Hey guys, this is Nikki Lead Veterinary Technician with Posh Dog Knee Braces. Today, let’s talk about Cranial Cruciate Ligament Repair (CCL/ACL) tears in a dog, and what your options are. First of all, if your dog is limping on the hind leg, be sure to get a diagnosis from your veterinarian before making any decisions. Once that takes place, be firm with your Veterinarian if needed and ask for the exact diagnosis. If they feel that your dog has a Cranial Cruciate Ligament tear, or CCL tear, then you do have some decisions to make moving forward. Let’s go into the options, and the pros and cons, as well as long term expectations.
First off, depending on your veterinarian, they may refer you to a specialist to verify the diagnosis. This is completely up to you, but do know that if you go to a specialist, they are typically surgeons, and will not be happy without scheduling your dog for surgery. Please know that you can say no. I can’t stress enough how important it is for you to take a breath, and go over all options before signing that dotted line.
Choosing to do just conservative management, with no support or surgery. This seems to be gaining momentum and popularity, because obviously options can cost money. There are supportive things to do, such as keeping your dog in a kennel, leash walks outside, supplements, acupuncture, laser, prp, ect. While this option is better for the budget, it is not for the busy owner, or owners with small children and other pets. While it sounds great, reality is that there is a great chance your pup will continue to re-injure their knee. At some point, the door will open, and your dog will want to run.
Someone will forget, your dog looks like he is dong better at 3 months, and in he comes with the leg hiked all the way up to the groin. Sound familiar? This can be a tough cycle, and the bones in the knee are still able to move, causing pressure on the meniscus as well increasing your dog’s chance of arthritis down the road. So, can a knee heal with conservative management alone? Possibly, but there could be long term issues if you do not do passive range of motion, PT, and exercising along with CM alone.
This is by far my favorite option, from years of experience working with orthopedics. Using an orthotic Brace in conjunction with PROM and PT, as well as supplements and support. Now I am not talking about the cheap over the counter neoprene braces that have a spiderweb of straps connecting to the harness or back, those are no better than just letting the knee recover alone.
I am talking about a custom made premium orthotic brace, such as the Posh Dog Knee Brace. Posh Brace fully stabilizes the knee, allowing for range of motion and squatting, while also acting as a shock absorber for the meniscus. This is going to help give a smoother recovery, and allow that scar tissue to form without a lot of re-injuries. Thus, this is one of the safer options, and definitely still less than surgery.
Tightrope, lateral suture, or extracapsular repair. This is the cheapest of the surgical options, and should only be used on patients under 30-40lbs, as the suture has double the chance of failing in larger breed patients. This method usually is in the $2k-$3k ballpark range now, and is literally using fishing line/or suture to wrap around the knee joint to keep things in place. There are several ways this can and usually does fail. The crimps can come off, the suture can break, the suture can slip, ect.
These patients are immobile for months, and do get a lot of atrophy in the joint. This seems to be sore to recover from, and without a brace post op, your dog is going to need to be kenneled for weeks to months, to allow for scar tissue to properly form. This technique is similar to if you braced, however, without the full stabilization and support, and double the cost.
TPLO or TTA surgery. Both of these will be suggested by your vet or surgeon, usually first. They both entail cutting of the tibia bone, and re-alignment using a plate and screws. This is permanent, and there is no going back if something doesn’t go the way it was meant to. I always save this for my last option, as it is extremely invasive, expensive, and does not give a guarantee of working. Too many patients have had lifelong lameness due to choosing this option, and are not able to recover fully.
There are many weeks needed for kenneling, so the leg will atrophy. This also causes overcompensating on the good knee, which again increases the chances of another CCL tear in that leg. If surgery does go well, and you are able to do a full Physical Therapy Program post op with a professional, your dog may have a good outcome, but this is not without risk.
Please email me at firstname.lastname@example.org if you would like to ask more questions about Cranial Cruciate Ligament Repair, CCL/ACL tears in dogs, and what the best options are for your pup. You can also contact via our forms or visit our Facebook page.