Cranial cruciate ligament (CCL) ruptures are a common orthopedic injury in dogs. Our Des Moines vets explain the injury as well as the CCL surgery process that is likely necessary for your dog.
What is a CCL?
The CCL is a connective tissue in the knee that connects and stabilizes the lower leg to the upper leg. It connects a dog’s tibia to the femur above that when torn, results in partial or complete joint instability, pain, and immobility. CCL ruptures are the result of a torn cranial cruciate ligament (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 CCL tears in dogs, 80% of cases are chronic onset ruptures which 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 tears 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
- Restricted mobility
- Stiffness after exercising
- 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 dog.
In dogs under 30 pounds, there is a possibility of recovery that doesn't require surgery through ample rest, anti-inflammatories, and physical rehabilitation. This is dependent upon the size of your pet, their 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 is the least invasive means of visualizing the structures of the stifle, the cranial, and caudal cruciate ligaments. The technique offers enhanced visualization and magnification of the joint structures. The technology developed for this procedure allows for minimal surgical incisions for partial CCL and meniscus tears. This method may not be an option for completely torn ligaments.
Lateral Suture or Extracapsular
Often recommended for small to medium-sized dogs, this surgery stabilizes the stifle (knee) through the use of sutures placed on the outside of the joint. This is one of the most frequently performed surgeries for this type of injury and is usually performed on dogs that weigh under 50 pounds.
TTA (Tibial Tuberosity Advancement)
TTA is a method of surgery that corrects the need for the CCL by cutting the top of the tibia, moving it forward, and stabilizing it in its new position using a plate. Therefore, the goal with TTA is to replace the ligament entirely, rather than repair it.
TPLO (Tibial Plateau Leveling Osteotomy)
TPLO surgery is becoming increasingly more popular and is the best option for larger dog breeds. The procedure entails cutting and leveling the tibial plateau. From there, the surgeon stabilizes the tibial plateau using a plate and screws. This surgery also eliminates the need for the ligament.
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 two weeks post-operatively, you can gradually increase the length of your dog’s leashed walks.
By the eighth week, your dog should be able to take two 20-minute walks each day and perform some of their basic daily living activities.
After ten weeks post-operatively, your vet will take x-rays to assess how the bone is healing. Your dog will be able to gradually be able to resume normal activities. We at Des Moines Veterinary Hospital recommend a rehabilitation program to optimize your dog’s recovery.
Whatever rehabilitation facility you attend should have experience in post-op recovery from orthopedic injuries such as the TPLO.
Some dogs have also experienced positive results via acupuncture treatments and laser therapy.