The traditional extracapsular lateral suture ECLS technique is the oldest surgical correction for cranial cruciate ligament (CCL) injury in dogs. The name of the procedure originates from the fact that the joint is stabilized outside the joint capsule (externally). CCL repair surgery typically begins with an initial examination of the inside of the knee. Both the traditional ECLS and the Tight Rope® procedures are considered extracapsular or external repairs of CCL injury. Both yield similar results with similarly low risks.