What is one of the most common orthopedic injuries seen in dogs?
One of the most common orthopedic injuries that we see in dogs involves the cranial cruciate ligament, or CCL, which is similar in function to the anterior cruciate ligament, or ACL, in people.
What factors make dogs more prone to cruciate ligament injuries?
There are definitely some predisposing factors that can make certain dogs more prone to cruciate ligament injuries, and one of them is breed. This condition is commonly seen in larger breeds, and some of the dogs we see with these injuries include Labradors, German Shepherds, and Rottweilers. However, cruciate ligament injuries can happen in dogs of different breeds and sizes.
Another factor is conformation, and what I mean by that is the dog's anatomy, stance, and gait. The shape and biomechanics of the knee can influence the forces placed on the cranial cruciate ligament and may contribute to an individual dog's risk.
Another important factor is body weight. Dogs that are overweight or obese can place additional stress on their joints, so maintaining a healthy body condition is an important part of supporting orthopedic health.
How are cranial cruciate ligament injuries in dogs different from ACL injuries in people?
Cranial cruciate ligament injuries in dogs are a little bit different from what people typically experience. In people, an ACL injury is often associated with an acute traumatic event that causes the ligament to tear.
Dogs can also experience an acute injury, but canine cranial cruciate ligament disease commonly involves progressive degeneration of the ligament over time. Eventually, the ligament can partially or completely tear, leading to instability, lameness, and discomfort.
What signs do dogs with cranial cruciate ligament injuries show?
The signs that we typically see can include progressive lameness, where the dog becomes increasingly reluctant to use the affected leg. If the ligament is completely torn, some dogs may put very little or no weight on that leg.
They may also sit in a characteristic way with the affected leg extended out to the side rather than tucked underneath them because flexing the knee can be uncomfortable.
How is a cruciate ligament injury diagnosed?
In order to diagnose a cruciate injury, the first step is typically a physical and orthopedic examination. We may also take X-rays to evaluate the knee and look for changes associated with the injury.
On physical examination, one thing we evaluate is instability in the knee. When the cranial cruciate ligament is damaged, we may be able to detect what's called cranial drawer motion, where the tibia moves abnormally in relation to the femur. We may also evaluate for another type of instability called cranial tibial thrust.
We can't directly see the cranial cruciate ligament on routine X-rays, but radiographs can show findings such as joint swelling, arthritis, or other changes. They can also help us evaluate the knee for other possible causes of lameness.
What are the treatment options for cranial cruciate ligament injuries?
After we've diagnosed the injury, treatment depends on factors such as the dog's size, age, activity level, degree of instability, other health conditions, and the severity of the injury.
Some dogs, particularly certain smaller or less active dogs, may be managed without surgery using weight management, controlled activity, pain and anti-inflammatory medications when appropriate, and rehabilitation. However, surgery is commonly recommended for many dogs with clinically significant knee instability because it can provide improved stabilization and function.
What is a TPLO procedure?
There are a few different surgical procedures that we can use for cranial cruciate ligament injuries, but one of the most common is called a TPLO. TPLO stands for tibial plateau leveling osteotomy.
Rather than replacing the damaged cranial cruciate ligament, a TPLO changes the biomechanics of the knee. During the procedure, we make a controlled cut in the upper portion of the tibia and rotate the tibial plateau to change the forces acting through the knee during weight-bearing.
A plate and screws are then used to stabilize the bone while the osteotomy heals. Bone healing generally takes several weeks, and we monitor that process during follow-up visits.
What is postoperative care like after TPLO surgery?
After TPLO surgery, recovery generally takes several weeks and involves a gradual reintroduction of activity. Initially, activity needs to be restricted while the bone heals and the surgical site recovers.
As healing progresses, we can gradually increase controlled activity to encourage appropriate weight-bearing and rebuilding of muscle mass. We may also recommend specific exercises for range of motion and strengthening.
Some dogs can benefit from professional veterinary rehabilitation or physical therapy as part of the recovery process. Follow-up examinations and imaging may also be used to evaluate healing before returning to unrestricted activity.
What are the long-term effects of cranial cruciate ligament injuries?
Dogs with cranial cruciate ligament disease can develop arthritis in the affected knee over time. Surgery can improve stability and function, but it doesn't necessarily prevent all progression of arthritis.
The long-term outcome depends on several factors, including the severity of the original injury, meniscal damage, the dog's weight and activity level, treatment, rehabilitation, and individual healing. Many dogs can regain good function after TPLO surgery.
Are dogs that tear one cruciate ligament at risk of tearing the other?
Another important thing to know about cranial cruciate ligament disease is that a dog with the condition in one knee has an increased risk of developing a similar problem in the opposite knee later on.
The exact likelihood varies between studies and individual dogs, so it isn't possible to predict with certainty whether the other knee will eventually be affected. It's something we keep in mind when monitoring a dog after a cruciate ligament injury.
If you’re looking for veterinary care you can trust, call us at (248) 609-1625 or email [email protected]. We’re here to keep your pet healthy, happy, and thriving!