What Is Cranial Cruciate Ligament Rupture?
Cranial cruciate ligament (CCL) rupture is one of the most common orthopedic problems in dogs. A dog’s stifle joint corresponds to the human knee joint, and the CCL is comparable to the anterior cruciate ligament (ACL) in humans. Just as in humans, a partial or complete rupture of this ligament is debilitating and extremely painful, resulting in lameness and joint instability. Untreated, CCL rupture results in additional degenerative changes in the joint and, eventually, osteoarthritis. CCL rupture can occur in any dog. Risk factors include obesity, existing osteoarthritis or instability in the knee, and a lack of proper conditioning for the activity taking place, such as a normally sedentary dog that suddenly begins vigorous play.
What Are the Signs of Cranial Cruciate Ligament Rupture?
The first sign of the disease is typically hind leg lameness. The degree of lameness depends on whether the injury is chronic or acute/traumatic and whether the rupture is partial or complete. As a result, some dogs may be slightly lame while others are unable to place any weight on the affected limb. Other signs include:
- Pain and stiffness
- A dog that sits abnormally because it no longer can or wants to flex its stifle joint
- Difficulty rising
- Joint swelling and/or muscle atrophy (wasting) in the stifle area
- Decreased activity level
Causes of Cranial Cruciate Ligament Rupture
Chronic Rupture: This occurs when the ligament has weakened and become damaged over time, as with osteoarthritis. Additional degenerative changes in the joint may result. Partial tears will eventually rupture completely if left untreated. Age, obesity, poor posture, and certain diseases can contribute to ligament deterioration and rupture.
Acute Rupture: Dogs typically injure their CCL while engaged in some type of physical activity during which the joint is hyperextended or rotated to such an extreme degree that the ligament tears such as playing vigourously in hard packed snow, over exertion in propelling to chase squirrels etc, or just normal play combined with being a little overweight.
Diagnosis of CCL is usually made based on clinical signs, physical examination, and radiographs (x-rays). During the examination, your veterinarian may conduct a “sit test” with your dog. Dogs with partial or complete tears of the CCL are reluctant to flex the stifle joint and may sit abnormally to one side with the injured leg held straight out. Your veterinarian will also evaluate the joint for abnormal movement or instability; this may need to be done with your dog under sedation. Any swelling in the joint or muscle atrophy will also be noted.
Your veterinarian may recommend surgical treatment for CCL rupture. Treatment recommendations are based on several factors, including the severity of the injury, the condition of other structures in the knee, and the size and overall health of the patient. Medical management typically consists of rest, appropriate pain medication (such as nonsteroidal antiinflammatory medications, or NSAIDs), and joint supplements and laser therapy.
Surgical treatment involves stabilizing the joint in order to create more normal joint movement. There are several surgical procedures that can accomplish this successfully. At Muskoka Animal Hospital we provide both the Extra capsular repair method and the Tibial Tuberosity Advancement Surgery . Both procedures are offered right here in Muskoka at our Huntsville clinic. If your dog is a candidate for CCL surgery, our doctor’s will discuss your surgical options with you.
The recovery period after surgery requires close following of the veterinarian’s instructions for a successful outcome. We have developed an individualized rehabilitation program that involves our support throughout the entire recovery process including counselling, physiotherapy, laser therapy and massage.After the surgery, closely follow your veterinarian’s instructions regarding limitations on activity to allow the surgical site to heal. Pain medications and physical therapy will be prescribed as needed. The prognosis varies based on the degree of joint degeneration and the ability of the dog to stay within a recommended weight.