Cruciate surgery is a repair surgery that is performed when the cranial cruciate ligament (CCL) is torn in the knee. This is considered the same as the human ACL. When it comes to orthopedic surgeries, this is the most common one that dogs have. In fact, 85 percent of all orthopedic-related surgeries are of this kind each year.

Because this is such a frequent injury in canines, there have been numerous procedures developed to repair this particular ligament. Each method comes with its own pros and cons. Therefore, it is crucial that you take the time to discuss all possibilities with your dog’s veterinarian in order to determine which method is the best one for your furry friend. Some factors that you should take into consideration include your dog’s age, size, weight, and even lifestyle. A couple of the factors to consider included the cost of the surgery as well as the preference of the surgeon.

One of the most commonly and oldest performed procedures is the extracapsular repair of the CCL. With this particular procedure the stability of the knee is restored by placing sutures outside of the joint. The CCL is responsible for ensuring that the tibia does not slide forward and out from beneath the femur, so by inserting sutures on the outside of the joint, the outside stabilization imitates the usual movement of the ligament. In this operation, a constant monofilament (which is a single fiber) nylon stitch, similar to that of fishing line, is positioned around the femur’s fabellar bone and looped through a hole that is drilled into the tibial tuberosity. Then, a stainless steel clip holes each end of the suture in place.

In addition, when a dog ruptures the CCL, it can result in knee instability, which can then result in damage to various other structures in the joint, such as meniscal tears. In such cases, appropriate diagnostics are essential. Determining the full extent of your dog’s injury will help in selecting the best surgical procedure not to mention increasing the probability of a successful recovery.

How Much Does It Cost?

The cost of your dog’s CCL surgery will depend upon the procedure that you choose. The cost generally includes the surgery, anesthesia, bloodwork, as well as post-surgical medications and care. In some cases, it could even include physical therapy for your dog after the procedure.

Are There Any Alternatives?

Though the extracapsular CCL repair is most frequently performed, this isn’t the only option that you have available to repair your canine’s torn CCL. For that reason, it’s important to sit down with a veterinarian and discuss all available options that you have available to you. As mentioned above, there are numerous factors that must be taken into consideration when selecting the appropriate surgical procedure for your dog, including the following:

• Your dog’s age
• Your dog’s weight and size
• Your dog’s activity level
• Financial considerations
• Degree of joint disease (such as arthritis)
• Post-operative care
• Access to a rehabilitation facility
• Access to an orthopedic surgeon as opposed to a general surgeon

Once you have considered all of the above, it is important that you also consider and discuss the potential for alternatives to CCL surgery—especially if the surgery may not be an option at this point in time. A few of your other alternatives to extracapsular CCL repair surgery are:

• Tibial Tuberosigty Advancement (TTA) Surgery
• Tibial Plateau Leveling Osteotomy (TPLO)
• Tightrope Technique

What Should You Know About the Recovery?

No matter which procedure you choose, the success of the surgery will be determine by the post-operative case. Non-weight bearing dogs will begin to lose their range of motion and muscle mass in the impacted leg quickly after the surgery. The sooner that the knee can be stabilized, the less muscle degeneration that will occur—and the quicker the post-op recovery.

The most crucial time for rehabilitation and recovery will be the initial 12 weeks following the surgery. It is important, as your dog’s owner, that you encourage your dog to initiate using its leg. In addition, controlled exercise is key to a successful recovery. After all, this is where rehabilitation is critical. Over the last couple of decades, human physical therapy techniques and principles have been adapted to assist canines in recovering after orthopedic surgeries.

During canine rehabilitation, a large number of the methods that are used are related to those that humans would undergo. The rehabilitation process begins shortly after the CCL procedure is performed. The exercises themselves focus on combating muscle atrophy, safe weight bearing of the leg, and improving overall range of motion.

Keep in mind that all dogs, similar to humans, do not make progress at the same pace. Therefore, make sure that you are consistent and conservative. If your dog is unwilling to do a particular exercise, don’t force the exercise on them. If available, always seek professional help. Note that recovery can take approximately 12 weeks, but it can take six months or longer for your dog’s leg to completely heal and become fully functional.

What Complications Can Be Expected?

The American College of Veterinary Surgeons report that the long-term outlook for dogs who undergo the CCL surgery is good. In fact, there are positive progress reports in 85 to 90 percent of the cases. Of course, like all surgical procedures, there is some risk involved. Some of the most common risks involved with the CCL repair surgery include lack of stabilization, infection, as well as implant failure.

Now, the most common risk with a torn CCL is osteoarthritis of the impacted joint. Regardless of what treatment that you decide to go with, arthritis will progress; however, it will progress at a much slower rate if the knee is stabilized and surgery is performed. It’s crucial to understand that arthritis is a very progressive disease that developed relatively quickly, especially in an injured joint. For that reason, arthritis prevention and management as well as joint supplements are strongly suggested for canines with a CCL injury—regardless of the surgical procedure that is selected.

If you would believe your dog has torn its cranial cruciate ligament or you would like to learn more about CCL surgery, please don’t hesitate to contact us at Huntsville Veterinary Specialists & Emergency.