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Cranial Cruciate Ligament

What is cranial cruciate ligament rupture?

The cranial cruciate ligament (CCL) is an important ligament inside a dog’s knee joints. It’s the same as the anterior cruciate ligament (ACL) in humans, and is one of several ligaments in the knee that connect the thigh bone (femur) to the shin bone (tibia).

While damage to the ACL in humans is normally caused by a sporting injury, dogs usually experience cranial cruciate disease, meaning their ligament degenerates slowly over time. Cruciate disease in dogs may cause the ligament to partially or completely rupture, particularly after strenuous activities like running or jumping.

What are the symptoms?

Limping, limb lameness and stiffness are the most common symptoms of cranial cruciate ligament rupture in dogs. The signs may appear suddenly after exercise in some dogs or occur gradually in others. The disease can be present in either one or both knees – if both knees are affected, your dog may struggle to get up, and you might notice a difference in their gait.

The diagnosis

Your dog’s diagnosis depends on whether they’ve suffered a complete or partial rupture of their cranial cruciate ligament. With complete ruptures, your dog will need to be examined by an orthopaedic surgeon, where they will feel your pet’s knee for “cranial drawer motion”. For partial tears or gradual degeneration of the ligament, radiographs or an MRI scan may be needed to gather more information.

If your vet suspects your dog might have cranial cruciate disease, exploratory surgery or keyhole surgery is usually recommended to confirm the diagnosis.

How do we treat cruciate disease in dogs?

There is a range of treatment options available for cranial cruciate ligament rupture. The best course of action will depend on the size of your dog and the severity of their rupture.

Non-surgical management: Some small dogs with CCL rupture can be treated without surgery through bodyweight management, physiotherapy, exercise modification and anti-inflammatories. However, stabilisation surgery is normally recommended first as it speeds the rate of recovery, reduces joint degeneration and enhances function.

Surgical management: There are a variety of different surgeries for cranial cruciate ruptures, including CCL replacement therapy, tibial plateau levelling osteotomy (TPLO) and tibial tuberosity advancement (TTA). Your specialist can advise on the best option for your pet.

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