We now have further evidence regarding the benefits of the minimally invasive extra-capsular repair approach known as the TightRope. This technique is far less traumatic than the tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA) techniques previously used, and demonstrates the highest safety–to–efficacy ratio over the long term. This allows dogs to avoid catastrophic complications and the intensive trauma of revisionist methods. Paws & Claws Animal Hospital is pleased to be the only veterinary clinic in the Wilmington, NC area to offer this technique.