When it comes to humans, ACL injuries are common among athletes. Did you know that dogs can suffer a similar injury in a ligament known as the cranial cruciate ligament or CCL? Our Nashville vets talk about ACL (CCL) type injuries in dogs and how treatment with surgery can help get your dog moving around again.
What is the CLL (Cranial Cruciate Ligament) in Dogs?
For humans, the anterior cruciate ligament (ACL) is a thin connective tissue in the middle of our knees.
When it comes to the anatomy of a dog, this connective tissue is called the cranial cruciate ligament (CCL) and it connects their bone below the knee (tibia) to their bone above the knee (femur). When it comes to dogs your can consider the CLL as their ACL and know exactly what we are talking about!
Comparing the two, the most relevant distinction is that the ACL (CCL) is always load-bearing because dogs never unbend their knees while standing. This "ACL" in dogs is thus subject to greater wear and tear than the average human's ACL and a dog's CCL naturally has to withhold greater stress.
What is the Differnece Between ACL and CCL Injuries?
For people, a torn ACL is usually caused by a sudden injury through movement, either jumping, running or twisting, it is uncommon for regular daily use to contribute to a torn ACL. In dogs, CCL injuries tend to come on gradually, becoming progressively worse until a tear occurs.
Signs That My Dog Has Suffered an ACL (CCL) Injury
Most commonly a dog who has torn their CCL will demonstrate stiffness (typically most noticeable after rest that follows exercise), as well as difficulty rising, jumping, and/or walking without a limp.
If your dog continues to use their ACL (CCL) even after they have suffered an injury, the ligament will become increasingly more damaged leading to further complications and injury.
Dogs suffering from a single torn ACL (CCL) will typically begin favoring the non-injured leg, which commonly leads to the injury of a second knee. Approximately 60% of dogs with a single ACL (CCL) injury will go on to injure the other knee soon afterward.
Is it Necessary For My Dog to be Treated for ACL (CCL) Injuries?
Treating a dog's ACL or, more accurately, CCL injury with a knee brace is a non-surgical option that may help to stabilize the knee joint in some dogs. The support provided by a knee brace gives the ligament time to scar over and repair itself. Treating ACL (CCL) injuries through the use of a knee brace may be successful for dogs when combined with restricted activity.
When is ACL (CCL) Surgery Recommended for Dogs?
You should ask your vet whether or not surgery is right for your canine companion. There are a number of different ACL (CCL) repairing surgeries that vary in preference based on dog breed, age, and size. Your veterinarian can recommend the best "ACL" surgery for your dog's specific needs.
Surgery for ACL (CCL) Injuries in Dogs
Extracapsular Lateral Suture Stabilization - ELSS / ECLS
This surgical treatment works by counteracting the sliding forward of the dog's shinbone ('tibial thrust') with a specifically placed suture.
The sliding motion of tibial thrust is caused by the transmission of weight up the dog's tibia and across the knee, causing the tibia to “thrust” forward in relation to the dog's femur (thigh bone). This forward thrust movement occurs because the top of the tibia is sloped, and the dog's injured ACL (CCL) which would normally be able to oppose the forward force, is no longer able to prevent the unwanted movement from occurring.
Extracapsular Lateral Suture Stabilization corrects tibia thrust by “anchoring” the tibia to the femur with a suture placed by your dog's surgeon. The suture stabilizes the dog's knee by pulling the joint tight and preventing the front-to-back sliding of the tibia so that the ACL (CCL) has an opportunity to heal itself, and the muscles surrounding the knee have a chance to regain their strength.
ELSS surgery is fairly quick and uncomplicated with a good success rate in small to medium-sized dogs. ELSS surgery can also be less expensive than other ACL (CCL) surgical treatment options. The long-term success of ELSS surgery varies in dogs of different sizes and activity levels. Speak to your vet to find out if ELSS surgery is an option for your injured dog.
Tibial Plateau Leveling Osteotomy - TPLO
The next surgical option we'll look at for treating your dog's injured ACL (CCL) is the tibial plateau leveling osteotomy (TPLO). This surgery is more complicated than ELSS surgery and aims to reduce tibial thrust without relying on the dog's ACL (CCL).
This surgery involves making a complete cut through the top of the tibia (tibial plateau), then rotating the tibial plateau in order to change its angle. Finally a metal plate is added to stabilize the cut bone as it heals. Over the course of several months, your dog's leg will gradually heal and strengthen.
Full recovery from TPLO surgery in dogs takes several months however some improvement can be seen within just days of the procedure. Following your vet's post-surgery instructions and restricting your dog's activities, are essential for successful healing. TPLO surgery in dogs has a good long-term prognosis, and re-injury is uncommon.
How long will it take for my dog to recover from ACL surgery?
Some dogs recover more quickly than others following ACL (CCL) surgery however, recovery from a torn ACL (CCL) is always a long process!
Many dogs are able to walk as soon as 24 hours after surgery, but a full recovery and a return to normal activities will take 12 - 16 weeks or possibly longer.
It is essential to follow your vet's instructions and pay attention to your dog's healing progress. It's important not to rush exercise following ACL (CCL) surgery. Never force your dog to do exercises if they resist as this can lead to re-injuring the leg.
Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.