The cranial cruciate ligament (CCL) is one of the major stabilizers of the knee, responsible for preventing internal rotation of the knee (stifle), forward displacement of the tibia (shin), and hyperextension of the joint itself. This ligament can tear during a sudden trauma, but more commonly deteriorates over a period of months. Following a CCL tear, patients will usually present with a severe, pronounced limp.

Our founder, Dr. Dean Wallace has been performing cruciate repair surgeries for more than three decades, and is proud to have seen hundreds of recovered patients return to normal activities.

Diagnosis

Diagnosis of a CCL tear involves an extensive physical examination. X-rays are taken under general anesthesia, so the patient’s limb may be manipulated without pain, in order to provide the best radiographic views of the area.

Treatment

Following examination and review of the x-rays, a determination of a best course of action will be made, taking into account a number of factors, from the severity of the tear, to the age and overall health of the patient. While some improvement can occur over time and with restricted activity (which can unfortunately lead to other health problems–obesity, etc.), a surgical CCL repair procedure is the best method to resolve lameness and minimize future osteoarthritis.

The most common surgical procedure to stabilize the knee is to create a new ligament (extracapsular cruciate ligament repair), other procedures such as a TPLO ( Tibial Plateau Leveling Osteotomy and TTA (Tibial Tuberosity Advancement Technique) can be performed if indicated.

A CCL repair is most often performed on dogs, but is occasionally performed on cats.

Post-Operative Recovery

All CCL patients will need to spend a minimum of 1-2 days in the hospital following the procedure. This is so pain and discomfort can be controlled using injectable and transdermal medications, as well as to restrict and monitor movement by the patient during this most critical period of recovery.

Once home, owners should do everything possible to limit their dog’s activity, as strict rest is required for proper healing. Initially, there should be no running, jumping or playing, as these can all lead to re-injury.

Activity should be increased gradually, with short, slow, leashed-walks beginning around the fourth week of recovery. Observation of the patient is absolutely crucial during this period in order to gauge the speed of recovery. Some dogs feel ready to run around and play within the first few weeks, they are not! A full return to normal activity is often allowed within 10-12 weeks, depending on the severity of the initial injury, age, breed, and overall health of the patient.