Cranial cruciate ligament (CCL) rupture is one of the most common orthopedic
conditions seen in the dog. This ligament is located inside of the knee. Its job is to help stabilize the knee and prevents theshin (tibia) from moving forward when the knee bends. There is also a Caudal Cruciate Ligament that helps to maintain stability. These two ligaments form a cross shape, which is where the term Cruciate comes from. The cranial cruciate ligament is the most common of the two ligaments to tear, due to its function in the knee. The most common scenario for cruciate damage is a dog running or playing who plants a rear leg while moving forward and turning the body. This puts too much strain onto the knee resulting in a partial or complete tearing of the cruciate ligament. The dog will be playing, often cry out, and become suddenly lame, unable to put any weight on the affected leg.
Once the cranial cruciate ligament has torn, arthritis will generally result due to the instability of the joint. When a dog has a sudden tear of the ligament or has a great deal of lameness due to instability, surgery becomes a necessity. Partially torn cruciates account for 25-30% of knee lameness. The medial meniscus (cartilage inside the knee joint) is also damaged or torn in 50% of the cases with a ruptured cruciate ligament. Surgery will increase the stability of the joint, thereby decreasing the dog's pain. Surgery involves creating a false cruciate ligament, increasing joint stability and cleaning out damaged cruciate ligament. Surgical treatment of a cranial cruciate ligament injury may be divided into two categories: extracapsular (outside of the joint) and intracapsular (inside the joint) techniques. The surgical treatment chosen is largely a matter of surgeon's preference, as several retrospective studies have shown that the success rate of any technique is near 90%, regardless of technique.
This is considered a surgical disease. Without surgical intervention, degenerative arthritis will occur, which can be crippling, especially to overweight, larger dogs. The earlier surgery is performed, the better the outcome. Degenerative arthritis can set in after just a couple of weeks. Because of the degenerative nature of the disease, and that once injured, more weight is placed on the other leg, there is a 50-70% chance the cruciate ligament on the other knee will rupture within one year.
Following surgery, the body will create scar tissue along the surgical area adding to the stability of the joint. Recovery from surgery takes at least 6 weeks while the body heals and the scar tissue is deposited. After surgery, you can expect your dog to not support any weight on the affected leg for at least 14 days. You want to limit activity to 'leash walks only' for the first two weeks. After the sutures are removed, you can discuss physical therapy with the doctor to help increase your dog's recovery from surgery.
Most patients are superb candidates for physical rehabilitation. Bucks Animal Rehabilitation Center is a full-service animal rehabilitation service offering a wide range of treatment modalities including hydrotherapy (underwater treadmill), therapeutic ultrasound, neuro-muscular electrical stimulation, massage, strengthening exercises, and much more. If you would like to learn more about the Bucks Animal Rehabilitation Center or would like to see if your pet is a candidate for physical rehabilitation, give us a call at (215) 918-2200.