ACL Surgery for Dogs Cost by Technique and Dog Size
In dogs, the “ACL” is called the cranial cruciate ligament (CCL). The repair technique drives most of the price, and dog size shifts it up or down. Figures below are per knee at a specialty hospital, including pre-op exam and X-rays but not rehab.
| Dog size | Lateral suture | TPLO | TTA |
|---|---|---|---|
| Small (under 20 lb) | $1,250–$2,650 | $2,950–$5,200 | $2,750–$4,750 |
| Medium (20–50 lb) | $1,400–$2,950 | $3,300–$5,800 | $3,100–$5,300 |
| Large (50–90 lb) | $1,450–$3,100 | $3,450–$6,100 | $3,250–$5,600 |
| Giant (90+ lb) | $1,750–$3,700 | $4,150–$7,300 | $3,900–$6,700 |
General practice vets who perform these surgeries often charge about 20% less, which is how the lower end reaches roughly $1,000 for a lateral suture and $2,350 for TPLO.
These ranges match published data. GoodRx lists lateral suture at $750 to $1,000 for the procedure alone, TPLO at $3,000 to $8,000 and TTA at $3,000 to $6,000. Chewy cites $3,000 to $6,000 per knee for TPLO, MetLife $2,000 to $5,000, and Lemonade $4,000 to $6,000 for ACL repair.
The three main techniques, briefly
- Lateral suture (extracapsular repair): a strong suture placed outside the joint to stabilize the knee. The University of Florida notes it works well in dogs under about 30 to 40 lb and is less predictable in bigger dogs.
- TPLO (tibial plateau leveling osteotomy): the top of the shin bone is cut, rotated and fixed with a plate. UF describes it as the most successful option for dogs of any size, particularly large breeds.
- TTA (tibial tuberosity advancement): the front of the shin bone is moved forward and held with an implant. Priced close to TPLO.
What’s Included in the Price
| Item | Typical cost |
|---|---|
| Orthopedic exam (general vet or surgeon consult) | $60–$250 |
| Knee X-rays (often under sedation) | $150–$400 |
| Pre-anesthetic bloodwork | $80–$200 |
| Surgery, anesthesia, implants, hospital stay | $1,000–$6,000+ |
| Pain medication and anti-inflammatories to go home | $50–$150 |
| Post-op X-rays around 8 weeks (bone-cutting procedures) | $150–$350 |
| Rehab evaluation | $100–$165 |
| Physical therapy session | $60–$120 each |
GoodRx points out that some surgery quotes exclude anesthesia, follow-up visits, medications, physical therapy or X-rays, so always ask what’s bundled. See our dog X-ray cost guide for imaging prices.
What Happens on Surgery Day and After
Most dogs are dropped off in the morning, have surgery under general anesthesia and either go home the same evening or stay one night. You’ll usually leave with pain medication, an anti-inflammatory, sometimes a sedative to keep your dog calm, and a cone to protect the incision.
A recheck and incision check typically follows at about 10 to 14 days. After TPLO or TTA, follow-up X-rays are commonly taken around 6 to 8 weeks to confirm the bone is healing, which is a separate charge at many clinics. Chewy notes follow-up visits every 4 to 6 weeks with exams and X-rays during recovery.
At home, recovery usually means crate or small-room rest, leash-only potty breaks, and blocking stairs and furniture. That’s where a sling, rugs on slippery floors and a supportive bed come in.
Rehab and Physical Therapy Costs
Recovery takes time. Chewy describes 8 to 12 weeks of strict activity restriction after TPLO, MetLife up to 12 to 16 weeks for full recovery, and UF at least 3 months of leash-only exercise.
Formal rehab is optional in many cases but common. Rehab clinics typically charge $100 to $165 for the initial evaluation and $60 to $120 per session, per published pricing from a rehab practice. A course of 6 to 8 sessions usually totals $450 to $1,100. Underwater treadmill work is often sold in discounted packages.
Home rehab exercises shown by your vet cost nothing but time. Many owners also buy a support sling, non-slip rugs or a ramp to protect the knee during recovery.
What Affects the Cost of Dog ACL Surgery
Size and weight
Bigger dogs need larger plates and screws, more anesthesia and more medication. Giant breeds commonly cost 20% or more above a medium dog.
Surgeon and clinic type
Board-certified veterinary surgeons at specialty hospitals charge the most. Some general practice vets perform lateral sutures or even TPLO for less. University teaching hospitals are another option to price out.
Age and health
Older dogs or dogs with other conditions may need extra bloodwork, heart checks or longer monitoring. Extra body weight also affects recovery and can add costs.
Meniscus damage
A torn meniscus is often found and treated during the same surgery. It may add a few hundred dollars.
Region
Prices are highest in big coastal cities and lower in rural areas and much of the Midwest and South.
Complications and the second knee
Infection, implant problems or a slow-healing bone cut can mean extra visits or surgery. And according to UF, about 30% to 50% of dogs rupture both cruciate ligaments within 1 to 2 years, so many families face this bill twice.
