The stifle (knee) joint in dogs, is very similar to the knee joint in humans, in that there are ligaments that run through the joint providing stability, and just like in humans, there can be many varying degrees of injuries in the stifle joint which makes it very important to have it properly diagnosed prior to rushing into surgery or treatment.

The injury could be something that happened suddenly as the result of a stressful event, or the injury could develop over time through normal “wear and tear”. Injuries that develop over time can be the result of many different factors, overuse, incorrect stifle joint angle, high impact activities, and many other things can contribute to cranial cruciate ligament injuries that develop over time. Ligament injuries that happen suddenly can be caused by jumping and landing awkwardly, twisting wierd on the leg, or being run into by another dog.

For the injury that happens suddenly, the dog will immediately stop bearing weight on the leg. Every dogs reaction will be different, as all dogs have different pain threshholds, but you as the owner will definitely be able to recognize that your dog has a problem. In stifle injuries that develop over time, the symptoms may not be so obvious, but they will still be noticeable. In slowly developing injuiries, the dog may limp occasionally, sit awkwardly (sloppy sit – sitting on the side, rather than on its legs), etc.

In both of these situations, it becomes necessary to have the injury diagnosed, and this is where things can get a little bit tricky. When consulting most vets and clinics, there will typically be multiple diagnosis methods available, each of which will be the preference of the practicing veterinarian. These are the typical diagnosis options for the stifle joint:

• X-Ray
  One recommended course of action will typically be an x-ray. The problem with an x-ray is that ligaments cannot be seen on x-rays (which I’ve learned through injuries of my own). X-rays basically serve one purpose, and that is to see if there are any broken, dislocated or misplaced bones.
• Manual Joint Manipulation
  Another course of diagnosis is manual manipulation of the joint in which the veterinarian checks for “drawer movement”. Drawer movement is the lamens term for instability in the joint, and comes from the fact that the knee joint will slide back and forth, like a drawer, if there is ligament damage because the ligaments won’t be there to hold the bones in place. Dogs will almost have to be sedated in order to test for “drawer movement” as it would be very painful for the dog to be awake during the procedure.
• MRI
  A common option in human injuries, having an MRI done is not as feasible for our pets, though it would quickly and easily be able to tell us whether there was a torn or ruptured ligament in the knee. The reason that MRI’s aren’t necessarily available for dogs is that the equipment is very expensive, and the cost of the procedure is highly expensive as well.

Of the above diagnosis options, an x-ray is usually recommended to check that there are no broken bones, and once that is verified, the veterinarian will check for drawer movement to determine if there is ligament damage. I’ve heard stories, and read stories of misdiagnosis online, and I’ll try to address that in another post, as this post will strictly focus on diagnosising cranial cruciate ligament injuries.

In a perfect world, we’d all be able to get MRI’s for our dogs if there was any question that they had a CCL injury, however, it’s not a perfect world, so we use the methods that are available to us. Thus, manual joint manipulation is one of the more common diagnosis techniqes, and with it, we have its drawbacks. The biggest drawback of manual manipulation to check for “drawer movement” is the possibility of furthering the injury. The injury can be worsened by any/all of the following:

• Sedation – as mentioned above, the vet will often sedate the dog in order to be able to manipulate the leg without the dog “fighting” it. This can result in over-torquing the joint.
• Rough exam – twisting of the joint

These factors can actually lead to injuries to other parts of the joint as there are multiple muscles, ligaments and tendons running through the knee. You may wish to be present durin the manipulation of the knee joint so that you can read your dogs reaction to the twisting.

Conclusion

I understand that all of the above isn’t necessarily great news if your looking for answers about your dogs recent injury, but I’m just trying to provide as much information as possible to allow you to make an informed decision on the treatment of your dog. If I had known a fraction of what I know now, I may have gone an entirely different route at the time of our dogs injury, but on the same note, I’m very glad that we went the surgical route as our dog has been doing great since her recovery. If you haven’t already, make sure you read our story.

Related Posts

• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs
• Diagnosing a Ruptured Cruciate Ligament in a Doberman Pinscher
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)

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.

Related Posts

• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)
• Tightrope Surgery in the Treatment of a Dogs Torn Cranial Cruciate Ligament
• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs

TPLO, or tibial plateau leveling osteotomy, is a common surgery performed on dogs to stabilize the stifle (knee) joint after a tear or rupture in the cranial cruciate ligament (CCL) (can be compared to the anterior cruciate ligament (ACL) in humans). Normally, the cranial cruciate ligament (CCL) prevents backward-forward movement of the stifle joint. When it tears/ruptures, the stifle joint becomes unstable and the dog suffers lack of mobility, lameness or loss of use and is subject to chronic and progressive arthritis in the stifle if untreated.

In a TPLO procedure, the tibial plateau, the portion of the tibia adjoining the stifle (knee), is cut and rotated so that its slope changes to approximately 5 degrees from the horizontal plane, forever changing the biomechanics of the dogs movement. This prevents the femur from sliding down the slope of the plateau. It is rumored that TPLO surgery generally results in faster recovery times compared to other procedures to stabilize the knee joint. Most dogs (over 90%) are expected to regain a very active and athletic lifestyle with no post-operative complications and without the need for any pain relieving medication.

Related Posts

• TPLO vs. TTA vs. Lateral Fabellar Traditional Technique – Cranial Cruciate Ligament Repair
• Cost of TPLO Surgery – Cost to Repair Torn Cruciate Ligament in Dogs
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)