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Success Rate of Lateral Suture in Small vs Large Dogs

Success Rate of Lateral Suture in Small vs Large Dogs

Lateral Suture

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Compare the success rate of lateral suture surgery in small vs large dogs, including outcomes, complications, and when the procedure is most effective

By 

Sustainable Vet Group

Updated on

August 4, 2025

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Success Rate of Lateral Suture in Small vs Large Dogs

What Is Lateral Suture Repair and Why Dog Size Matters

Lateral suture repair, also known as extracapsular repair, is a surgical method used to treat cranial cruciate ligament (CCL) tears in dogs. It works by placing a strong nylon suture outside the knee joint to hold it stable while scar tissue forms and strengthens the area over time. This allows the joint to regain function without relying on the damaged ligament.

The success of this technique depends heavily on the size and weight of the dog. It’s most effective in small to medium-sized dogs under 50 pounds, as their lower body weight puts less stress on the suture.

In contrast, larger or heavier dogs place much more force on the knee, which increases the risk of suture failure, joint instability, or slower healing. Choosing the right surgery depends on matching the procedure to your dog’s body type and lifestyle.

Success Rate in Small Dogs (Under 35–50 lbs)

Lateral suture repair works especially well in small to medium-sized dogs. When done early and followed by proper care, most dogs under 50 pounds heal without major problems. Their lighter body weight puts less stress on the repaired joint, leading to better results and faster recovery.

  • 85%–90% of small dogs regain near-normal limb use within a few months of surgery. Many go back to walking, light play, and daily activities without pain.
  • Complication and revision rates are low in smaller dogs. The suture holds better under less pressure, reducing the risk of failure.
  • Recovery is usually faster, and these dogs often need fewer pain medications after the first few weeks.
  • Long-term outcomes are strong, especially for dogs with mild activity levels. Most do well without needing TPLO.
  • Basic home rehab is often enough, with simple exercises like sit-to-stand, leash walks, and controlled movement. Professional rehab is helpful but not always required.

For small breeds, lateral suture repair offers a safe, affordable solution with high success rates. With rest, care, and proper follow-up, these dogs often enjoy full, comfortable mobility again.

Success Rate in Large Dogs (Over 50 lbs)

Lateral suture repair is less predictable in large or heavy dogs, especially those weighing over 50 pounds. While it can still be successful in some cases, the added body weight and joint pressure increase the risk of complications. For these dogs, outcomes vary more and require closer management.

  • Success rates are often below 80%, especially in active or overweight dogs. Some may continue to limp or favor the leg even after healing.
  • Suture failure is more common, particularly if activity restrictions are not followed strictly in the early weeks. Sudden movement or jumping can undo the repair.
  • Persistent lameness or early arthritis may develop due to joint stress and incomplete healing. This can reduce long-term comfort and mobility.
  • Up to 10% of large dogs need revision surgery, especially if the suture loosens or the meniscus is damaged. Some may require a switch to TPLO later.
  • Strict post-op restrictions are critical, along with long-term joint care. Supplements, weight control, and low-impact exercise all play a role.
  • Lifelong NSAIDs or pain meds are often needed to manage stiffness and inflammation.

While lateral suture repair can work in select large dogs, it’s generally considered a short-term solution. For better long-term results, advanced procedures like TPLO are often recommended.

Risk of Complications by Dog Size

The risk of complications after lateral suture repair depends heavily on your dog’s size and how closely post-op care is followed. On average, the overall complication rate is around 7%, but this number increases with larger, more active dogs.

  • Larger dogs are more likely to experience issues like meniscus damage, implant failure, or joint instability, especially if activity restrictions are not followed. Their higher body weight puts more strain on the suture and healing joint.
  • Smaller dogs, in contrast, tend to have fewer complications when crate rest, leash-only walks, and basic rehab are done correctly. Their lighter frame makes it easier for the suture to hold and for scar tissue to form effectively.

One important risk to understand, regardless of size, is the chance of a tear in the opposite leg’s CCL. This happens in about 40% of dogs at some point after surgery and may require similar treatment later.

Knowing these risks helps set realistic expectations. With careful planning, many complications can be avoided or managed early. Your vet will help guide you based on your dog’s body size, lifestyle, and healing progress.

