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Posted on 12-09-2013

Hey sports fans out there, can you name one athlete that has had surgery on his or her knee? If you like football, you can probably name about a dozen. Athletic injuries of the knee account for the vast majority of sports related injuries. Did you know this is true in dogs? At Eagle Animal Hospital knee injuries, especially rupture of the Cranial Cruciate Ligament, is the number on orthopedic injury in mid to large breed dogs.

The Cranial Cruciate Ligament (CCL), or Anterior Cruciated Ligament (ACL in humans), is the primary ligament located within the knee joint. This ligament is responsible for keeping the knee stable by limiting inward rotation and forward movement on the tibia (shin bone) relative to the femur (thigh bone). It also helps to avoid over extension of the knee.

Trauma associated with running and jumping can result in rupture of the knee ligament. At Eagle Animal Hospital, when we see a patient with a ruptured CCL, there is often a history of chasing a ball or running/playing in the backyard. The owners will report hearing the dog yelp in pain and come back limping.

Diagnosing a ruptures CCL in dogs entails taking a complete history, performing a comprehensive physical exam and taking x-rays of the knee. If you are a professional athlete, or have good insurance, an MRI or CT scan can visibly show the torn ligament. These are rarely done in dogs due to expense (and they are not usually necessary). When taking a complete history, the doctors at Eagle Animal Hospital ask if the injury is acute (just happened), chronic (has been like this for awhile) how it happened and how it has progressed since it occurred. These questions can give us the clues needed to diagnose the injury. Upon physical examination, our veterinarians will note a dog that is lame in one of it’s hind legs. Depending on the degree of injury, this could be a mild limp or a non weight bearing lameness with the dog holding one hind leg entirely off the ground. Our doctors will then palpate the knee. With a torn CCL, the knee will be swollen, painful, and there will be a noticeable laxity referred to as a “drawer”. X-rays can aid in diagnosis. These x-rays will not show ligament injury, but our veterinarians want to make absolutely sure there are no fractures, tumors or arthritic changes in the knee joint that would complicate recovery.

Torn CCL treatment in dogs varies depending on the severity of the injury, the nature of the dogs daily activity and the breed of the dog. Many small breed dogs, and dogs that have mild or partial tears of their ligament, can be managed with strict rest, anti-inflammatories and pain medication. With rest, the ligament that is partially damaged can scar and heal. However, this takes 6-8 weeks of very strict rest. Many larger breed dogs, dogs that are athletes (agility training/ect) or have complete rupture of their CCL’s require surgical repair of the knee. There are several surgical approaches to repairing CCL’s in dogs. The two most common surgeries are Lateralization Surgery and TPLO (Tibial Plateau Leveling Osteotomy). Both of these procedures are very good at correcting a rupture CCL. The same factors that apply to whether or not surgery is nexessary can sometimes applied to which type of surgery would be best.

Correction of torn CCL’s is very important. If the knee remains unstable over any period of time the degenerative processes leading to arthritis begins. Once arthritis has occurred the changes cannot be reversed. This may lead to permanent damage and long term joint pain.

We are proud to be able to offer surgical correction for this type of injury here at Eagle Animal Hospital. Dr. Matunis has been trained, and become proficient, at performing the Lateralization Technique for surgical repair of Cranial Cruciate Rupture. If you have any questions, or feel you dog may have a ruptured CCL, please feel free to call or visit our office.

Written by David Matunis, VMD

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