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Cranial Cruciate Ligament Rupture - A Common Injury in Dogs

Sunday, January 01, 2017

Allison Rohde Newgent, DVM
Garden State Veterinary Specialists

The dog’s knee is anatomically similar to people. It is a joint of the back leg where the femur (thigh bone) and the tibia (shin bone) meet. Two of the major stabilizing structures are the cranial and caudal cruciate ligaments. The cranial cruciate ligament (CCL) is equivalent to the anterior cruciate ligament (ACL) in people. It prevents the tibia from shifting forward during amublation and prevents hyperextension of the knee. The forward movement of the tibia relative to the femur is called cranial tibial thrust or cranial drawer. When found on examination by your veterinarian, it is diagnostic for CCL rupture.

As in people, CCL injury is common in dogs and is often accompanied by injury to the meniscus. The underlying cause may be trauma or degeneration of the ligament over time. The main symptom observed is lameness or limping due to pain caused by the instability and abnormal motion within the joint. In the case of a complete tear, definitive diagnosis can usually be reached on physical examination alone. However, in the event of a partial tear, additional testing such as sedated examination, radiographs (x-rays), and arthroscopy (joint scope) may be needed.

After diagnosis, numerous treatment options are available. The two main categories of treatment are conservative management and surgical repair. Conservative management relies on the body’s ability to stabilize the knee over time through the creation of scar tissue. Treatment involves activity restriction and non-steroidal anti-inflammatory (NSAID) pain medication. Due to ongoing instability, this leads to significant arthritis and often chronic lameness. So, conservative management is not generally recommended.

Surgical repair not only allows for immediate stabilization and reduced arthritis, but also allows for the evaluation and treatment of concurrent meniscal injury. Surgical options differ between dogs and humans. The “Lateral Fabellar Suture” involves the surgical placement of large nylon suture material. This type of repair relies on the deposition of scar tissue to provide permanent stability. It is generally suitable for small to medium-sized dogs. The “Tibial Tuberosity Transposition” (TTA) and “Tibial Plateau Leveling Osteotomy” (TPLO) techniques involve the use of saws to precisely cut the tibia and reconfigure the geometry of the knee. The bone is held in place using plates and screws. Over time, bone healing provides permanent stability. This type of surgery is generally suitable for medium to large and extra-large dogs. It does not rely on the formation of scar tissue and minimizes the development of arthritis.

Post-operative care generally entails 6 – 8 weeks of strict activity restriction, followed by another 6 – 8 weeks of leash walks and a gradual return to normal activity. Complication rates are low but infection, implant failure or breakage, and delayed healing may prolong recovery.

If your pet is limping or you suspect he or she may be suffering from orthopedic disease, please contact your regular veterinarian. They can examine your pet and may refer you to a board certified veterinary surgeon if necessary.

This article is for informational purposes only and should not be used as a substitute for the professional advice of your veterinarian.

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