Cranial Cruciate Ligament (CCL/ACL) Surgery in Dogs

Cranial Cruciate Ligament (CCL/ACL) rupture can occur in dogs of all sizes, though it is most commonly found in medium to large breeds or senior dogs.

Diagnosis and Decision Making

• Veterinarians primarily diagnose the condition through physical examination and palpation.

• X-rays may be used to assess damage to surrounding bone structures.

• The ligament tear may be partial or complete.

• Non-surgical (Conservative) Treatment: This may be considered for small dogs with incomplete tears. Methods include rest, weight control, pain medication, joint supplements, or using a knee orthosis.

• Surgical Treatment: Surgery is generally necessary for most cases, especially for dogs with chronic pain or poor limb function.

Surgical Methods

There are two main surgical approaches:

1. Extra-capsular / Suture Technique (Artificial Ligament):

• Uses sutures or synthetic materials to stabilize the knee joint in place of the ruptured ligament.
• Best suited for small to medium-sized dogs.
• Recovery to normal limb use typically takes about 2 months.

2. Osteotomy Techniques (Bone Alignment):

• Involves cutting and repositioning the bone to change the mechanical angle of the knee, providing stability without needing the ACL (e.g., TPLO - Tibial Plateau Leveling Osteotomy, TTA - Tibial Tuberosity Advancement).
• Highly popular for large or active dogs as it often yields better long-term results.
• Recovery to normal limb use typically takes about 3-4 months.

Post-Operative Care and Recovery

• Confinement: This is critical for 8-12 weeks. Owners must prevent the dog from running, jumping, or engaging in strenuous exercise.

• Physical Therapy: Essential for a faster and stronger recovery. Methods include laser therapy and hydrotherapy (swimming or underwater treadmill).

Risks and Complications

• Potential complications include infection, non-union of the bone, or failure of the implants/sutures.

• Osteoarthritis: This condition often develops regardless of whether surgery is performed.

• Bilateral Risk: Dogs that experience a rupture in one knee have a high probability of developing the same issue in the other knee in the future.