rehabilitation instructions.

Riverbend Veterinary

Riverbend Veterinary orthopedic surgeries performed in-house at your local veterinary clinic in King County, WA and surrounding areas.

Contact Details

Carnation, WA 98014

(913) 708.3394