What is the ACL or CCL?
In humans, the anterior cruciate ligament (ACL) is a thin, connective tissue that runs diagonally across the middle of our knee.
This connective tissue in dogs is called the cranial cruciate ligament (CCL). It connects the dog’s femur (bone above the knee) to their tibia (the bone below the knee). The CCL is particularly prone to injury as a dog’s knee is always bent when standing, so this ligament is always tense.
Acute onset (sudden injury) can occur when the ligament twists or tears, or injuries can be caused by age, type of breed, obesity, or other factors.
How are ACL & CCL injuries different?
Athletes, especially, are particularly familiar with ACL injuries, which can happen as a result of acute trauma caused by sudden movement from a quick change in direction or a jump. Our four-legged friends tend to feel CCL injuries occur gradually. They grow progressively worse with activity until a tear occurs and causes acute pain.
What are the symptoms of ACL injuries in dogs?
If your dog injures his CCL, you may hear him yelp in pain, and he may not be able to put any weight on the leg with the injury. Other common signs of a CCL injury include:
- Limping
- Lameness in hind leg
- Stiffness (usually mostly noticeable following rest after exercise)
- Difficulty standing and jumping
These symptoms will become more apparent over time and the injury can worsen if your dog attempts to continue with physical activity after enduring this injury. Dogs suffering from one torn CCL will typically start to use the non-injured leg during activity, which can cause injury to the second knee within a relatively short timeframe.
How are ACL injuries in dogs treated?
Your veterinarian should examine your dog to determine if the cause of his pain is a CCL injury, or something else. Following diagnosis, treatment options can range from knee braces to surgery to correct the problem.
Your vet will determine the right treatment based on your dog’s weight, size, lifestyle and age. Financial implications and surgeon’s preference may also be factors. Treatment options include:
Knee Brace
This non-surgical option may be successful with some dogs, combined with a reduction in their activity levels. It can help stabilize your dog’s knee joint and allow the ligament time to scar and repair itself.
Extracapsular Repair (Lateral Suture)
During this surgery, the torn ligament is replaced with an artificial ligament on the outside of the joint. This procedure is usually recommended for small to medium-sized dogs weighing less than 50 pounds.
Tibial Plateau Leveling Osteotomy (TPLO)
This surgical technique involves eliminating the need for the CCL ligament by cutting and flattening the tibial plateau, then using a plate and screws to secure it in a new position.
Tibial Tuberosity Advancement (TTA)
With this surgery, we can also remove the requirement for the CCL ligament by cutting the top of the tibia, shifting it forward, then using a stainless steel metal plate to secure it in its new position.
What should I expect during recovery from ACL surgery?
Because every dog is unique, so is every recovery period - not all dogs recover at the same speed. Ask your veterinarian for advice and if your dog resists exercises, do not force them. Recovery takes time - expect your dog to need 16 weeks (four months) or longer to completely heal and return to functioning normally once again.