What is a Cruciate Ligament?

There are 2 ligaments in the knee (stifle) that are called the cruciate ligaments because they cross each other. One runs from the back of the femur (thigh bone) to the front of the tibia (shin bone). This one is called the cranial cruciate ligament. The other one runs from the front of the femur to the back of the tibia and is called the caudal cruciate ligament. Cruciate ligaments are important for the hinge joint function of the stifle joint. They help to keep the stifle aligned and the cranial cruciate ligament especially prevents internal rotation of the stifle, forward displacement of the tibia, and hyperextension.

What is a cranial cruciate ligament tear?

A cranial cruciate ligament (CCL) tear in the dog is similar to an ACL tear in people. It can be an abrupt tear during trauma or some other strenuous activity as in people. However, it can also be a slow deterioration of the ligament over weeks or months, potentially affection both knees. Following a CCL tear, the limp is usually quite severe. While some improvement may occur with time, surgery is the method of treatment for most dogs and cats with a CCL tear. Over the past 30 years numerous surgical techniques have been developed to help correct the instability created by a CCL tear. In cats, small breed dogs, and some older large breed dogs we usually perform a surgical technique that is referred to as a standard cruciate repair. Following removal of the torn CCL, a synthetic ligament is created. Stability of the stifle is immediate following surgery but most pets will not fully use the leg for several weeks. A combination of strict rest and physical therapy will benefit in the recovery period and in the ultimate use of the leg. The standard repair can also be preformed in moderate-sized breeds and less commonly in large breeds, but often times a TPLO is the best option for these dogs.

What is the aftercare?

Strict rest is required following surgery to allow for proper healing of the surrounding soft tissues. Initially, there should be no running, jumping, or playing. After the first month of strict rest, a gradual introduction of controlled activity is preformed until 3 months following surgery. Physical therapy is also preformed to improve the speed of healing.

Are there any risks or complications?

There are a few risks or complications with stifle surgery. Be sure to discuss them at your appointment. We would like to have pertinent blood work to assess the risk for general anesthesia. The risk is usually very low for healthy animals with normal blood work. It is further reduced by local pain control during anesthesia, which is accomplished by an epidural anesthesia. Most complications are minor in nature. With some minor complications, additional medications or other forms of physical therapy may be required. Complications such as infection, suture reaction or reaction to the artificial ligament, tearing of the artificial ligament, or future meniscal tearing are possible. Major complications, those requiring additional surgery, are rare. As long as the activity restrictions provided by us are adhered to, the chance that additional surgery will be needed is low.

Can the leg be re-injured following surgery?

After the healing is complete, it is rare for problems to develop. However, it is not unusual to see an occasional limp in some dogs for several months following surgery. Some dogs will have already developed arthritis in the affected stifle or will develop it post operatively, this could lead to a source of stiffness or limping occasionally in the future.