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Routine stifle exploration during canine cranial cruciate ligament surgery sounds like common sense, until you ask the uncomfortable question: what if “doing more” doesn’t reliably improve long-term function for most dogs? We sit down with Dr. Dan Low to unpack long-term outcomes after high tibial osteotomy procedures (TPLO and CCWO) performed without routine arthroscopy or arthrotomy and without proactive meniscal evaluation, a real-world approach many clinicians use but rarely see studied in depth.

We break down what high tibial osteotomy actually changes in the cruciate-deficient stifle, then get practical about evidence. Dan explains why this large case series matters, how uncommon events become easier to estimate with bigger numbers, and why validated owner-reported tools like LOAD (Liverpool Osteoarthritis in Dogs) and the Canine Orthopedic Index give us a more standardized view of recovery than vague “good” or “excellent” labels. We also discuss one of the most debated points in veterinary orthopedics: late meniscectomy. When a meniscal sparing strategy produces a low late-intervention rate that looks similar to rates reported in explored joints, it raises a bigger issue about which meniscal lesions are truly clinically meaningful.

We don’t pretend one study settles the debate. You’ll hear the strongest criticisms of this design, the patient groups where exploration still makes sense (uncertain diagnosis, revision cases), and the unanswered research questions that could reshape how we balance morbidity, time, and cost in dog knee surgery. If you treat CCL disease, refer cruciate cases, or counsel owners through surgical options, this conversation will sharpen how you explain risk-benefit decisions without defaulting to habit.

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JAVMA article: https://doi.org/10.2460/javma.25.11.0736

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