Cranial cruciate ligament (CCL) ruptures in dogs are a relatively common orthopedic injury. Our Vancouver vets explain cruciate ligament ruptures including the signs and treatment options for dogs.
What is a cruciate ligament?
The cruciate ligament, also known as the cranial cruciate ligament (CCL), is a connective tissue in the knee that connects and stabilizes the lower leg with the upper leg. It connects a dog's tibia to its femur. When torn, the joint becomes partially or completely unstable, causing pain and immobility.
CCL ruptures are the result of a torn CCL in a dog's stifle (knee), which is equivalent to the ACL in humans.
How to Identify a CCL Injury
When it comes to complete or partial cranial cruciate ligament ruptures in dogs, 80% of cases are chronic onset ruptures that are caused by degeneration and usually occur due to aging. This is most commonly seen in dogs ages five to seven.
Acute onset ruptures are most commonly seen in pups four years or younger. These ruptures are caused by injuries a dog will sustain just running around living their daily lives.
Symptoms of a CCL rupture may include:
- Crepitus (crackling noise of bones rubbing against each other)
- Decreased range of motion
- Hind leg extension while sitting
- Pain when the joint is touched
- Lack of motivation to exercise
- Irritability
- Restricted mobility
- Stiffness after exercising
- Swelling/Inflammation
- Thick/firm feel of the joint
- Weight shifted to one side of the body while standing
- "Pop" sound when walking
If you notice any of the listed symptoms above, contact your vet and schedule an examination for your pup.
Non-Surgical Treatment
In dogs weighing less than 30 pounds, adequate rest, anti-inflammatories, and physical rehabilitation may result in a non-surgical recovery. This depends on your pet's size, overall health, and the severity of your dog's CCL injury.
Your veterinary surgeon will advise you on the best course of action for your dog.
Treatment Via Surgery
CCL surgery is the most common surgery performed in dogs and is estimated to make up about 85% of all orthopedic surgeries performed every year on dogs. Given that this is such a common injury, several procedures have been developed over the years to repair the ligament. Each technique has its pros and cons, so it is important to discuss the options with your veterinarian to determine which procedure would be best for your dog's situation. Below are the most common methods of repairing the injury.
Arthroscopy
Arthroscopy is the least invasive method for visualizing the structures of the stifle, cranial, and caudal cruciate ligaments. The technique improves the visualization and magnification of joint structures. The technology developed for this procedure allows for small surgical incisions for partial CCLs and meniscus tears. This method may not be suitable for completely torn ligaments.
TPLO (Tibial Plateau Leveling Osteotomy)
TPLO surgery is gaining popularity and is the best option for larger dog breeds. The procedure involves cutting and leveling the tibial plateau. Following that, the surgeon secures the tibial plateau with a plate and screws. This surgery also removes the need for the ligament.
TTA (Tibial Tuberosity Advancement)
TTA is a surgical procedure that corrects the need for the CCL by cutting the top of the tibia, moving it forward, and stabilizing it in its new position with a plate. As a result, the goal of TTA is to completely replace the ligament rather than simply repair it.
Lateral Suture or Extracapsular
This surgery, which is commonly recommended for small to medium-sized dogs, stabilizes the stifle (knee) with sutures placed on the outside of the joint. This is one of the most common surgeries for this type of injury, and it is typically performed on dogs weighing less than 50 pounds.
Post-Op Recovery
No matter which operation is performed to repair the ligament, it is the care your dog receives after surgery that will determine how successful the operation is. The first 12 weeks following surgery are a crucial time for recovery and rehabilitation. Limited exercise and encouraging your pup to begin using their leg are keys to a successful recovery.
At 2 weeks postoperatively, you can gradually increase the length of your dog’s leashed walks. By the 8th week, your dog should be able to take two 20-minute walks each day and perform some of their basic daily living activities.
After 8-10 weeks following surgery, your veterinarian will take x-rays to see how the bone is healing. Your dog will eventually be able to resume normal activities. Here at Columbia River Veterinary Specialists, we recommend a rehabilitation program to help your dog recover. The rehabilitation facility you choose should have experience with post-op recovery from orthopedic injuries like the TPLO.
Some dogs have also experienced positive results via acupuncture treatments and laser therapy.
Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. Please make an appointment with your vet for an accurate diagnosis of your pet's condition.