Dog Knee Ligament (CCL) Repair

Cruciate Ligament in Dogs, Canine Cranial Cruciate Ligament (Crucial)

The cranial cruciate ligament in dogs provides stability to the knee (stifle) joint. Any strain, tearing or rupture of the cranial cruciate ligament can, and will, result in knee (stifle) instability. A strained cranial cruciate ligament can, in many cases, be repaired or heal itself without surgery. Strains should be treated with conservative management. Tears and ruptures of the cranial cruciate ligament require more drastic treatments such as orthopedic surgery. When it comes to surgical repair of the CCL, there are multiple CCL surgery options available and it is always best to consult with your veterinarian prior to deciding which option is best for your dog.

The necessity of the cranial crucial ligament (CCL) can be compared to the necessity of the anterior cruciate ligament (ACL) that is found in humans. While there are people who have bypassed having surgery with a torn ACL, their knees are typically less stable for the remainder of their lives and their activity has to be severly limited. The same holds true for canines - should a torn or ruptured CCL be left untreated, the dog will survive, but may display lameness in the limb with the torn ligament, and the dogs activity level will not be the same as that of what it was prior to damaging the ligament.

Conservative Management as a Cranial Cruciate Ligament (CCL) Treatment Option

Though this wasn’t our first choice when dealing with our dogs ruptured cranial cruciate ligament, Conservative Management (or Conservative Treatment) is a non-surgical option of CCL treatment that should be considered by all dog owners prior to surgery.

Consider the human knee for example, you’ve all probably heard of torn or ruptured ACL’s (meaning the ligament is entirely severed), and you’ve also heard of partially torn ACL’s (meaning the ligament is still intact, but has definiate damage. Now, let’s consider a pro athlete, surgery will be necessary for either case - torn ACL or partially torn ACL. However, let’s say we have a 40 year old man with a desk job who doesn’t do too much physical activity. Surgery would be the best bet for a torn ACL, however he could probably get through the rest of his life with a partially torn ACL, and using a brace and conservative management in situations where any further damage to the ligament could occur.

The same hold true for dogs, however, the unfortunate thing is that we don’t have the option of giving a dog an MRI, which will actually show the extent of ligament damage. With dogs, we can have an x-ray, and we can have veterinarians check for instability (drawer movement), but we will not not for sure if the ligament is completely torn, or just partially torn. This is where conservative management comes in. Depending on the size of your dog (conservative management is typically not an option for large dogs - 40+ lbs), the amount of instability (drawer movement) in the stifle (knee) joint and the amount of lameness your dog displays in the injured limb, your veterinarian may recommend conservative management rather than a surgical procedure.

For conservative management, these principles must be strictly adhered to, otherwise the stifle joint will be unable to recover naturally:

1. Weight management / Diet control
2. Complete restriction of movement in the beginning, along with rest
3. Use of anti-inflammatory medications

Weight Management is not only something that will be recommended in the case of conservative management, but it will often be recommended following surgical procedures as well. Our dog dropped 1/3 of her body weight after surgery through diet control and weight management.

Rest & Restriction is required to allow the knee joint to heal in any way if its going to. This process can take 4-8 weeks, and at the end of this period, if the dog is still exhibiting lameness in the limb, surgery might be the best option.

Anti-Inflammatory Medications can be used in combination with weight management and rest & restriction to help remove the swelling in the limb and let it recover.

Before beginning a conservative management regimen, it is always best to contact your veterinarian and have the CCL injury professionaly diagnosed. After seeing a friend of mine try conservative management with a Labrador, I’d recommend seeing a vet ASAP after the injury.