Cranial cruciate ligament (CCL) ruptures are a common orthopedic injury in dogs. Our Los Angeles 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 that connects and stabilizes the lower leg to the upper leg in the knee. It connects a dog's tibia to the femur above, resulting in partial or complete joint instability, pain, and immobility when torn. CCL ruptures are caused by a torn cranial cruciate ligament (CCL) in the stifle (knee) of a dog, which is equivalent to the ACL in humans.
How to Identify a CCL Injury
When it comes to a CCL injury 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
- 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
There is a chance that dogs under 30 pounds can recover without surgery by getting plenty of rest, anti-inflammatories, and physical therapy. This is determined by 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 of visualizing the stifle, cranial, and caudal cruciate ligament structures. The technique improves joint structure visualization and magnification. This procedure's technology allows for minimal surgical incisions for partial CCL and meniscus tears. For completely torn ligaments, this method may not be an option.
Lateral Suture or Extracapsular
This surgery, which is frequently recommended for small to medium-sized dogs, stabilizes the stifle (knee) by using sutures placed on the outside of the joint. This is one of the most common surgeries for this type of injury, and it is usually performed on dogs weighing less than 50 pounds.
TTA (Tibial Tuberosity Advancement)
TTA is a surgical procedure that replaces 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 repair it.
TPLO (Tibial Plateau Leveling Osteotomy)
TPLO surgery is gaining popularity and is the best option for larger dog breeds. The tibial plateau is cut and leveled during the procedure. The surgeon then uses a plate and screws to stabilize the tibial plateau. The ligament is also no longer required as a result of this surgery.
A Dog's Recovery From CCL Surgery
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, your veterinarian will take x-rays to see how the bone is healing. Your dog will gradually be able to return to normal activities. To maximize your dog's recovery, we at Rancho Park Veterinary Clinic recommend a rehabilitation program. The rehabilitation center 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.