This is making me a nerd on the details, but I want the OP to be able to return from having consulted Dr. Google and be technically correct…
Perhaps more semantics, but all the repair methods (nylon suture/tightrope, TPLO-tibial plateau leveling osteotomy, TTA-tibial tuberosity advancement) that have been mentioned here are extracapsular techniques, not intracapsular. The name refers to whether the stabilization is inside or outside the joint capsule and with all of these, implants are placed outside of the joint. Going into the joint to remove cruciate fragments, or more commonly to check the meniscus, happens routinely and doesn’t make the procedure intracapsular.
Intracapsular techniques were considered outdated when I graduated in 2001 and you are unlikely to find someone that performs them anymore. They use the dog’s own tissue (portion of patellar tendon or connective tissue along the thigh usually) and are placed through the joint in an orientation similar to the cruciate ligament like a graft. The profit margin is higher and cost lower on these actually due to quick surgical time, no need for specialized orthopedic surgical instruments (high speed drills and saws), and minimal implants (at most a screw). They fail because the inflammation in the joint degrades and weakens the transposed tissue and it tears. With so many better options available, I believe most would argue that intracapsular repairs are below current standard of care.
Of the extracapsular techniques, there are two main approaches. The TPLO and TTA involve cuts (and then plates/screws) to the upper shin bone that change the weight bearing angles and forces inside the joint and patellar tendon. These are both very popular, especially with large breed, active dogs and one of these would likely be best for your pup. The other (lateral fabellar suture, tightrope, ole’ doc and his 80 pound test fishing leader line) involves a strand placed between the upper and lower leg bones across the joint that restricts motion on the joint similar to the cruciate ligament. The method works great when the suture doesn’t break, so not the best for a large active dog that puts a huge loading force on the leg during play.
The really good advice a few people here have mentioned is to plan for the second leg to blow in the future and then be happy with your good luck if it doesn’t. Just like all orthopedic issues and probably unecessary to mention in a triathlon forum, making sure your dog is at a lean body weight with good muscle strength can really help with longterm return to function.
I think the reason our dog responded so favorable atfer the second blow out is she is considered by most people (not vets) the be a “skinny labrador”. Yes, you can actually see her waistline and has been really active her entire life!