Your dog's knees are always load-bearing, which is why injuries can happen so easily. Here, our Lakewood vets discuss cranial cruciate ligament (CCL) ruptures in dogs and how surgery can be used to treat them.

What is the cranial cruciate ligament?

The cranial cruciate ligament (CCL) is one of the ligaments that helps your dog's knee move. It's a band of connective tissue that helps connect the femur and tibia (the bones located above and under the knee), allowing the knee to function. However, this ligament is also the most prone to injury.

What is a CCL injury in dogs?

A partial or complete rupture of the cranial cruciate ligament in dogs (or ACL injuries, as they are sometimes called) can happen without warning and can cause your dog a great deal of discomfort. CCL tears occur due to acute trauma stemming from a sudden movement such as a jump or change of direction; regular daily use should not contribute to a torn CCL. In dogs, CCL injuries tend to occur gradually, progressively worsening until a tear occurs.

What happens when the CCL tears?

When your pup is suffering from a torn CCL, the pain arises from the knee's instability and a motion called 'tibial thrust'.

Tibial thrust is a sliding motion caused by the weight transmission up your dog's shin bone (tibia) and across the knee, causing the tibia to 'thrust' forward about the dog's thigh bone (femur). This forward thrust movement happens because the top of the tibia is sloped, and your pup's injured CCL cannot prevent the unwanted movement.

Continued activity on a mildly injured leg will cause the injury to worsen and symptoms to become more pronounced. Dogs suffering from a single torn CCL will typically begin favoring the non-injured leg, which commonly leads to the injury of a second knee. Approximately 60% of dogs with a single CCL injury will injure the other knee soon afterward.

What are the common symptoms of CCL injuries in dogs?

Here are the signs your dog may have torn their CCL:

  • Sudden pain in the leg
  • Instability in your dog's knee
  • Swelling around the knee
  • Weakness in the back leg
  • Favoring one leg over the other
  • Limping
  • Stiffness after exercise

If you think your dog may have a torn cranial cruciate ligament, call your vet and schedule an appointment or contact an emergency vet immediately.

How can surgery treat CCL ruptures in dogs?

It's important to know that CCL injuries cannot heal on their own. If your pup is showing signs of a torn ACL, it's important to see a vet and have the condition diagnosed so that treatment can begin before symptoms become more severe and painful.

Dogs who experience cranial cruciate ligament ruptures are usually recommended one of the following knee surgeries to address the pain and help them return to an active lifestyle.

What are the different types of CCL surgery?

Tibial Plateau Leveling Osteotomy (TPLO)

TPLO is more complicated than ELSS surgery but is typically very successful in treating ACL injuries in dogs. This surgery option reduces tibial thrust without relying on the dog's ACL. The procedure involves making a complete cut through the top of the tibia (the tibial plateau) and then rotating the tibial plateau to change its angle. A metal plate is added to stabilize the cut bone as it heals. Over several months, your dog's leg will gradually heal and strengthen.

Tibial Tuberosity Advancement (TTA)

TTA is similar to TPLO but tends not to be used as often to treat ACL injuries in dogs. This knee surgery involves surgically separating the front part of the tibia from the rest of the bone and then adding a spacer between the two sections to move the front section up and forward. This helps to prevent much of the tibia thrust movement from occurring. A bone plate will be attached to hold the front section of the tibia in its correct position until the bone has had sufficient time to heal. Dogs with a steep tibial plateau (angle of the top section of the tibia) are excellent candidates for this type of ACL surgery.

Extracapsular Lateral Suture Stabilization (ELSS / ECLS) 

This ACL surgery is typically used to treat dogs that weigh less than 50 pounds and works by preventing the tibial thrust with a surgically placed suture. The suture stabilizes your pup's knee by pulling the joint tight and preventing the front-to-back sliding of the tibia so that the ACL has time to heal and the muscles surrounding the knee can regain their strength. ELSS surgery is fairly quick and uncomplicated, with an impressive success rate in smaller dogs.

What happens during pet surgery in Lakewood?

Your veterinarian will start by assessing your dog's knee to determine the extent of the injury, its severity, and which of the above surgeries your dog may require. Some of the methods they will use during examination and diagnosis include:

  • X-rays of the stifle and tibia
  • Palpation (your dog may be sedated or given light anesthesia for this)
  • Laboratory analysis of fluid drawn from the knee

Your dog's surgery might be scheduled for the same day these tests are conducted or later, depending on various factors, such as your vet's availability and the severity of your dog's condition. The vet will anesthetize your dog and give them painkillers and antibiotics to help manage pain and prevent infection. Most dogs are cleared to go home the next day.

What can you expect while your dog recovers from CCL surgery?

After CCL surgery in dogs, the recovery could take 16 weeks or more. It's essential to carefully follow all of the post-operative care instructions your vet gives you. Your vet will probably prescribe antibiotics and painkillers when they send your dog home after their surgery. Your dog will probably be forced to wear the cone of shame after the procedure.

In the first few weeks, your dog will have a few regular vet visits to monitor the healing process and remove any sutures that may be needed.

It is also important to restrict your dog's activity and movements to toiletry purposes only. You should keep your dog on a leash to prevent running, stair climbing, and jumping. After several weeks have passed, you may gradually increase your dog's activity and movement.

You will need to bring your pup for a follow-up a few weeks after their surgery, which usually occurs after four to six weeks. At this visit, your vet will monitor the function of your dog's leg, take X-rays to assess the healing and advise you about increasing your dog's daily activity. Additional tests and evaluations may be recommended based on your dog's case.

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 to accurately diagnose your pet's condition.

Is your dog limping or showing signs of pain while walking? Contact our vets for an examination. We are able to diagnose and treat various conditions, such as CCL tears.