Study Comparisons: Lateral Suture vs TPLO

Several studies have compared the success of lateral suture and TPLO, especially in small dogs with different joint angles or activity levels. These findings help owners and vets make informed choices based on anatomy, cost, and long-term health needs.

  • One study found only 50% success with lateral suture in small dogs with steep tibial plateau angles, while TPLO showed 100% success in the same group. Joint angle plays a key role in how stable the knee stays post-surgery.
  • TPLO may reduce long-term NSAID use in high-risk dogs. Since the joint is more stable after TPLO, many dogs need fewer pain meds in the months and years following recovery.
  • Lateral suture may still be preferred when TPLO isn’t an option. This includes cases with limited budgets, older dogs, or those with other health risks that make more invasive surgery unsafe.

While TPLO can offer better mechanical results in some dogs, lateral suture remains a strong option when chosen carefully. Vets weigh these factors during consultation to help owners pick the best plan for their dog’s size, health, and lifestyle.

Beyond Weight: Other Factors That Affect Success

While body weight plays a big role in the success of lateral suture repair, it’s not the only factor that matters. Several other details can strongly influence how well your dog heals and how long the repair lasts. Ignoring these factors can lead to poor outcomes, even in small dogs.

  • Joint angle and bone conformation affect how much strain is placed on the suture. Dogs with steep tibial slopes may have more stress on the joint, increasing failure risk.
  • Activity level and daily lifestyle matter, too. Working dogs or very active pets are more likely to push the joint too soon, while calm house pets usually recover better.
  • Surgeon skill and suture material quality also impact success. A precise procedure using durable materials leads to better long-term stability.
  • Post-op commitment is crucial. Owners must follow rest plans and avoid shortcuts, especially in the first six weeks.
  • Access to rehab tools like swimming, underwater treadmills, or laser therapy can speed recovery and improve joint strength.

Together, these factors help determine if lateral suture is the right choice—and how well your dog will recover after surgery.

When Is Lateral Suture Still a Good Option for Large Dogs?

While lateral suture repair is not the first choice for most large dogs, there are some cases where it can still work well. With careful planning and strict post-op care, certain big dogs can recover successfully using this method.

  • Senior or low-energy large dogs that don’t run or jump often put less strain on the joint, making suture failure less likely.
  • Owners who can commit to long-term confinement and daily rehab are more likely to see positive outcomes, even in heavier dogs.
  • Dogs with health risks like heart problems or other conditions may not be safe candidates for TPLO, making lateral suture a safer alternative.
  • When cost is a major factor, lateral suture provides a lower-cost option that can still offer relief if managed correctly.

In these cases, lateral suture remains a valid, thoughtful choice when matched with proper care and realistic expectations.

FAQs About Lateral Suture Outcomes in Different Sized Dogs

Is lateral suture only effective for small dogs?

Lateral suture is most effective in small to medium-sized dogs under 50 lbs. Their lower body weight puts less strain on the repair, leading to higher success rates. While it's not limited to small dogs, results in larger breeds are less predictable and require stricter recovery protocols.

Can large dogs recover fully with lateral suture?

Some large dogs can recover well, especially if they are older, calm, and have low activity needs. Success depends on strict rest, proper rehab, and close monitoring. However, many large dogs eventually need TPLO if the suture fails or lameness continues.

What affects success more: dog weight or activity level?

Both matter, but activity level often plays a bigger role. Even a small, high-energy dog can damage the repair, while a large, calm dog might recover better if well-managed. Ideal outcomes come from controlling both weight and movement.

Is TPLO always better than lateral suture?

Not always. TPLO offers more stability, especially in large or active dogs, but it's more invasive and expensive. Lateral suture is still a great option for smaller dogs or when TPLO isn’t safe or affordable.

How long do lateral sutures last in large dogs?

In large dogs, the suture may not last long-term. Over time, the joint relies more on scar tissue. Some large dogs do well for months or years, but others may experience loosening or failure within the first year.

What are signs that the lateral suture has failed?

Signs of failure include return of limping, toe-touching, swelling, joint clicking, or reluctance to bear weight. If your dog had been improving but regresses, it may be a sign that the suture has loosened or the meniscus is damaged. Prompt vet evaluation is needed.

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