Dr Alistair Grant answers 5 questions on cruciate ligament disease

Cruciate ligament disease is a very common condition we see coming into the clinic, fortunately, there are a number of ways to deal with the injury so that your dog can still enjoy full mobility and comfort after treatment.  Dr Grant took the time to answer five common questions about Cruciate ligament disease:

1. What is cruciate ligament disease and what signs should I be looking out for?

Cruciate ligament disease is a term used to describe an injury to the cranial cruciate ligament (CCL) of the knee in dogs. The cranial cruciate ligament is the same as the anterior cruciate ligament (ACL) in the human knee. Although dogs can ‘snap’ their CCL in the same way that humans do (a common injury in football), it is far more commonly a degenerative condition where the ligament frays and breaks down over time. The process is not fully understood but we think it is largely due to differences in the anatomy and the shape or structure of the dog’s knee.

Cranial Cruciate Ligament Medical Diagram
Source: VET MD

The primary sign of CCL disease is lameness in the affected leg (it can only be a back leg). The lameness may be subtle and may come and go but is generally progressive over time. Sometimes the lameness appears very suddenly but sometimes it can be very gradual. Changes in gait can also indicate mild lameness or discomfort which may be due to underlying CCL disease.

2. If diagnosed what happens then? Will my dog have to go to a specialist?

CCL disease is an extremely common diagnosis. Generally, the diagnosis is suspected after a full history is taken and a thorough physical examination is completed. This diagnosis is then supported by radiographs and ultimately confirmed at surgery. Whilst medical management can be used to control pain associated with the condition (caused by joint swelling and also by osteoarthritis), surgery is generally recommended to maximise your dog’s long-term comfort and function in that leg.

There are a variety of procedures used to treat CCL disease. The preferred method used at Stabler & Howlett Veterinary Surgeons is the TPLO (tibial plateau levelling osteotomy) for larger dogs and extracapsular repair (often called the De Angelis technique) for small dogs. Nearly all dogs will be able to be treated at Stabler & Howlett however under some circumstances, we may recommend referral to a specialist centre. We are able to facilitate this referral if and when it is required.

3. Is it really necessary? Is it surgery that I could put off?

Surgery is considered the best treatment to maximise comfort and function for the long term. As time goes on, patients with CCL disease will suffer degenerative joint disease (osteoarthritis) which can progress quite quickly. Whilst surgery is not an option for all owners, it is generally recommended that surgery be performed and that it be performed as soon as reasonably possible – this gives us the opportunity to remove damaged tissue, stabilise the joint and reduce the progression of osteoarthritis.

4. What is the success rate like?

We aim for patients to have full function after surgery – the recovery period is generally up to 12-16 weeks after surgery with a gradual reintroduction to exercise. Not all patients will regain complete function however it will nearly always allow better use of the limb than if surgery is not performed.

5. Are there any supporting activities or supplements that can aid in recovery?

As with many surgeries, the rehabilitation process at home is just as important as the surgery itself. A combination of rehabilitation, exercises and graduated return to exercise is used with all patients to manage their recovery. These are routinely discussed with owners after surgery and are modified according to each individual. Routine revisits are scheduled throughout the recovery to check on progress and make any adjustments required.

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