Cost of Non-Surgical (Conservative) Management
Some dogs, often small or older ones, are managed without surgery. Whether that suits your dog is a decision for your vet. GoodRx notes that minor injuries may be managed with rest, anti-inflammatory medication, knee braces and physical therapy, while untreated injuries can lead to arthritis and lameness. Costs to expect:
- Recheck exams: $60–$100 each at a general vet
- Anti-inflammatory or pain medication: often $30–$100 a month
- A custom knee brace: made to measure, often several hundred dollars or more
- Rehab: $450–$1,100 for a course of sessions
- Weight management food, if recommended by your vet
Over a year or more, ongoing medication and visits can add up, so ask your vet for a written estimate of both paths.
Could pet insurance cover a bill like this?
Accident & illness plans typically reimburse 70–90% of eligible vet costs after the deductible, if the condition is not pre-existing and the waiting period has passed. Premiums for dogs average about $62/month and for cats about $32/month (NAPHIA, 2025).
Coverage is subject to each policy’s terms, exclusions and state availability.Does Pet Insurance Cover ACL Surgery for Dogs?
Cruciate ligament tears are usually handled as illness or orthopedic claims, so accident-only plans may not cover them. Accident-and-illness plans often do, subject to your deductible, reimbursement rate and annual limit. MetLife, for example, shares a case where a TPLO bill of about $2,900 was reimbursed close to $2,400.
Watch for three terms: orthopedic or cruciate waiting periods (longer than standard illness waiting periods at some insurers), pre-existing condition exclusions, and “bilateral” clauses that may exclude the second knee if the first was injured before coverage began. Our is pet insurance worth it? guide covers how to compare plans for large, active breeds like the golden retriever.
Signs of an ACL Tear
Book a vet visit if your dog suddenly limps on a back leg, toe-touches or holds the leg up, sits with one leg out to the side, or struggles to rise or jump. Contact your vet or an emergency vet right away if your dog won’t bear any weight, cries in pain, or the limb is swollen or at an odd angle.
How to Save Money on Dog ACL Surgery
- Get estimates from two or three clinics, including a specialty hospital and a general vet who does orthopedic surgery.
- Ask for a fully itemized quote that shows X-rays, anesthesia, implants, meds and rechecks.
- Price out a veterinary school hospital near you.
- Use financing such as CareCredit or Scratchpay to spread the cost.
- Ask about home rehab exercises in place of, or in addition to, paid sessions.
- Insure young dogs early, before any knee issue is noted, so both knees are covered.
- Keep your dog lean. Healthy weight is part of preventive care for joints.
- Dog support sling for rear legs (post-surgery)Check price on Amazon
- Orthopedic memory foam dog bedCheck price on Amazon
- Dog ramp for cars or furnitureCheck price on Amazon
Frequently Asked Questions
How much is ACL surgery for a dog?
Per knee, a lateral suture repair usually costs $1,000 to $3,700, while TPLO and TTA typically run $2,200 to $7,300 including pre-op X-rays. About $4,500 is typical for a TPLO on a large dog at a specialty hospital. Add $450 to $1,100 if you choose formal physical therapy.
How much does TPLO surgery cost?
TPLO surgery usually costs $3,000 to $6,000 per knee at a specialty hospital, and up to about $7,300 for giant breeds. GoodRx cites $3,000 to $8,000, Chewy $3,000 to $6,000 and MetLife $2,000 to $5,000. Some general practice vets who perform TPLO charge less.
Why is TPLO more expensive than lateral suture?
TPLO involves cutting and repositioning part of the shin bone and fixing it with a bone plate and screws, which needs specialized equipment, implants and surgical training. Lateral suture uses a strong suture outside the joint and takes less time. Which one fits a given dog is a decision for the vet or surgeon.
What if my dog tears the ACL in the other knee?
It’s common. The University of Florida’s small animal hospital reports that about 30% to 50% of dogs rupture both cruciate ligaments within 1 to 2 years of each other. Budget for the possibility of a second surgery, and check how your insurance handles the other knee.
Does pet insurance cover ACL surgery for dogs?
Many accident-and-illness plans cover cruciate ligament surgery, but often with a longer orthopedic waiting period at some insurers and exclusions for pre-existing knee problems. Some policies also treat the second knee as pre-existing if the first was injured before enrollment. Read the terms carefully.
- GoodRx Health — How much does dog ACL surgery cost?
- MetLife Pet Insurance — TPLO surgery for dogs
- Chewy — TPLO surgery for dogs: benefits, cost and more
- University of Florida Small Animal Hospital — Cranial cruciate ligament rupture
- Lemonade — How much does dog surgery cost?
- Pawsitive Steps Pet Rehab — Pet therapy FAQ (rehab pricing)
Not veterinary advice. Prices are estimates for budgeting, not quotes. Ask your veterinarian for a written, itemized estimate. If your pet is injured, in pain or acting unwell, contact your vet or an emergency animal hospital right away.